The Most Common Reasons People See the Doctor for Scalp Pain
Whether it comes on suddenly or has been building for a while, dealing with scalp pain is distracting and uncomfortable. It also raises questions like, “why does my scalp hurt?” as well as what you can do to make the pain stop.
Unfortunately, scalp pain is a common complaint dermatologists hear, says Ife J. Rodney, M.D., a board-certified dermatologist and founding director of Eternal Dermatology + Aesthetics. There are actually a slew of reasons why you might be dealing with scalp pain right now, along with a variety of treatments.
Meet the experts: Ife J. Rodney, M.D., a board-certified dermatologist and founding director of Eternal Dermatology + Aesthetics; Joshua Zeichner, M.D., director of cosmetic and clinical research at The Mount Sinai Hospital; Gary Goldenberg, M.D., a board-certified dermatologist practicing in New York City
Here’s what could be behind your scalp pain, as well as how to fix it, according to doctors who treat it regularly.
The main causes of scalp pain
There are a lot of potential culprits behind your scalp pain. These are the most common ones doctors see and diagnose.
Tension from hairstyles
“I see this all the time,” Dr. Rodney says. “it occurs across all ethnicities and hair types—it just depends on how you style your hair.” The pain happens because certain hairstyle can put physical stress on the hair follicles, impacting the nerves and leading to pain, says Joshua Zeichner, M.D., director of cosmetic and clinical research at The Mount Sinai Hospital.
The location of your scalp pain due to a hairstyle can vary depending on the style itself, Dr. Rodney says. “People who pull their hair back into a bun can have tenderness around the hairline, while those who wear extensions can have tightness and tension all over,” she says.
Dermatitis
Dermatitis is a “catch-all term” to describe inflammation of the skin, Dr. Rodney says. There are a few potential causes of this on your scalp, including seborrheic dermatitis, which is similar to dandruff, and even an allergic reaction to a shampoo or product you used, she says.
When you have dermatitis in your scalp, it causes inflammation that can irritate the nerves in that area, leading to pain, says Gary Goldenberg, M.D., a board-certified dermatologist practicing in New York City.
Migraines and other headaches
Migraines and other forms of headaches can cause scalp pain.
A tension headache usually feels like a band is wrapped tightly around your forehead, and the pain can extend to your scalp, according to the U.S. National Library of Medicine.
If you suffer from chronic migraines, you might experience something called allodynia, which is where the nerve endings in your scalp feel especially painful to touch. “Sometimes the pain can be referred to the scalp and caused the scalp feel tender, sore, or even painful, especially to touch,” Dr. Goldenberg says.
Scalp psoriasis
Psoriasis is a chronic skin condition that causes itchy, scaly patches to appear on the skin, including the scalp.
“Scalp psoriasis is a condition where your immune system gets angry at the skin, leading to inflammation,” Dr. Zeichner says. “Patients typically developed red plaques with thick scale, which can be itchy, uncomfortable, or in some cases painful.”
Scalp psoriasis can also cause flakes and even cracks to form in the skin on the scalp, Dr. Rodney says.
Folliculitis
This is what happens when the hair follicles become infected and inflamed, Dr. Goldenberg explains. “Especially in acute cases, the inflammation may cause scalp to hurt and feel tender to touch,” he says.
Ringworm
Ringworm, aka tinea capitis, isn’t actually caused by a worm—it’s a fungal infection, Dr. Zeichner says. This can lead to a distinct rash with a circular shape and can lead to balding patches, Dr. Rodney says.
“You may have pus-filled pumps, and those areas can itch, leading to breaking of the skin and triggering the nerves,” she says. “People should be treated promptly, otherwise it can lead to scarring and permanent hair loss,” Dr. Zeichner says.
Sunburn
There are different levels of sunburn, but they can all cause pain. “It often hurts, even on the scalp,” Dr. Goldenberg says. “This is caused by inflammation of the skin cells on the scalp.”
Dr. Zeichner says that he frequently sees scalp sunburns in the part of the hair or along the front of the scalp, making it important to pay close attention to sunscreen in those areas.
Hair loss
Hair loss is not usually painful at baseline, Dr. Goldenberg says. “However, there are types of scarring or inflammatory hair loss, which, due to inflammation, may cause the scalp to feel irritated and even painful,” he says.
One form of this, known as central centrifugal cicatricial alopecia, can be especially painful, Dr. Rodney says. “The hallmark symptoms are burning, soreness, and tenderness of the scalp,” she says.
How to treat scalp pain
The right treatment for your scalp pain ultimately depends on what’s behind it and treating that underlying condition. But doctors say these can help across a range of issues:
Wearing loose hairstyle to release tension on the scalp.
Using antibacterial shampoo, which can clear up mild rashes.
Avoiding products with fragrance or other potential irritants.
Using cooling packs on your scalp.
Taking an OTC medication like acetaminophen or ibuprofen for temporary pain relief.
How to keep your scalp healthy
There are a few things you can do to keep your scalp healthy, whether you’re currently dealing with pain or want to prevent it from happening in the first place.
Wear sunscreen, including on your part.
Try not to scratch your scalp, which can cause bleeding and pain.
Use mild shampoos.
Limit the use of heat-styling tools, which can tug on your hair and even burn the scalp.
Use new products in small amounts to see how you’ll react first.
Consider using an anti-fungal shampoo to reduce the amount of fungus on your scalp.
When to see a doctor for scalp pain
If your scalp feels sore one day and fine the next, it may have been due to something like a hairstyle you wore for the day or irritation from a new product. But if you find that this is a regular issue for you, Dr. Rodney recommends seeing a dermatologist.
“These can be very early signs of what will become long-standing, permanent hair loss,” she says. “Time is really of the essence.”
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