7 Reasons Your Scalp Hurts

Medically reviewed by Susan Bard, MD

Pain or soreness on the scalp can be triggered by a number of different factors, including skin conditions, headaches, infections, and more. The scalp has numerous blood vessels, nerve endings, and hair follicles underneath the skin, making it a sensitive area for pain.

Depending on the underlying cause, the level of scalp sensitivity can range from mild to severe, and may feel like a throbbing, irritated, tingling, itchy, or burning sensation.

Fortunately, there are many at-home, over-the-counter (OTC), and prescription treatment options to help manage scalp pain. Your treatment for scalp pain will depend on the root cause.

Dermatitis

Different types of mild skin inflammation—often categorized under the general term dermatitis—result in dry, itchy, inflamed patches of skin, like a rash. Dermatitis can appear anywhere on the body, including the face and scalp, leading to pain or discomfort in the area.

Dermatitis develops from different causes, including genetics, an overactive immune system, allergens, or irritating substances. For example, a compound called paraphenylenediamine (PPD) commonly used in hair dye might cause allergic contact dermatitis on the scalp when applied.

If you have a painful, irritated, or inflamed scalp that seems to be caused by dermatitis, you should visit a healthcare provider to determine the trigger and treatment options.

Tension From Hairstyles

Certain hairstyles can lead to scalp pain and discomfort. In particular, tight hairstyles can cause blood vessel inflammation along the scalp and hair follicles.

High ponytails, updos, buns, braids, or any hairstyle that pulls tightly on the hair can damage the follicle and lead to pain as well as hair loss or damage. This type of hair loss is known as traction alopecia, which is essentially gradual hair thinning in areas where hairstyles have been tugging.

If wearing your hair down or loosening your hair elastic doesn't seem to reduce your scalp pain—or if you notice hair loss occurring simultaneously—consider seeing a healthcare provider for treatment recommendations.

Headaches and Neurological Conditions

Headaches and neurological disorders like migraines cause head pain, and they may also impact the scalp.

A tension headache, usually characterized by a dull or tight ache around the temples, develops when muscles in the neck and scalp become too tense and contract. For some people, the resulting pain can feel worse on the scalp than on other parts of the head.

It's also common for people with chronic migraine to experience allodynia—where nerve ending signals cause the scalp to feel abnormally painful in response to common actions, like hair brushing or wearing a hat. Severe pain on the scalp may also develop with occipital neuralgia, where nerves that run across the scalp become injured and inflamed.

Any worsening or changing headache patterns that impact the scalp may be a sign to visit a healthcare provider for new or updated treatment guidance.

Scalp Psoriasis

Most people who have psoriasis also experience scalp psoriasis, which means that they develop dry, itchy, scaly, and painful scalp patches.

With psoriasis, the immune system mistakenly attacks healthy cells in the body and triggers inflammation—in this case, on the scalp. Scalp psoriasis tends to be very itchy, which can cause bleeding if the patches are scratched too roughly. A burning sensation and soreness on the scalp are also common.

Try avoiding triggers for scalp psoriasis, such as stress, cold weather, or dry air. If prevention measures aren't helping, ask a healthcare provider for additional treatment options.

Infection

Scalp pain may also be the result of a fungal or bacterial infection of the skin.

Hair follicles on the scalp may become infected with bacteria due to frequent shaving or wearing tight hats—especially in hot or damp weather. This is known as folliculitis, and can lead to a painful, itchy, and tender scalp plus a red or discolored ring around the follicle.

Fungal infections on the scalp like ringworm (or tinea capitis) will lead to one or more scaly, uncomfortable balding patches that may be painful—and are contagious. Avoid sharing combs or towels with other people to prevent getting or sharing ringworm.

Antifungal medications and antibiotics are usually needed to clear one of these infections, so if pain and irritation aren't going away it's best to see a healthcare provider for prescription treatment.

Hair Loss

Scalp pain is sometimes experienced with different types of hair loss.

Research shows that people with telogen effluvium (hair loss caused by extreme stress) and alopecia areata often report scalp sensitivity as a symptom. Another form of hair loss primarily experienced by Black women known as central centrifugal cicatricial alopecia also commonly causes scalp itchiness, pain, and tenderness.

To get to the root cause of your hair loss and scalp discomfort, ask a healthcare provider for targeted treatments that can help with both issues.

Sunburn

Even if hair covers most or much of the area, the sun naturally beats down directly on your scalp—leading to pain, inflammation, and discomfort when a sunburn develops. Scalp sunburns can form with just a small amount of UV exposure, even in winter months.

A mild scalp sunburn can usually be treated at home with soothing remedies, and prevented by wearing hats and sunscreen on the scalp. Get medical help if you notice a fever, chills, increasing pain, dizziness, or blistering with your sunburn.

Treatments for Scalp Pain

Specific treatment for scalp pain will depend on the underlying cause. But there are a few at-home and over-the-counter (OTC) remedies that can help address pain and common scalp problems.

Some of these options include:

• Using antibacterial shampoo to potentially clear mild rashes or flaky patches

• Applying anti-itch and salicylic acid-containing scalp products to help control itchiness, irritation, and inflammation

• Avoiding contact with irritants for dermatitis or scalp psoriasis-related pain

• Performing a gentle self-massage on the scalp with your fingertips or a tool to soothe tension headaches and improve circulation in the area

• Using cool packs or heating pads for temporary relief of discomfort and inflammation

• Releasing tight hairstyles to allow hair strands and follicles to relax

How to Maintain a Healthy Scalp

Giving your scalp a little extra care can help improve hair health and potentially prevent pain or sensitivity. Consider incorporating some of the following recommendations into your routine:

• Avoid scratching your scalp as much as possible to reduce the risk of irritation, bleeding, and hair loss

• Shampoo and style gently, limiting the use of blow dryers and hot tools that can tug on the hair and irritate or even burn the sensitive skin on the scalp
  

• Reduce stress, which can make conditions like scalp psoriasis worse, and incorporate neck stretching to prevent tension headache-related scalp pain

• Protect your scalp from sunburns by wearing a hat or using powder or spray sunscreens specially formulated for your hair on the area

• Test out any new hair or scalp products in small amounts to help reduce the chances of scalp pain or sensitivity from irritant exposure
  

When to See a Healthcare Provider

Some types of scalp pain may resolve on their own or with the help of OTC treatments. However, if you notice scalp pain that's long-lasting or moderately painful, it's best to visit a healthcare provider.

The provider will ask questions about your medical history and symptoms, and examine the scalp area to assess for any visible clues. From there, they may perform a skin biopsy to check for the presence of any rash-causing pathogens. They may also order a blood test or imaging to rule out any underlying health conditions or neurological disorders.

Based on the results from your in-office visit, the provider can recommend a treatment plan to resolve or manage the scalp pain.

For example, they might prescribe a medicated shampoo or topical product to help with conditions like dermatitis. The provider can also drain any boils or bumps on the affected scalp area.

Infections usually require oral or topical antibiotics or antifungal medication, along with topical corticosteroids to help relieve inflammation and related symptoms.

For a skin condition like scalp psoriasis, a combination of topical and oral prescription medications, injections, and light therapy are treatment possibilities.

Neurological conditions like migraines have a range of prescription treatment options, including different classes of medications and injectables to help reduce headache frequency and pain, and prevent migraine attacks.

A Quick Review

Scalp pain can stem from a range of different causes, including skin conditions, infections, hair styling habits, headaches, sunburn, and more. Treatment to reduce scalp discomfort will depend on the underlying cause, and can vary from self-massage, medicated shampoos, or topical or oral prescription medications. Prevention tactics like scalp care, gentle washing, reducing stress, and protecting skin from the sun can help in some cases.

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