Sore scalp
definition
Sensory disturbances on the scalp that are accompanied by pain or tingling or itching are called "trichodynia". Translated, this actually means something like "sore hair", as many people have the feeling that this is where the pain comes from. However, hair has no nerves and therefore cannot cause pain. Often the aching scalp cannot be clearly distinguished from the common headache.
A painful scalp is often caused by tension and stress. It is also often associated with hair loss. However, the scalp can also be sore in connection with the flu or cold. Often no abnormalities can be seen externally. Therefore, the cause of scalp pain is often difficult to diagnose. Women tend to have sore scalps more often than men.
Causes of a Sore Scalp
A sore scalp can have several causes. Tense muscles or irritated nerves often play a major role. One of the most common causes is muscular tension in the shoulder, neck and neck area. The tension spreads to the head muscles and causes pain on the scalp because the blood circulation is reduced. In addition to poor posture, this tension can also be caused by stress, grinding teeth or as a harbinger of flu or other infectious diseases.
Migraines can also be accompanied by a sore scalp. If there are rashes or inflammation of the scalp due to neurodermatitis, psoriasis or fungal infections, the scalp can also hurt. However, there are externally typical signs such as reddening (erythema) or flaking. In the case of fungal infestation, it is usually circular redness. Often these are also accompanied by itching. But inflammation of the scalp caused by care products can also irritate the scalp and cause pain. Injuries to the scalp, for example from blow-drying or water that are too hot, can also cause discomfort. Long-lasting mechanical stimuli such as caps, hats or hairbands that are too tight or wearing a braid for a long time can cause temporary headaches.
You might also be interested in: Migraines; Shoulder and neck pain
The burn-out syndrome as a trigger
Illnesses such as burn-out syndrome or depression, but also everyday stress, can be associated with a sore scalp or these psychosomatic causes can trigger the pain. Especially if no other cause can be found for the scalp pain, a psychosomatic background should be considered. Nervous exhaustion - especially stress or burnout - often leads to tension in the shoulder and neck muscles. If this tension persists for a while, it can negatively affect blood flow to the scalp and cause pain. If the circulatory disorder extends so far that the scalp is no longer adequately supplied with nutrients, hair loss can also occur. For such illnesses - especially if it is a possible burnout or depression - a doctor should be consulted and treatment should be initiated. It is important to treat the psychological distress and learn a different way of life through therapy. The sore scalp then usually disappears quickly on its own.
More on this subject: Burn-out syndrome
Sore scalp from a cold or flu
A cold or flu is often associated with a headache. These are then the result of the common cold and are known as secondary headaches. The aching head can either be a harbinger or, after initial symptoms such as a sore throat or runny nose, then accompany them. Since the immune system works harder in the event of an infection, various messenger substances (so-called cytokines) are released that can cause pain. Blood vessels are also dilated, which can cause headaches - of varying intensity. This can lead to sensitivity to touch on the head and severe pain. However, these disappear again after a few days. If the pain is accompanied by a stiff neck, the meninges may be irritated. One then speaks of a meningism.
Mechanical stress on the scalp
Pain after a braid that is too tight or with heavy hair is completely normal and not dangerous. The painful scalp is caused by mechanical stress on the scalp and the hair roots. The nerves become irritated and the entire scalp hurts. Extensions can also be subject to strong mechanical stress, especially as the hair length increases, as the weight of the artificial hair pulls on the scalp. At first, the head or scalp can get used to the additional weight, so that the pain is only temporary. However, if these recur or persist, the extensions should be removed and the scalp relieved.
Nerve pain
Pain in the scalp caused by nerve pain (neuralgia) can occur in different areas of the head, depending on which nerve is affected. The irritation of the nerves can have different causes. Often, a shortage of blood and nutrients or pinching of the affected nerves are the cause of neuralgia.
After a herpes zoster on the head, a so-called post-zoster neuralgia can occur. The viruses remain in the nerve cells even after the disease and interfere with the transmission of stimuli. This causes burning or stabbing pain, which can be short or long-lasting in phases. These post-herpes zoster neuralgia are often accompanied by a feeling of numbness in the painful areas.
Read more under: Neuralgia
Borreliosis as a cause of scalp pain
Borreliosis is a disease caused by bacteria. These are transmitted to humans by ticks. The first and most common symptom is reddening around the tick bite (erythema migrans). Diffuse, one-sided headaches can occur. Cranial nerves are often affected by the infection and can cause numbness or pain in the side of the scalp around the ear or face. If the infection is not treated, it can persist and become chronic. Then, after months to years, in addition to jumping joint pain, exhaustion, tiredness, dizziness and drowsiness, diffuse, unilateral or cap-shaped headaches or scalp pain can occur. Treatment of Lyme disease is very important and should be done urgently to prevent serious complications.
Read also: How do you recognize Lyme disease?
diagnosis
The diagnosis is usually made through the symptoms and questioning the patient. In order to find out whether there is tension in the shoulder, neck and neck area, the doctor will palpate these areas. If it is a fungus on the scalp (tinea capitis), you can take a swab from the inflamed and flaky areas and cultivate the fungus. The diagnoses psoriasis and neurodermatitis are made through targeted questioning and assessment of other body regions such as arms, legs and lower back. Injuries and irritations to the scalp can also be detected by inspecting the head.
Concomitant symptoms
Depending on the cause, the accompanying symptoms may vary.
On the one hand, itching and tingling sensation on the scalp can occur even without an external finding. In addition, hair loss is often associated with trichodynia. The pain can be so severe that it is accompanied by dizziness. If a fungal attack is the cause of the pain, there will be visible red, circular and scaly rashes on the scalp. In these areas, the hair usually falls out. If tension is to blame for the sore scalp, it is often preceded by neck or shoulder pain.
A sore scalp can also appear as a side effect of the flu along with typical symptoms such as runny nose, sore throat, general malaise, fever and also earache. If the scalp is dried out or irritated by shampoos or other care products, the scalp can cause dandruff in addition to pain.
More information on this topic: Burning scalp
Sore scalp with hair loss
Many patients with sore scalps report hair loss. This can also be found exactly where the head hurts. This hair loss is explained by an insufficient supply of blood to the scalp. If there is tension in the shoulder, neck or head area, blood vessels can be impaired. There are many small blood vessels under the scalp that feed the scalp, muscles and hair. If these are compressed by excessive muscle tension, they cannot transport a sufficient amount of blood and nutrients to the scalp and hair. If the scalp is not supplied with sufficient oxygen and nutrients for a long time, hair loss occurs in these areas. The hair loss can usually be reversed by adequate treatment of the cause - such as stress or tension due to incorrect posture.
Aching scalp with earache
If the pain occurs particularly in the ear area, neuralgia can be behind it. This is sudden, severe nerve pain. These disappear again after a few seconds, but can reappear as a series shortly afterwards. Recurrence can occur up to 100 times a day. In the ear, the sensitive branches of the trigeminal nerve are the main cause of pain. Here, too, the pain is caused by an insufficient supply of the nerve. Typical here, however, is the unilateral occurrence of the pain.
Earache and sore scalp can also be associated with an ear infection. These can be various infections, with the actual earache spreading to the surrounding skin. For example, the pain can be triggered by otitis media or an inflammation of the external ear canal. So-called shingles on the ear (zoster oticus) can also cause pain on the skin around the ear. In most cases, this results in typical, grouped blisters on and around the affected ear.The pain can be felt a few days before the skin appears.
Pain to touch
If the scalp hurts to the touch, the nerves are irritated and over-sensitivity (hypersensitivity) occurs. This hypersensitivity can appear as a side effect with almost any cause. However, there is often a strong sensitivity to touch in connection with neuralgia. Here, the nerves are strongly irritated and can no longer adequately respond to normal stimuli and therefore signal light touches to the brain as pain.
Localization of the pain
Unilateral scalp pain
If pain in the scalp area only occurs on one side, nerve pain (neuralgia) is often responsible.
In most cases, the nerves that pull the back of the head over the side to the forehead are responsible. These nerves are called the major occipital nerve and minor occipital nerve, and the pain they cause is called occipital neuralgia. In addition to infections, causes of nerve pain can also be problems with the intervertebral discs, which pinch and irritate the nerves. Muscle tension in the neck or osteoarthritis in the cervical joints can also be responsible for the neuralgia. The pain is described as stabbing or piercing, and the head is often very sensitive to touch.
The duration of the pain varies. It can only last a few minutes or last for several days. Unilateral, pulling pain can also result from unilateral sinusitis or maxillary sinusitis. If these are not properly ventilated, the pain can spread to one side of the head. An irritated or inflamed wisdom tooth can also cause unilateral, radiating headaches. If this is not removed, these can occur again and again.
Bilateral pain of the scalp
Bilateral pain on the scalp is common in herpes zoster (facial rose) on the head and face. Herpes zoster is triggered by reactivation of the varicella zoster virus, which is the primary infection that causes chickenpox. The first sign, in addition to general weakness and a feeling of illness, may be a severe headache that is pressing and usually starts at the back of the head. The scalp and hair are often sensitive to touch. Normally, herpes zoster only occurs on one side. However, since the nerve cords on the scalp branch out in large numbers, the entire scalp is affected and therefore there is holistic pain. Two to three days after the onset of pain, the typical skin symptoms such as grouped blisters and reddening appear.
So-called craniomandibular dysfunction (CMD) - i.e. a misalignment of the jaw - can cause dull or pulling pain by influencing the neck muscles, tendons and joints, which usually radiate from the back of the head to the temples. Sensitivity to touch of the scalp and hair is also typical.
Treatment of scalp pain
Treatment for the sore scalp depends on the cause.
Psychological help is urgently recommended for burnout and depression. Physiotherapy and regular exercise are advisable to relieve bad posture and tension. Skin diseases such as neurodermatitis and psoriasis should be treated by a dermatologist. If the sore scalp is caused by a fungus, the doctor will prescribe an oral antifungal medicine.
Lyme disease is treated with an antibiotic (doxycycline) that must be taken for two weeks. If Lyme disease becomes chronic, the antibiotic may have to be taken longer. If there is a facial rose, this is treated antivirally with acyclovir. It is essential to note that herpes zoster in the head and face area is always treated with medication.
Normal pain pills usually do not help enough or not at all with nerve pain (neuralgia). Therefore, so-called anticonvulsants are prescribed, which are used for seizures. These regulate the excitability of the nerves down and thereby reduce the sensitivity to pain. Antidepressants or opioids can also be administered. Which drugs are used in which combination depends on the individual effect on the patient. If irritated or inflamed wisdom teeth are responsible for the pain, they should be removed.
Treatment with homeopathic remedies
Taking homeopathic remedies can help heal certain underlying diseases and alleviate symptoms.
It is recommended to take Chamomilla (chamomile) if the scalp is very sensitive to pain. If the sore scalp is caused by an infection or flu, we recommend taking Ferrum phosphoricum globules. In the case of burning pain, taking Arsenicum album can relieve the symptoms; it can also be used in the case of herpes zoster on the scalp. To treat herpes zoster, therapy with Cantharis or Rhus vernix can promote healing. The pain of post-zoster neuralgia can be relieved by taking Hypericum perforatum, Vaccinotoxinum or Magnesium phosphoricum.
Treatment with home remedies
If pain on the scalp occurs due to mechanical stress or tension, a gentle scalp massage can provide relief, as the scalp and muscles are better supplied with blood. With neuralgia, cooling or warming the affected areas can improve the pain. What exactly helps varies from patient to patient and should be tried. However, neuralgia should be treated by a doctor as soon as possible and the home remedies should only be used as a support.
Duration of pain
The duration will vary depending on what is causing the pain.
If the pain is caused by the flu, it usually disappears after a few days. Tension, stress and mental illness must be treated accordingly. Some improve sooner, others later, or the accompanying symptoms disappear with successful treatment. The painful scalp caused by a braid can - after loosening the braid - last from minutes to several hours. Neuralgia - including post-herpetic neuralgia - usually last for a year, but can also require lifelong treatment.
