A sore scalp can be caused by infected hair follicles, scalp pimples, or tension from certain hairstyles that may pull the hair too tight. Other causes for scalp tenderness include trauma from a head injury, or underlying skin condition like eczema or cellulitis. Read on for more information on causes and treatment options.
6 most common cause(s)
Symptoms of scalp pain
Scalp pain is often very uncomfortable and disconcerting. Scalp pain symptoms can take a variety forms and it is difficult to find at-home relief that does not include multiple painkillers. For some people, the scalp pain symptoms can be so severe as to require missed days at work or school.
Even though it may be difficult to think clearly through the scalp pain, it is important to take note of the quality of your pain and any patterns. Is the pain dull? Sharp? Tight? Stabbing? When did the pain start? Is it constant or does it happen only at particular times? Are there any triggers to the pain? Such observations may help you and your doctor find the correct cause
Common accompanying symptoms of scalp pain
If you're experiencing scalp pain, it's also likely to experience:
- Skin that feels warm to the touch
- Flaking or itching
- Burning
- Pain that spreads: Such as from the scalp to the face, jaw, neck or shoulders
Causes of scalp pain
The overwhelming majority of cases of scalp pain can be attributed to causes that put direct pressure or tension on the scalp. However, there are medical issues that can affect the nerves and blood vessels of the scalp and these can lead to debilitating scalp pain symptoms. Regardless of the source, most causes of scalp pain are benign and treatable once proper medical attention is obtained.
Medical causes
Medical causes of scalp pain may include the following.
- Neurologic: Neurologic causes such as headaches and trigeminal neuralgia (a nerve condition that affect sensation to your face) can cause scalp pain symptoms and pain that spreads to other parts of your head such as the jaw, teeth and lips. Nerves can also be affected by certain viruses that result in scalp pain.
- Autoimmune: Some autoimmune diseases can cause inflammation of the blood vessels in your head leading to scalp pain. One such condition is called Giant Cell Arteritis, also known as Temporal Arteritis.
- Dermatologic: Skin conditions such as eczema or dandruff can cause inflammation of the scalp. This inflammation can cause excessive itching that may result in tenderness and scalp pain.
Environmental causes
Environmental causes of scalp pain may be related to certain exposures or events.
- Sunburn: A long day outside can cause sunburn not only on your body but also on your scalp. Symptoms of a scalp burn can feel very similar to those of sunburn on the body, including symptoms of pain and tenderness.
- Tension: Hairstyles such as ponytails or braids can cause strain and tension to the scalp that may result in pain and discomfort.
- Trauma: Any situation where your scalp is hit or cut can result in prolonged scalp pain. Often the injury may not be initially apparent due to location of the laceration (i.e. back of the head) or hair covering the scalp [8].
This list does not constitute medical advice and may not accurately represent what you have.
Giant cell arteriis
Giant cell arteritis is a disorder that causes inflammation of arteries of the scalp, neck, and arms. It narrows the arteries, which keeps blood from flowing well.
Rarity: Rare
Top Symptoms: fatigue, joint pain, new headache, fever, muscle aches
Urgency: Primary care doctor
Whitehead
Whiteheads are caused by hair follicles becoming clogged with oil & dead skin cells. When the clogged pore is closed to the air by a layer of skin cells, the oil/dead skin cells remains white (as opposed to a blackhead).
Though large whiteheads can be removed by a dermatologist, most cases can be treated with proper hygiene and over-the-counter medications/treatments. Look for products containing benzoyl peroxide or salicylic acid.
Rarity: Common
Top Symptoms: small facial lump, yellow or white facial bump
Symptoms that always occur with whitehead: small facial lump, yellow or white facial bump
Urgency: Self-treatment
Uncomplicated head injury
An uncomplicated closed head injury is a diagnosis of exclusion. If someone has been seen by a physician and more serious types of injury are deemed unlikely, this is a common variation of closed head injury.
Rarity: Uncommon
Top Symptoms: head or face injury, face pain, headache resulting from a head injury, scalp pain, new headache
Symptoms that always occur with uncomplicated head injury: head or face injury
Symptoms that never occur with uncomplicated head injury: bleeding from the ear, nausea or vomiting, current loss of consciousness, feeling confused and not making sense while talking
Urgency: Phone call or in-person visit
Temporomandibular joint (TMJ) dysfunction disorder
Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.
The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.
TMJ disorder has three types:
- Pain or discomfort in the muscles controlling the TMJ.
- Dislocation or injury to the jawbone.
- Arthritis of the TMJ.
Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.
Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.
Severe skin abscess
A skin abscess is an infection of the deeper skin that's typically due to bacteria seen on the skin. Recently, infections are more frequently caused by Staph. Aureus (puts the "staph" in "staph infections"). If the infection begins to spread, urgent treatment is required.
You should head to the nearest ER by car since your infection seems like it might be spreading. It is likely that you will be prescribed antibiotics. Surgery may be required to get rid of the whole abscess after the inflammation has died down. Do not drain the abscess yourself.
Rarity: Rare
Top Symptoms: fatigue, fever, painful neck lump, marble-size neck lump, pink or red neck bump
Symptoms that always occur with severe skin abscess: pink or red neck bump, red bump
Urgency: Hospital emergency room
Pimple
Pimples are also called comedones, spots, blemishes, or "zits." Medically, they are small skin eruptions filled with oil, dead skin cells, and bacteria.
Pimples often first start appearing at puberty, when hormones increase the production of oil in the skin and sometimes clog the pores.
Most susceptible are teenagers from about ages 13 to 17.
Symptoms include blocked pores that may appear flat and black on the surface, because the oil darkens when exposed to the air; blocked pores that appear white on the surface because they have closed over with dead skin cells; or swollen, yellow-white, pus-filled blisters surrounded by reddened skin.
Outbreaks of pimples on the skin can interfere with quality of life, making the person self-conscious about their appearance and causing pain and discomfort in the skin. A medical provider can help to manage the condition, sometimes through referral to a dermatologist.
Diagnosis is made through physical examination.
Treatment involves improving diet; keeping the skin, hair, washcloths, and towels very clean; and using over-the-counter acne remedies.
Rarity: Common
Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump
Symptoms that always occur with pimple: pink or red facial bump
Urgency: Self-treatment
Giant cell arteritis
Giant cell arteritis is a disorder that affects the blood vessels in the head and neck and can cause headaches, vision problems, jaw pain, and arm pain.
Giant cell arteritis is usually evaluated by a primary care doctor who might perform a physical exam and order a blood test to look for inflammation. They might prescribe steroids to help lower the inflammation.
Eczema (atopic dermatitis)
Atopic dermatitis, also called eczema, dermatitis, atopic eczema, or AD, is a chronic skin condition with an itchy rash.
AD is not contagious. It is caused by a genetic condition that affects the skin's ability to protect itself from bacteria and allergens.
AD is most often seen in infants and young children. Most susceptible are those with a family history of AD, asthma, or hay fever.
Infants will have a dry, scaly, itchy rash on the scalp, forehead, and cheeks. Older children will have the rash in the creases of elbows, knees, and buttocks.
Without treatment, a child may have trouble sleeping due to the intense itching. Constant scratching may cause skin infections and the skin may turn thickened and leathery.
Diagnosis is made through physical examination, patient history, and allergen skin tests.
AD cannot be cured, but can be controlled through prescribed medications, skin care, stress management, and treatment of food allergies. Those with AD often have allergies to milk, nuts, and shellfish. Keeping the skin clean and moisturized helps prevent flareups.
Cellulitis
Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.
The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.
Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.
Symptoms arise somewhat gradually and include sore, reddened skin.
If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.
Symptoms of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.
Diagnosis is made through physical examination.
Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.
Rarity: Uncommon
Top Symptoms: fever, chills, facial redness, swollen face, face pain
Symptoms that always occur with cellulitis: facial redness, area of skin redness
Urgency: Primary care doctor
Skin abscess
A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.
Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.
If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.
Diagnosis is made through physical examination.
A small abscess may heal on its own, through the body's immune system. But some will need to be drained or lanced in a medical provider's office so that the pus can be cleaned out. Antibiotics are usually prescribed.
Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.
Rarity: Common
Top Symptoms: rash with bumps or blisters, red rash, red skin bump larger than 1/2 cm in diameter, pus-filled rash, rash
Symptoms that always occur with skin abscess: rash with bumps or blisters
Urgency: Primary care doctor
Scalp pain treatments and relief
At-home treatments for scalp pain
To address your symptoms at home, you can try these methods.
- Resist scratching: If you are experiencing symptoms of flaking or itching along with your scalp pain, resist the urge to scratch your scalp. Often scratching may seem to provide temporary relief, but in the long run it can exacerbate inflammation and make your scalp pain worsen.
- Address stress:Take note of any stressors in your life that may be contributing to headaches. Find ways to relax and destress.
- Try hairstyles that are more loose: Minimize hairstyles such as high ponytails or braids that cause tension to the scalp. Often prolonged use of such hairstyles can lead to hair loss or receding hairline in addition to the pain.
- Protect your scalp from the sun: Putting sunscreen in your hair may not be the most pleasant option, so wear a hat on days you will be outdoors to prevent sunburn of the scalp. If wearing a hat is not an option, spray a mix of water and aloe vera juice or onto your scalp to protect against the strong rays of the sun.
When to see a doctor for scalp pain
If your scalp pain persists despite the remedies above or you have experienced any trauma to the scalp, make an appointment with your doctor. Depending on the cause of your pain, your doctor may suggest:
- Anticonvulsants: Do not be alarmed; your scalp pain is most likely not the result of seizures. Several anticonvulsant medications can also be used to combat nerve pain. Your doctor may prescribe gabapentin or carbamazepine.
- Skin creams or steroids: Dermatologic conditions such as eczema can be treated with topical skin creams and steroids. If your dermatologic condition is very serious, you doctor may prescribe systemic treatment.
When scalp pain is an emergency
Seek medical attention immediately if you experience sudden onset scalp pain accompanied by fever or visual symptoms. These could be signs of temporal arteritis which must be treated quickly.
FAQs about scalp pain
Why do I experience scalp pain while pregnant?
Hormonal changes during pregnancy cause dermatological changes to the scalp, ranging from dry, itchy skin to greasy, acne-prone skin. These changes can lead to new development or worsening of existing skin conditions like eczema or seborrheic dermatitis, which can cause you to have a tender scalp. Furthermore, headaches and migraines can contribute to scalp pain.
Can you have scalp pain from wearing your hair up?
The base of each of your hair follicles contain sensory nerve fibers. Bending the hair stimulates these nerve endings, allowing you to feel that your hair has been moved. Putting up your hair into a ponytail stimulates the nerve fibers. The tighter or heavier your ponytail, the more pressure that is placed on the nerve fibers, which will transmit signals to your brain that will be interpreted as a painful and uncomfortable sensation.
Why is my scalp burning?
Burning scalp pain can occur for a variety of reasons. The pain may be stemming from inflammatory skin conditions such as dandruff, fungal infection, psoriasis, or eczema. The pain may also be secondary to an underlying neurological dysfunction, most likely either temporal arteritis or trigeminal neuralgia. Electric-like pain is a particularly specific sign of possible inflammation or compression of nerves in the vicinity of the pain.
Can my scalp get sunburned?
Yes, the scalp can undergo sun damage. Although men and women with significant hair loss are more prone to sun damage, having hair will not completely protect you against sunburn. Just like the rest of the skin, UV rays can still reach the scalp after one spends an extended amount of time out in the sun. Wearing a cap/hat will reduce the risk of exposure.
Why is my scalp itchy?
The scalp can be itchy for numerous reasons. The most common reason is dandruff, which occurs when your body undergoes an inflammatory response due to an overgrowth of yeast on the scalp, causing itching and flaking. Other common causes include psoriasis (an autoimmune disease), tinea capitis (a fungal infection known as ringworm), head lice, and reactions to foreign chemicals such as new hair dyes or anything coming into contact with the scalp.
Questions your doctor may ask about scalp pain
- Did you get hit in the head?
- Any fever today or during the last week?
- Have you experienced any nausea?
- Did you faint?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
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