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Pain and Tenderness – When the Scalp Sends Out a Serious SOS


Hi there! Scalp pain and tenderness are different from general scalp sensitivity. This isn’t just about feeling a bit tender after a tight hairstyle or a rough brush—this is pain that makes it uncomfortable or even unbearable to touch your head. It’s a signal that something more serious might be going on beneath the surface, and it’s not something to brush off. As hair professionals, we need to be able to identify what is happening.





Causes of Scalp Pain and Tenderness


There are several potential causes for scalp pain and tenderness, and understanding them is crucial for addressing the issue:


Scalp Inflammation and Infections

Folliculitis: This is an infection of the hair follicles that can cause pain, tenderness, and even pustules on the scalp. It’s often bacterial but can also be fungal.

Fungal Infections: Fungal infections like tinea capitis (ringworm of the scalp) can lead to painful, inflamed areas on the scalp. These infections can cause hair loss and require antifungal treatment.

Psoriasis: Psoriasis on the scalp can lead to red, scaly patches that are painful and tender to the touch. It’s an autoimmune condition that needs medical treatment.


Scarring Alopecia (Cicatricial Alopecia)

Scarring alopecia is a group of conditions that cause permanent hair loss through the destruction of hair follicles and their replacement with scar tissue. This type of hair loss is often associated with pain and tenderness, as the inflammation destroys the hair follicles and damages the surrounding tissue.

Lichen Planopilaris (LPP) and Frontal Fibrosing Alopecia (FFA) are examples of scarring alopecia that are linked to pain and tenderness on the scalp. Research suggests that the pain is due to the ongoing inflammatory process that is damaging the hair follicles. If you’re experiencing these symptoms, it’s essential to seek medical attention promptly to prevent further hair loss.


Nerve-Related Pain

Trigeminal Neuralgia: This is a nerve disorder that causes intense pain along the scalp and face. The pain is often described as sharp or burning and can be triggered by the slightest touch or even a breeze.

Occipital Neuralgia: Another nerve-related condition, occipital neuralgia, involves the nerves at the back of the head and can cause severe pain in the scalp and behind the eyes.


Scalp Tenderness from Tension

Tension Headaches: Sometimes, the pain and tenderness on the scalp are associated with tension headaches, where the muscles in the scalp become tight and sore. This can lead to a sensation of tenderness when touching the scalp.


Product Reactions and Allergies

Severe allergic reactions to hair care products can cause scalp pain, especially if they lead to a condition known as contact dermatitis. This is where the skin becomes inflamed and irritated, causing pain and tenderness.


The Connection Between Scalp Pain and Scarring Hair Loss


Scalp pain, especially when associated with tenderness and inflammation, can be an early warning sign of scarring hair loss. This type of hair loss is particularly concerning because it’s usually irreversible. Scarring alopecia is an inflammatory condition that destroys hair follicles and replaces them with scar tissue. The pain often comes from the ongoing inflammation that’s damaging the follicles.


Research indicates that certain types of scarring alopecia, like Lichen Planopilaris (LPP), are linked to autoimmune reactions where the body mistakenly attacks its own hair follicles. The inflammation not only causes pain but also leads to permanent hair loss if left untreated. Early detection and treatment by a trichologist or dermatologist are crucial to managing the condition and preserving the remaining hair.


Could It Be Fungal?


Fungal infections like tinea capitis can also lead to scalp pain and tenderness. These infections cause inflammation and can result in scaly patches, hair loss, and even swollen lymph nodes. While less common in adults, fungal infections should still be considered, especially if you notice circular, inflamed patches on the scalp.


Studies have shown that fungal infections can cause a range of symptoms, from mild itching to severe pain and tenderness. These infections require antifungal medications to resolve, and early treatment can prevent more serious complications, such as scarring or permanent hair loss.


If your client is experiencing scalp pain and tenderness, it’s important to have them consult with a healthcare professional—preferably a trichologist or a dermatologist who specializes in hair and scalp conditions. They can help diagnose the underlying cause and recommend appropriate treatments to address the issue before it leads to more serious complications.


Don’t Ignore the SOS


Scalp pain and tenderness are not just uncomfortable—they’re serious signals from your scalp that something is wrong. Whether it’s an infection, a nerve issue, or the early stages of scarring hair loss, these symptoms need to be addressed quickly to prevent long-term damage. If the scalp is sending out a serious SOS, don’t wait—have your clients seek professional help and give the scalp the care it needs.


Here's to pain free scalps,

Tabitha

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