Understanding Scalp Pain and Hair Loss: Causes, Symptoms, & Treatments

Scalp tenderness can be both painful and puzzling, especially since it’s hard to see what’s going on on top of your head. If you’re wondering why your scalp feels sore and are concerned about excess shedding, you’ve come to the right place.

Is there a connection between scalp pain and hair loss? Potentially, but soreness up top doesn’t automatically mean you’re gonna lose all your hair.

Here, we’ll cover whether scalp pain is a cause of hair loss. (Spoiler alert: Not on its own, but it could be a symptom of certain types of hair loss).

We’ll also discuss other reasons for a sore scalp, like certain skin conditions or a too-tight hairstyle. Whether you’re experiencing a mild prickling sensation or severe pain on the crown of the head, we have the info you need to find relief.

Scalp pain can manifest in different ways. You may feel it all the time, or you might notice the soreness specifically when moving your hair, like while tying it back or running your hands through it.

Symptoms of a sensitive scalp include:

• Pruritus (irritated skin that makes you want to itch)

• Pain

• A burning sensation

• Prickling or stinging

• Soreness

But why is your scalp sore? Keep scrolling for potential reasons.

While we usually think of hair loss as a painless condition (at least physically), certain types of hair loss are associated with pain. In fact, this has its own word — trichodynia — an umbrella term to describe a sensation of pain or burning of the scalp or hair in the context of hair loss.

Below, find more information on types of hair loss that sometimes cause scalp tenderness.

Alopecia Areata

Alopecia areata is a form of hair loss caused by an autoimmune condition. The body attacks the hair follicles, causing patchy hair loss.

Alopecia areata can cause a sore scalp, especially in the affected areas. One 2022 study found that out of 49 people with alopecia areata, 12 also had scalp sensitivity.

Telogen Effluvium

Telogen effluvium is reversible hair loss associated with high levels of stress, illness, or injury. It causes rapid hair shedding.

The 2022 study mentioned above found that 39 percent of patients with telogen effluvium also presented with scalp sensitivity in the form of pain, burning, or itching. This was a much higher percentage than other types of hair loss.

Traction Alopecia

Why is my hair sore at the roots? It could be traction alopecia. This type of hair loss is caused by wearing overly tight hairstyles (like bun, braids, or ponytails) that pull at the root. It’s most common among Black women but can happen to anyone.

All the pulling on the scalp can cause a sore scalp or even tension headaches.

Cicatricial Alopecia

Scarring alopecia, also known as cicatricial alopecia, is a group of rare disorders that destroy hair follicles and replace them with scar tissue. Unlike other types of hair loss where the hair follicle remains intact (and so regrowth is possible), scarring alopecia irreversibly damages hair follicles.

One study found that out of 249 alopecia patients, 89 (35.7 percent ) had trichodynia, — and it was more common in the cicatricial alopecia group than for people with other forms of hair loss.

Types of scarring alopecia include lichen planopilaris and central centrifugal cicatricial alopecia (CCCA). The former is inflammation affecting skin and mucous membranes, and the latter is hair loss in the center (crown) of the scalp.

Androgenetic Alopecia

Androgenetic alopecia is just another word for male pattern baldness. It’s caused by a genetic sensitivity to a male hormone (androgen) called DHT (dihydrotestosterone), a byproduct of testosterone.

Excess DHT can miniaturize (as in shrink) hair follicles, causing hair to fall out over time.

Male pattern baldness isn’t typically painful, but it can be. In the 2022 study that looked at hair loss and scalp sensitivity, around 21 percent of the men who experienced androgenic alopecia also had a painful scalp or tenderness.

Interestingly, some studies have suggested a correlation between anxiety about hair loss and perceived pain (trichodynia). But other studies have refuted that link.

Scalp ringworm is a common fungal infection affecting the scalp and hair follicles. 

The most common symptom of scalp ringworm is a red, itchy rash on the scalp, often accompanied by areas of hair loss caused by the fungus attacking the hair shaft itself.

The rash often has a scale-like texture. Black dots on the scalp are another sign of scalp ringworm.

Why is the crown of my scalp sore? Other potential causes of a sore scalp include psoriasis, folliculitis, and seborrheic dermatitis, along with various ailments, habits, and environmental factors.

Here’s what to know.

Scalp Psoriasis

Psoriasis is a skin disorder that causes thick, scaly plaques to form. It happens when the immune system speeds up the production of new skin cells. This skin condition can be triggered by stress, hormones, dry air, or cold weather.

Psoriasis can affect any part of the body, including the scalp. 

Common symptoms include a red rash or silvery, scaly skin. Scalp psoriasis could also make your skin crack, bleed, itch, burn, or feel extremely sore. 

Folliculitis

Folliculitis is an infection of the hair follicles that leads to small red or white sores on the scalp.

Folliculitis sores are sometimes mistaken for acne or razor burn, and they can develop a crusty texture that takes a long time to heal. Although bacteria is most commonly the cause, excess product buildup or not washing your hair frequently enough can also cause it. 

Scalp folliculitis isn’t usually particularly painful, but it can cause itching and general discomfort. If left untreated, it might lead to hair loss.

Seborrheic Dermatitis

Seborrheic dermatitis is a form of eczema characterized by a red, scaly rash on the scalp. It can have a swollen or greasy appearance with white or yellow scales.

The affected area might burn or feel very itchy, especially on the scalp. When scratched, small dandruff flakes may come loose.

Some guys wonder if an itchy scalp leads to hair loss. Most conditions that cause an itchy scalp won’t directly cause your hair to fall out. But in some cases, intense itching is associated with temporary hair loss because all that scratching can damage hair follicles.

Other Possible Reasons for Scalp Pain

Additional causes of scalp tenderness or soreness include:

• Scalp acne

• Cysts

• Allergic reactions

• Infections

• Viral diseases like shingles or measles

• Over-brushing

• Sunburn

• Lice

Rarely, scalp tenderness can indicate severe health conditions, like occipital neuralgia (when nerves on the scalp are injured and inflamed).

There’s also a very small possibility it’s allodynia. That’s when you feel pain in response to a normal stimulus like brushing or lightly touching the scalp. Allodynia is sometimes a side effect of migraines.

You can learn more about these conditions in more detail in our guide to common scalp conditions.

So, how do you treat scalp inflammation? Treatment for a sore scalp will vary depending on what’s causing the pain or tenderness to begin with.

For example, if you’re experiencing dandruff or seborrheic dermatitis, a shampoo with pyrithione zinc may be all you need to get relief (our dandruff detox shampoo is a good option). Or you might just need to take your hair out of that overly tight bun.

But for more severe conditions, medication may be necessary.

Most conditions that cause a sore scalp or inflammation are treated with a topical product — though in some cases, oral antibiotics might be needed.

Here’s what might help:

• Medicated shampoos

• Topical medications to treat inflammation, itching, and other symptoms

• Antifungal medications

• Scalp moisturizer or lotion to treat dryness

• Gentle scalp massage

• Keeping your hair clean and free of product buildup

• Antibiotics

Always speak to a dermatologist or another healthcare provider about how to treat scalp pain.

Hair loss medications can help treat hair loss associated with certain types of scalp sensitivity or pain.

Two popular options approved by the U.S. Food & Drug Administration (FDA) specifically for male pattern baldness are minoxidil (the active ingredient in Rogaine®) and oral finasteride (the active ingredient in Propecia®).

We offer minoxidil solution, minoxidil foam, finasteride tablets, and a topical hair loss spray that combines the two ingredients.

Oral minoxidil is also an option for some people, but it requires a prescription (unlike its topical counterpart).

Wondering, Why is my scalp sore? Here’s the TL;DR on scalp pain and hair loss:

• Scalp tenderness can be caused by various factors. This includes common skin conditions like dandruff and psoriasis to infections and even hairstyles that put too much strain on the scalp. 

• A sore scalp often isn’t the only symptom. You might also experience itchiness, a burning sensation, or even hair loss, depending on the underlying cause. Trichodynia is the word used to describe hair loss accompanied by scalp pain.

• There’s no one-size-fits-all solution for scalp tenderness. Treatment will depend on what’s causing it. Sometimes, switching to a medicated shampoo is all it takes to relieve a sore scalp. Other situations may call for topical medications or even oral antibiotics. Lifestyle changes, like avoiding tight hairstyles or managing stress levels, can also be helpful.

If your scalp tenderness is severe or doesn’t improve with home remedies, consult a dermatologist or another healthcare provider to figure out the best course of action.

To learn more about scalp care, check out our guide to the connection between an itchy scalp and hair loss.

You can also explore prescription and over-the-counter hair loss treatment options available through our platform.