Why Does Your Hair Hurt? Derms Break Down the Potential Reasons

Hair pain may not be the most common topic of conversation when you're catching up with friends, but it is definitely a very real condition. Scalp tenderness can get pretty uncomfortable, and it can arise for a whole bunch of reasons, from simple things like oil buildup that occur if you're not washing your hair frequently enough, to more complex medical conditions like shingles.

To get a better understanding of hair pain, we spoke to dermatologists Morgana Colombo, MD, and Anna Guanche, MD, who filled us in on the most common causes of hair and scalp pain, the best ways to treat hair pain, and even how to prevent it. Keep reading to learn more.

What Can Cause Hair to Hurt?

If your hair hurts and you can't figure out why, here are some possible explanations:

Not Washing Your Hair Enough

If you don't wash your hair frequently enough (the specific recommendation ranges depending on your hair type), oils may accumulate and build up on your scalp, contributing to hair pain.

Wearing Your Hair Too Tight

Tying back your hair too tightly is not the greatest idea. "Tension or heavy weight on hairs can produce inflammation and pain," Colombo tells us. Unfortunately, hair pain isn't the only potential problem here: If you wear your hair pulled back too tightly for a prolonged period of time, this can also lead to hair loss, she says.

Migraines

It only takes one migraine to know that they're absolutely no fun to endure. Migraines cause many different types of pain, including dull or sharp pain throughout your scalp or even just in one area. "Patients with migraines may also have allodynia, where nerves on the scalp become hypersensitive to pain and minimal touch or pressure on the scalp will trigger significant scalp or hair pain," Colombo says. 

Hair Loss

If you're shedding a lot of hair, you might experience scalp or hair pain, especially at the crown of your head. This pain may also occur before the shedding begins, the dermatologists say.

Nerve Pain

Your scalp or hair may hurt if you have shingles or another condition that's causing nerve pain. "Patients will present with pain on the scalp in a localized area," Colombo says.

Inflammation

Dandruff and psoriasis are two inflammatory scalp conditions that can cause scalp pain, itchiness, and redness, Colombo says.

Folliculitis

Deep folliculitis is a skin condition, often caused by a bacterial or fungal infection, where hair follicles become inflamed and painful. Folliculitis might appear like a pink or red bump or pimple on the scalp.

Bacterial and fungal infections on the scalp are rare, but they can present as inflamed plaques that are pink, scaly, painful, or itchy, and may be draining pus, Colombo says.

Dermatitis

Dermatitis is a broad term used to describe skin rashes and irritation. Various forms of dermatitis can cause hair pain, including allergic dermatitis and irritant contact dermatitis. Dermatitis can arise as a reaction to hair dye or other hair products and can lead to inflammation, itching, and pain.

How Can You Treat Hair Pain?

For any sort of hair pain, it's a good idea to see a dermatologist to identify the root cause. Here are some different treatment options they may recommend to address your hair pain:

• If you have dandruff or psoriasis, Colombo suggests washing your hair with anti-dandruff shampoo at least once each week. Some options include Head & Shoulders, Nizoral, Neutrogena T/Sal, or Neutrogena T/Gel.
• If your hair pain is associated with a migraine, take an over-the-counter pain reliever. Ice packs can also help, Colombo says.
• Massage your scalp with tea tree or coconut oil for a soothing effect.
• If you have painful pimples on your scalp—aka folliculitis—Colombo recommends washing your scalp with an over-the-counter salicylic acid shampoo like Neutrogena T/Sal or a tea tree oil shampoo a couple times each week.
• If you suspect that you have a scalp infection, see your doctor. They may prescribe an antibiotic, antifungal, or antiviral medication.
  
• If your hair pain is from the way you're styling your hair, let your hair down for a while.
• Topical steroids may be prescribed to treat inflammatory conditions like seborrheic dermatitis or psoriasis, irritant dermatitis, and more rare conditions such as lupus, discoid lupus, or scarring alopecias, Guanche says.
• If you're experiencing flakiness and discomfort related to dandruff or psoriasis, over-the-counter cortisone lotion can be helpful, Colombo says. It may decrease inflammation and pain.

How Can You Prevent Hair Pain?

Here are some doctor-recommended methods for preventing hair pain:

• Avoid tight ponytails, tight braids, and extensions that put tension on your hair and scalp or leave your hair feeling heavy.
• Avoid harsh chemical hair treatments.
• If you're going to be outdoors for a long time, wear a hat to avoid sunburn.
• Keep your scalp clean by washing your hair at least once each week. If you have an oily scalp, dandruff, or psoriasis, you may need to wash your hair more frequently.
• Keep an anti-dandruff shampoo on hand if you're prone to psoriasis or dandruff.
• If you frequently experience migraines, try avoiding your migraine triggers. If you get a migraine, treat it right away rather than waiting until it becomes unbearable.

When to See a Doctor

"When more than two to three days have passed and topical remedies, over-the-counter pain relievers, and cool compresses haven't helped, or if there are visible changes to the skin of the scalp such as a rash, scabs, pustules, scales, swelling, and hair loss, then you should see your dermatologist," Guanche says.