Scalp soreness driving you nuts? Here’s what’s going on

It's understandable if losing your hair makes you feel down. But what if losing your hair physically hurt, too?

According to a National Institutes of Health study, up to 50% of men experience androgenetic alopecia, or male pattern baldness, by age 50 [1]. Women are also at risk, with 49% of women experiencing some level of hair loss during their lifetimes [2].

Sometimes, hair loss is the least of your worries, though. If you’re a bad luck charm, you might also have other conditions alongside it, with trichodynia, or burning scalp syndrome, being one of the most debilitating. So, if your scalp feels like an ongoing bushfire, here’s what it’s all about.

What is trichodynia?

Trichodynia might accompany your hair loss, and it can be incredibly uncomfortable. Whenever anything touches your scalp, it feels like a burning, crawling, or itching sensation. The greater the contact, the worse the pain. It's important to note that it's not a regular part of losing your hair.

Sadly, it’s something that’s not been studied to any great extent, which is why you won’t find much scientific study about it online. According to one of the more recent studies, 35.7% of people with hair loss conditions had some level of trichodynia, with it being more common in women [3].

On a side note, it’s not the same as conditions like scalp dysesthesia or cutaneous dysesthesia syndrome. These are similar conditions, but they’re typically localised to the scalp skin, whereas trichodynia syndrome also hits the hair itself [4].

Once again, it’s not normal, and it’s usually linked to other conditions. This isn’t a condition that goes away just by changing your brand of shampoo.

Is trichodynia scalp pain real? 

Trichodynia has studies showing that it exists, so it’s undoubtedly a thing, but some have argued that it’s a side effect of other conditions, rather than a syndrome in its own right. To this day, we still don’t know why studies have shown that females are more likely to have it than men.

Some have argued that it’s something that’s all in your head, with men more mentally prepared for going bald compared to women. After all, women usually tie their identities more closely to their hair than men do. Others have hypothesised that it’s because of differences between the genders in how they process pain.

It’s real and it’s not just in your head, but the lack of literature means treating the problem is still a big challenge for medical professionals.

What are the symptoms of trichodynia?

The most common trichodynia symptoms are burning, itching, and painful sensations on your scalp and in your hair. Some people might also see red patches on the scalp, which is caused by diffuse erythema, or a dilation of the blood vessels. 

It’s pure inflammation, but trichodynia isn’t always linked with swelling, redness or flaky skin. That’s why doctors have to rule out other skin conditions first [5]. Could it be due to the hair products you use, such as hair dye or shampoo?

Generally, no, but they can confuse diagnosing the symptoms. Examples of conditions relating to hair products causing an itching or burning scalp include:

• Lupus
• Dermatitis
• Folliculitis decalvans
• Scarring alopecia 

In short, trichodynia is difficult to prove via symptoms alone, which is why your doctor will usually go through a process of elimination to get there.

What causes trichodynia?

Trichodynia’s status as a syndrome means we don’t really know what causes it. All we have are correlations that could point us in the right direction.

For example, what we do know is that people with scarring alopecia, which is an inflammatory disease with symptoms like pain and scarring, do have it more often than other groups [6].

Some causes that have been floated include:

• Neurological disorders: Some have hypothesised that it could be due to neuropeptide substance P, a neurotransmitter that modulates pain. When contorted, it reduces your pain threshold. It’s why we’ve seen similar conditions like scalp dysesthesia paired with issues like multiple sclerosis.
• Psychiatric disorders: Many patients with trichodynia syndrome also have underlying psychiatric disorders, with a study showing that around 1 in 3 of their group had both trichodynia and depression [7]. And, today, around 16% of Australians suffer from some form of depression or anxiety disorders [8]. Of course, it doesn't have to be a diagnosed condition. Sometimes, poor stress management could be to blame.
• COVID-19: Believe it or not, COVID-19 has also been linked with hair loss, with some cases being linked with a hair loss condition called telogen effluvium. One study found that 66.3% of COVID-19 patients studied also had telogen effluvium, and 58.4% had trichodynia [9]. It’s a flimsy connection, but one worth looking at.

As it stands, all we have are options for exploration. It’s such an uncommon condition that it hasn’t been thoroughly researched, even though we’ve known about it since at least the 1960s.

Does trichodynia cause hair loss?

Trichodynia isn’t something that causes hair loss, but it accompanies other conditions that do cause hair loss. These include:

• Cicatricial alopecia
• Telogen effluvium
• Scarring alopecia

An examination into patients suffering from hair loss found that only 29% of patients reported hair pain that would later be diagnosed as trichodynia. However, the study concluded that there wasn’t a direct link between the condition and hair loss [10].

Can you get trichodynia without hair loss? 

It’s perfectly possible to have a burning or itchy scalp without losing your hair. Some people have been diagnosed with trichodynia even though they don’t have any active hair loss condition.

Let’s go back to the definition of the condition. It’s nothing more than a burning, itching, or crawling pain in the scalp and hair. At no point does the accepted medical definition reference hair loss.

Does trichodynia go away on its own?

Trichodynia isn’t something that appears for no reason. There’s always some form of underlying cause that triggers it.

Ignoring it and hoping that it goes away isn’t a plan that’s going to bear fruit. If you try to ignore it, the chances are the pain will stay as it is or it will get worse over time. Generally, it’s not something that goes away with hope and faith.

Is trichodynia a permanent condition?

Trichodynia doesn’t have to be a permanent condition. It all depends on what the underlying problem is. If that’s treatable, doctors can work to remove the trigger for trichodynia, which will cause your symptoms to improve, if not disappear.

How to treat hair loss

Treating hair loss and treating trichodynia aren’t the same things. Most people who have the syndrome also have a condition relating to hair loss. Treating the hair loss may also have the knock-on effect of treating your trichodynia if the triggers are the same.

So, what are your options for dealing with hair loss?

Clinical-strength treatments

Clinical-strength treatments, like the one Pilot offers, are designed to address hair loss head-on.

Pilot's clinical hair loss treatment is tailored to your individual hair concerns, and with online consults with an Aussie practitioner, you can get to the root cause of your hair loss. From here, your Pilot practitioner will create a customised treatment for you.

Your formula is delivered discreetly to your door, and you can access unlimited practitioner follow-ups if and when you need them. And the results speak for themselves: 90% of men on either kept or regrew their hair when using one of the treatment options Pilot can provide.

Red light therapy 

Low-Level Laser Therapy (LLLT), better known as red light therapy, uses lasers on the red light wavelength to stimulate hair follicles. Some patients who have undergone the full treatment have seen their hair thickness and density improve.

The science behind it relies on the activation of a special enzyme called cytochrome c oxidase, which is found in the mitochondria of your cells. By stimulating it via lasers, your cells produce more energy, which can improve blood flow and stimulate growth throughout your hair follicles.

Your mileage may vary on this one, with one study finding that just 35% of men said that they’d experienced hair growth [12].

Hair transplants

Hair transplants are by far the most effective option for getting your hair back. The problem, if you’ve got advanced hair loss, is that it’s often too late for many treatment options. Thus far, nothing can compete with a hair transplant because it restores your hair follicles by transplanting follicles from a donor area to where you’re going bald.

As a permanent hair restoration solution, whether you’re using Follicular Unit Extraction (FUE) or Follicular Unit Transplantation (FUT), success rates have been pegged by clinics and scientists alike as anywhere from 80% to 90% [13].

Regrowing your hair is possible 

Trichodynia might not be the cause of your hair loss, but it’s certainly rubbing salt into the wounds. While treating the underlying trigger may cure it, it usually won’t bring back your hair. For hair restoration, you need targeted treatments to restore thickness and density.

Every journey starts with consulting a medical professional. Working with Pilot gives you access to qualified Aussie medical practitioners and proven hair loss treatments. Start targeting your hair loss by getting in touch with a professional today.