Sensitive scalp: How to identify scalp pain and tenderness

If you've noticed a new shampoo making your head burn, or your head feels itchy for no reason you can think of, you could be suffering from scalp tenderness. A sensitive scalp can cause discomfort and be distracting during your daily routine.

Scalp tenderness is a common concern, with around 60% of women and 40% of men having sensitive scalps. Reasons for scalp pain can vary greatly. This can be linked to several medical conditions, ranging from dandruff to infection. If skin is severely sensitive, it may mean that the scalp is hypersensitive – which can be alleviated with proper care.

Though your skull is hard, your scalp is actually quite tender, so it's not uncommon for this area to feel itchy or sting. Your scalp has more blood vessels than any other area of the body, as well as many nerve endings, so a sensitive or hypersensitive scalp can cause significant discomfort.

Symptoms of a sensitive scalp can include burning, tingling, pain, numbness, throbbing, itching and redness. Your scalp may also simply feel tight and itchy. Usually there aren’t any visible symptoms, but sometimes a tender scalp leads to peeling or flaking of the skin.

Scalp sensitivity varies according to a person's scalp characteristics. This can be more frequent and intense in those with dry or greasy scalps. People with scalp tenderness also tend to have sensitive skin in another area.

If your symptoms are severe you may have a hyperreactive scalp. Whether you have a mild or extreme case, it’s important to consider what factors may be causing the sensitivity in your scalp.

Shampoo is one of the main causes of scalp sensitivity for many people. The harsh cleansers or surfactants in many shampoos can wash away the scalp’s acid mantle – the natural acidity that protects your skin – leaving it susceptible to dryness and irritation.

Exposure to certain climatic conditions (e.g. sun, cold, heat, wind), pollution or stress can also cause you to experience sensitivity in the scalp area. Considering these and other factors will help you determine why your skin is so sensitive and how to best improve its condition.

Some people report having a hypersensitive or sensitive scalp after receiving treatment for skin conditions such as atopic dermatitis or psoriasis. Atopic dermatitis is a common condition associated with general inflammation of the skin, and can affect the scalp. Symptoms include swelling, flakes, crusts or blisters.

Scalp pain is also linked to many forms of headaches, especially ones that involve the nerves that run from the back of the neck to the forehead.

Other causes of a tender scalp  include:

• Regularly using hair dye and hair relaxers - treatments that bleach, colour or straighten hair can cause scalp tenderness
• Chemicals in soap, cosmetics, water, some drugs and pollution
• Sun burn - if you have thin hair, or none at all, the skin on your head is more susceptible to burning, increasing the risk of solar keratosis
• Infections of the hair follicles
• Tight headbands, hair styles and helmets
• Hormonal changes – e.g. pregnancy, menopause, menstrual cycle
• Food allergies or sensitivities

When your skin’s natural protective barrier is disrupted by one or more of these factors, microinflammations of the scalp can also become a leading cause of increased sensitivity. They occur when the skin cells in your scalp become inflamed, making it more vulnerable to irritation.

What are microinflammations? They’re mild inflammations of the skin. They’re so mild, in fact, that even clinical testing won’t pick them up. But if we study skin tissue encountering  microinflammations, we can detect the presence of inflammatory immune cells – in other words, the skin is responding to irritation with inflammation and thereby attempting to repair  itself. If these skin cells are then subjected to further irritation, the skin can flip into a “true” inflammatory response.

How are they related to scalp conditions? There’s growing evidence that microinflammations of the scalp are involved in most common scalp disorders - from thinning hair and dandruff, to scalp dryness, itchiness and sensitivity.

Scalp pain can also be worsened or triggered by hair loss. If you experience sudden hair loss or brittle hair, you may have an underlying health problem such as thyroid disease, iron deficiency, or an autoimmune disease. Some medications can also cause hair loss. Contact a doctor if you are at all concerned.

Using a shampoo for sensitive scalps, washing more carefully and brushing your hair gently are all ways to treat a tender scalp. Eucerin DermoCapillaire Calming Urea Shampoo and Eucerin DermoCapillaire Calming Urea Scalp Treatment have been developed to give your scalp the gentle cleaning and care it needs.

To ease scalp pain, ibuprofen or similar over-the-counter medication can relieve inflammation or headaches. Essential oils, like rosemary or lavender, can help heal sores that may be the cause of scalp tenderness once diluted.

In many cases, conditions causing scalp tenderness will go away without treatment. However, there are some steps you can take to treat a sore scalp:

• gently massage the scalp with your fingertips in circular motions (make sure your nails aren't too long)
• apply ice in 10-minute intervals
• use tools to manipulate the scalp, like a massager or scrubber
• slowly let down hair that has been held in a tight position for a long time

Your scalp reacts badly to many shampoos or hair products: These often contain harsh cleansers or chemicals. 

You’ve recently been exposed to one or more of the major causes listed above: Especially if your symptoms developed soon afterwards.

You have red, scaly, silvery-looking patches on your scalp: You may have Psoriasis.

Your scalp is extremely itchy: You may have a dry and itchy scalp.

You have white flakes or yellow scales on your scalp and hair. You may have dandruff or seborrheic dermatitis.

If the treatments outlined above do not relieve scalp irritation, your symptoms are severe, or your scalp becomes inflamed, weepy or sore, your doctor may prescribe stronger medication or a special shampoo.

Vinegars, natural oils and drinking eight glasses of water a day are among the natural remedies that have been claimed to treat a sensitive scalp. Although drinking enough water is good for your overall health, it won’t treat scalp sensitivity on its own. There is also no evidence to support the effectiveness of the other remedies listed here.