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What Are the Causes of a Sensitive & Painful Scalp?

author image Dr. Ann M. Hester
Dr. Ann M. Hester is a board-certified internal medicine specialist and author. She is also the creator of the Patient Whiz patient engagement app for iOS and Total en Salud health app in Spanish.
What Are the Causes of a Sensitive & Painful Scalp?
A young woman is sitting with her hand on her head. Photo Credit George Doyle/Stockbyte/Getty Images

Your scalp may become painful and sensitive for a wide variety reasons, ranging from common skin conditions and infections, to the physical irritation from scratching or harsh chemicals. Even neurological conditions, such as headaches, may cause scalp pain and sensitivity. Sometimes you can pinpoint the cause quickly and easily. At other times, however, the cause may be more elusive and/or require a doctor's evaluation.

Common Skin Disorders

Seborrheic dermatitis is a common skin condition that can lead to scalp pain and sensitivity. It can range in severity from a mild case of dandruff to a more full-fledged dermatitis with inflammation of the scalp, causing itching and scratching. This leads to worsening pain and sensitivity. Your scalp may look reddish, with tiny white or greasy scales. Psoriasis is another common skin disorder that frequently affects the scalp, especially near the hair line; it may occur with seborrheic dermatitis. Though these conditions differ, the same cycle of itching, scratching and worsening of the pain and sensitivity can apply to each.

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Chemical and Ultraviolet Damage

A wide variety of chemicals have the potential to irritate your scalp and cause pain and sensitivity. Although virtually any chemical can cause a sensitivity, harsh chemicals, such as hair dye, permanent wave solution and hair straighteners, are more likely to cause pain and sensitivity than shampoos, conditioners and other everyday products. The sun also can wreak havoc on your scalp, especially in spots that are not covered or protected by thick hair.

Infections and Infestations

If you notice itchy little bumps on your scalp, you might have an infection of your hair follicles, called folliculitis. Bacterial infections can develop secondarily, especially when the original skin condition is made worse by scratching. With head lice and ringworm, your natural response is to scratch. The more you scratch, the more likely you are to irritate your scalp.

If you have ever had chickenpox, the zoster virus, which causes chickenpox, sometimes re-emerges years later in a different form, causing a rash known as shingles. Shingles can involve your face and scalp and is often associated with pain and sensitivity, which may be present before the bumps even appear.

Neurologic Causes

Headaches can cause scalp pain and sensitivity. With tension headaches, you may feel like a there is a tight band around your head. With chronic migraines, your scalp may be unusually sensitive to touch, causing pain with even gentle brushing.
Headache from a condition known as temporal arteritis can involve the scalp. It is a medical emergency that may lead to vision loss. Symptoms include head pain at the temples and visual disturbance. A neurological condition called occipital neuralgia can cause a sudden sharp stabbing sensation in the back of the head near the neck and may be the result of past trauma in some instances.

When to Seek Medical Attention

In addition to any signs of a medical emergency, there are other warning symptoms that should be heeded. For a fever of 101 F or greater, immediately seek medical attention. Milder fevers could also indicate an infection and should not be ignored. Redness and warmth of your scalp may signify an infection called cellulitis. If you develop drainage or pus from your scalp, you should seek medical attention. If your vision becomes blurred or you lose sight in one eye, it could be the result of temporal arteritis which requires emergency medical treatment.

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