Raechele Cochran Gathers, MD Many of us suffer from scalp tenderness from time to time. If your scalp hurts, it could be because of any number of problems. Dandruff, scalp irritation, psoriasis, or even a hair style that’s too tight can cause your scalp to hurt. But there are also two less commonly discussed causes of scalp tenderness–CCCA and DLE– that all of us need to know about! These diseases can make your scalp hurt and can even make you lose your hair.
Why Does My Scalp Hurt?
When your scalp hurts, it’s a signal that there’s a problem—usually some type of inflammation—going on in your scalp. Inflammation can occur from many causes, including:
- Tight hairstyles/Traction
- Seborrheic Dermatitis/Dandruff
- Reaction to a styling product
- Psoriasis
- Inflammatory Disorders
- Infections
- Autoimmune Disease
- Malignancy
Most of the time, the cause of your hurting scalp and your scalp inflammation is nothing terribly serious, and can be treated with various topical products, which will eventually soothe your hurting scalp and stop the tenderness. If your scalp hurts and the tenderness is not going away, you need to see a doctor to make sure that nothing serious is going on.
Two Important Causes of Scalp Tenderness
Both Discoid Lupus Erythematosus (DLE) and Central Centrifugal Cicatricial Alopecia (CCCA) can cause your scalp to hurt. Besides causing scalp tenderness, both conditions can cause you to lose your hair permanently. The good news is this: Your hurting scalp can be treated, and If the conditions are caught early, your hair can usually be saved!
1. Discoid Lupus Erythematosus (DLE)
DLE is a type of skin lupus. It’s an autoimmune disease, which means that for some reason your body begins to attack its own cells and tissues. Unlike systemic lupus, DLE may not make you feel sick at all! Often, the only signs of DLE are tender and sensitive areas on the scalp. The areas where your scalp hurts may be discolored, brown or red, but if you’ve got a lot of hair, you might not be able to see that!
Besides tender areas on your scalp, people often develop DLE spots in areas that get sun exposure. In classic cases, you might also see discolored, brown or pink patches in the ears and on the face.
DLE
Not only can DLE make your scalp hurt, it can also lead to permanent scars, discolored areas and hair loss. Sometimes people with DLE mistakenly think that they had a curling iron or pressing comb burn that is just slow to heal. If you think that you might be suffering from DLE, be sure to see a dermatologist immediately!
2. Central Centrifugal Cicatricial Alopecia
Central Centrifugal Cicatricial Alopecia is a scalp disease with a big name. And unfortunately, it can cause big problems! Even though most people haven’t heard of CCCA, it’s actually the most common cause of permanent hair loss in African American women!
CCCA
CCCA is caused, in part, by inflammation in the scalp, which gradually destroys your hair follicles. It’s more frequent in women who’ve worn tight braids and certain weave hairstyles. In people with CCCA, a small patch of hair thinning usually starts right at the center of your scalp. Your scalp may hurt or be tender in this area. With time, this area of alopecia can grow to involve the entire top of your head. CCCA is the most common cause of permanent hair loss in African American women!
While people with CCCA can experience scalp tenderness, irritation and even tingling, some people with CCCA don’t notice any discomfort at all. Because CCCA can cause permanent hair loss, it’s super critical to catch it early! While a hurting scalp can signal CCCA, not all women with CCCA have discomfort. Be sure to read about the other signs of CCCA here.
Another reason to know about CCCA: It has been associated with uterine fibroids! Fibroids can lead to a bloated lower abdomen, excessive bleeding, pain, pregnancy complications, painful intercourse, loss of fertility and the need for costly and traumatic medical procedures. There are several treatments for CCCA, including steroid shots, that can be very effective. You can read more about how we treat CCCA in this post.
Conclusion
If your scalp hurts, it’s important that you take it seriously. While there are many common causes of scalp tenderness, there are also more serious causes—like DLE and CCCA—that disproportionately affect black women. If your scalp hurts, be sure to see a doctor. You might save your hair—and your life.
Featured Image CCCA: Herskovitz I and Miteva M. Clin Cosmet Investig Dermatol. 2016; 9: 175–181.
