Raechele Cochran Gathers, MD Sometimes scalp tenderness is minor, and goes away quickly. However, sometimes a tender scalp can indicate something more serious. While mild scalp tenderness can be caused by scalp irritation or certain hair styles, scalp tenderness can also signal some very serious conditions that should be addressed as soon as possible.
Seven Causes of Scalp Tenderness
1. Hair styling/traction alopecia
Tight hairstyles are a common cause of a tender scalp. Some of the biggest offenders are sew-in weaves that have been done incorrectly, or braids that are too tight. Even a tight rod-set or bantu knots can cause a tender scalp. Too-tight ponytails can also cause a tender scalp. As a general rule, if you notice that your scalp is tender during a hairstyle, change it immediately. Prolonged tension and pulling on the scalp can lead to hair loss called traction alopecia. Tenderness is your body’s way of letting you know there is a problem.
2. Irritation from products
When your scalp is being irritated by a product, it becomes inflamed. Not all products are made for everyone, and if you’re using something new, and suddenly develop an itchy or tender scalp, it’s time to stop that product until a doctor can evaluate you. Inflammation can be mild, causing just slight itchiness. But it can also be more severe, leading to tenderness and even infections of the scalp.
3. Seborrheic dermatitis
Seborrheic dermatitis is a very common condition, causing excessive scaling and dandruff on the scalp. It can also cause redness and tenderness of the scalp. Untreated, seborrheic dermatitis can lead to hair breakage and alopecia.
4. Discoid lupus erythematosus
Discoid lupus erythematosus (DLE) is a serious autoimmune disease that can lead to permanent scarring of the skin and scalp, and also cause permanent hair loss. In autoimmune diseases, the body, for unknown reasons, begins to attack its own tissues. People with DLE often notice tender areas of the scalp as a first sign of the disease. Looking closely, these areas may be darker or even reddish, but sometimes, the only sign is the tenderness. Sometimes people think that the tender spots are from a hair dryer burn or from the flat iron. These tender spots eventually become so inflamed that the hair falls out, and scar tissue can replace the hair. DLE can cause scarring on other areas of the body, especially in areas exposed to the sun, like the face. DLE can also be associated with systemic (body) lupus, which can be very serious and even deadly.
5. Infections
Scalp infections and folliculitis (inflammation of the hair follicles) can cause scalp tenderness. Sometimes, people develop infections in the scalp from certain bacteria or fungus that they’ve been exposed to. Certain hair-styling choices, like tight weaves or relaxer burns can also lead to inflammation and infection. These infections can make the scalp tender, and can also lead to hair loss and other serious medical complications. Also viral infections, like shingles, can affect the scalp and cause it to be tender.
6. Central centrifugal cicatricial alopecia
Central centrifugal cicatricial alopecia (CCCA) is the most common form of permanent hair loss in African American women. It is thought to be associated with hairstyles that cause chronic traction or pulling on the scalp. One of the first signs of CCCA can be scalp tenderness, especially at the crown. CCCA is important to diagnose and treat early, so that you have a better chance of avoiding permanent hair loss. One study reported that CCCA could be associated with uterine fibroids, a serious condition that can lead to excessive bleeding, loss of reproductive ability and other complications.
7. Autoimmune diseases & underlying medical problems
There can be many other causes of scalp tenderness. Sometimes, other autoimmune diseases like sarcoidosis, psoriasis, and dermatomyositis can appear in the scalp and cause tenderness. Certain types of migraine headaches, underlying vascular (blood vessel) problems and other conditions, including some cancers, can cause the scalp to be tender or hurt.
Conclusion
Scalp tenderness can be caused by a variety of reasons, some of them mild, and others that are quite serious and that can cause permanent hair loss or even be life threatening. Be proactive. If you’re experiencing scalp tenderness that isn’t going away, you should see your doctor.
