Causes for a tender scalp range from those that are minor such as using
a harsh shampoo to those that
require medical care such as thyroid problems, infections and skin
conditions such as scalp psoriasis or seborrheic dermatitis. Related
symptoms can provide clues as to the cause such as hair loss pattern,
skin rash, flaking or lesions. Typically, the scalp
gets dry and itchy as the result of sores, bumps, blisters, flaking,
crusting and itching. Treatment depends on the underlying
cause. Be sure to see a Doctor is scalp tenderness is accompanied by
other symptoms such as headache, or if the condition worsens over
Tender Scalp Causes
The list of things that may cause tender scalp is quite lengthy, and
may include many of the following reasons:
During low humidity months, dry air can impact the
scalp causing symptoms such as itch. Treatment for this condition
includes purchasing an air humidifier and keeping a home at 68F.
Scarring Alopecia (also called Follicular degeneration syndrome, hot
comb alopecia, CCSA): This
condition starts with slowly increasing hair loss on the scalp crown or
top progressing to the front hairline, starting age 20 to 30. Symptoms
such as scalp tenderness and itch (pruritis) are also common.
The condition is seen more often in African American men and
women. Diagnosis is based on the appearance of the hair loss and
through a skin biopsy. Treatment is with prescription steroids.
While the exact cause is not known, it is believed that
excessive use of harsh hair care products and methods in the African
American community can lead to this condition.
Products and Shampoo: Overuse of hair care
products made with harsh chemicals
(e.g. sodium laureth sulphate) can destroy hair follicles and the oil
glands around them, also causing scalp pimples. Consider
to a mild shampoo and stop using hot water in favor of warm water.
Shampoos can lead to itch if it is removing essential oils
from the hair, causing dryness. Chemical stripping of your natural
sebum from the scalp by
shampoos affect pH balance.
Folliculitis (chronic or severe scalp folliculitis is called acne
necrotica): Scalp folliculitis when inflammation occurs at
the base of the hair follicle. The condition scalp folliculitis has
symptoms such as the formation of a number of small lesions or pustules
on the scalp. Other symptoms include itch. The condition can
be caused by mites, yeast and bacteria. Treatment is with shampoos which
contain ciclopirox or ketoconazole. Doctors may also use
antibiotics, steroid creams or antihistamines.
Necrotica (acne varioliformis): This condition is a more
severe form of scalp folliculitis. In addition to papules (pimples) on
the scalp, black crusts can form. The condition may also
appear on the face.
organisms show up when the sebum is stripped (e.g.
melassesia globbosa and pitysporum ovale) Yeast causes itchy, flaking
(fungal infection called Tinea Capitis): scalp
ringworm has symptoms such as a pink scaly rash with itch or hair loss
with no rash. It is highly contagious. The infected
area can ooze pus (kerion) if an individual is allergic to the fungus.
Scalp Ringworm is
caused by a fungus and requires treatment with some type of natural topical, topical
cream or shampoo
Source: CDC/Dr. Lucille K. Georg
Scalp Cellulites (perifolliculits): The
condition Dissecting Scalp Cellulitis is a form of folliculitis with
the formation of pustules (puss filled pimples) at the hair base. The
problem is caused by skin flakes (keratin) which do not fall away from
the skin properly. The result is scalp scarring and hair loss. Skin
lumps or bumps when pressed may yield fluid. This is a rare
condition. It tends to occur in African American men age 18
to 40. Treatment involves the use of antibiotics, removal of scars and
keeping the wounds infection free.
Tender Scalp due to Scalp
Cellulitis, a rare condition seen in African
Source: American Family Physician
contact dermatitis: this condition occurs when
the scalp comes in contact
with an irritating chemical
contact dermatitis: this condition results when the scalp
comes in contact
with something that causes an allergic reaction
infections (e.g. shingles, chickenpox)
shoulder, neck injuries (all our muscles are
The scalp conditions psoriasis and seborrheic dermatitis are
the most common
scalp problems evaluated by dermatologists and are often confused with
Psoriasis is often found on multiple body locations while seborrheic
dermatitis is found above the neck on the face and scalp. With
psoriasis, there is clear separation between diseased areas and the
scalp, whereas seborrheic scalp dermatitis, the lines between diseased
and healthy portions of scalp are blurred together.
Dermatitis: characterized by greasy
scales on scalp and face accompanied by itch. It occurs from clogged
sabaceious oil glands. Approximately 25% of all people will
have this problem at some time. It is believed to be
triggered by a fungus and is more often seen in individuals with young
immune systems such as infants or those with compromised immune systems
such as the elderly.
Psoriasis: Symptoms of scalp psoriasis include silvery
scales on the scalp and
body locations, usually the knees and elbows. It occurs when new
skin cells are generated faster than old skin cells fall off the body.
This is a process that normally takes 28 days, but in people
wiht psoriasis, new cells are produced and come to the skin surface in
as little as 4 days. These new cells bunch at the surface
causing scalp itch and scales.
Scalp Psoriasis Video
Source: Principles of Pediatric Dermatology
Tender Scalp Symptoms
causes of tender scalp can be seen, others cannot, but that does not
mean something isn’t wrong. They may include:
A spot near the crown being sore, extremely tender and
sensitive to touch
A spot right on top of the head that started out being
tender, but progressed to being painful over time
Shooting pain in other parts of the scalp (e.g. around or
by the ears, back and base of neck, forehead and upper facial areas)
There may be pain in the jaw area as well
The best rule of thumb when dealing with tender scalp is if it hurts,
get it checked out. Before you go to the doctor, consider what things
you know are not causing your tender scalp and tell the doctor that
when you see him. For instance, dandruff will not cause shooting pains
in your scalp. Think about who you have come into contact with in the
past few months and whether or not they had a scalp problem or had a
disease such as scabies.
Tender scalp (and at times hair loss) may happen for a variety of
reasons ranging from hairstyle to disease. This is why it is best to
visit a doctor or dermatologist for an accurate diagnosis in order to
treat your problem. Whether or not you require medication(s) to deal
with your problem or may be able to use herbal or natural remedies
depends on the reasons for your tender scalp.
Diagnosis of Tender Scalp
Diagnosis of tender scalp is usually done based on visual presentation,
based on skin scrapings and various other tests, depending on what the
doctor thinks may be the cause. For instance, if the doctor suspects
ringworm, he could do a scalp scraping or use a UV lamp.
Tender Scalp Treatment
Depending on the cause of a person’s tender scalp, the treatments may
be as varied as the causes. Simple steps include stopping the
use of hair products such as gels. Avoid shampoo ingredients that
remove natural moisturizing oils from the scalp such as sodium lauryl
sufate and sodium sulfate. For itch, try an over the counter
product such as Scalpicin.
If scalp tenderness does not respond to over the counter treatments, be
sure to see a Doctor.
At home symptom specific tender scalp treatments include:
Natural Hair Loss Scalp
Essential Oils: Combinations of essential oils such as
chamomile, rosemary, sage and avocado when massaged into the scalp can
support hair growth. Oils are available in products such as ReGrow
Scalp Massage Oil. This can be a helpful approach when recovering from one of the skin conditions mentioned or to retain the hair you have.
Sore Scalp Treatment:
Neem oil: Mix with shampoo to help scalp soreness.
Add 15 drops to shampoo.
Scalp itch is either caused by dry skin or yeast buildup
due to the
buildup of dead skin cells (also called dandruff, the condition is
referred to as pityrosporum), To treat, use a dandruff shampoo
that contains ketonconazole. A good choice is Nizoral A-D.
Scalpicin drops or wipes are a medicated over the counter
product that can help ease itch from minor causes such as dandruff.
Fungal Conditions such as
Ringworm can usually be effectively treated with natural remedies,
natural soaps, over the counter fungal creams, shampoos or essential
oils. This includes:
Natural Ringworm Remedies: A topical treatment such as Dermisil
uses plant extracts to treat ringworm.
Medicated Soap: Soaps such as Dermisil
Ringworm Medicated Soap that contain ingredients such as Palm
Kernel and Coconut Oil and Lavendar can help to eliminate
Ringworm on the body.
Tea tree oil: Create your own tonic by mixing warm water
with 15 drops of oil. Massage into scalp.
Medicated shampoos or anti-fungal creams, such as NIzarol
A-D, Selsun Blue or Zincplex. Look for ingredients such as terbinafine,
clotrimazole, miconazole or ketoconazole. See a Doctor if over the
counter medications do not work.
Scalp Psoriasis Treatment
Shampoos that contain ketoconazole (2%), tar or zinc are
rotated. If these do not bring relief, then a Doctor will
prescribe short term use of topical coritcosteroids or a mild steroid
oil such as fluocinolone oil (Derma-Smoothe/FS scalp oil).
Once the steroids are no longer needed, shampoo will be used to control
the problem. The condition will be controlled in 1 to 2 weeks.
Similar to treatment for scalp psoriasis, with more
emphasis on anit-fungals such as shampoos that contain ketoconazole and
zinc. A common topical foam used to treat seborrheic
dermatitis is a foam is called Extina
(ketonconazole based). If this doesnt' work, other topical
immunomodulatory drugs are available such as Protopic ointment and
Scarring Alopecia (also called Follicular degeneration syndrome, hot
comb alopecia, CCSA)
As mentioned above, this tender scalp causing condition is
thought to be caused by changes in scalp condition due to the use of
harsh hair care methods (hot combs) and products. Therapies
include the use of prescription steroid products and discontinuation of
those hair care products that may have triggered the condition.
Other Scalp Therapies:
Natural Remedies such as Nat mur, Kali mur, Kali sulph and
Galium are homeopathic ingredients that support healthy skin and
healing. A natural remedy such as Skin Dr. can be used along with
prescription products recommended by your Doctor.
Aloe vera gel
As mentioned scalp tenderness can be due to minor or major issues.
Be sure to see a Doctor if tender scalp issues
do not improve or if they cause pain.
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