Experiencing a burning sensation on your scalp accompanied by hair loss can be naturally concerning. Your first thought might be that you are suffering from some common scalp problem or an allergic reaction. That may very well be true, however, it may not necessarily be the case.
There are multiple dermatological, neurological, autoimmune or environmental conditions which could produce these symptoms. But, in some cases, the issue is rooted in psychological distress, rather than a physical illness. It is the case of trichodynia, also known as burning scalp syndrome.
This syndrome of complex origins is twice as common in women as it is in men [1] [2] and it is associated with chronic stress, anxiety and depression [1][2]. It is encountered in about a third of people who are experiencing hair loss due to telogen effluvium and androgenetic alopecia (male/female pattern baldness) [1] [3].
The good news is that in most cases, conditions which cause burning scalp and hair loss are treatable (or at least manageable). And more often than not, your hair is likely to grow back with proper treatment, once the root cause of the issue is under control.
This article will tell you more about:
If you are experiencing a burning sensation on your scalp accompanied by hair loss, it is ideal to share your symptoms with a dermatologist or trichologist (hair specialist) and get a proper diagnosis. That is because, left untreated, your condition could get worse and lead to further hair loss.
However, if that is not possible at this time or your appointment is still some time away, here are some of the most common scalp conditions and the symptoms you should look out for:
If you notice no physical changes to your scalp and aren’t aware of any pre-existing medical condition which could be causing your scalp burning and hair loss, your symptoms might have a psychological root.
Burning scalp syndrome, also known as trichodynia, is sometimes encountered in people who are experiencing hair loss, especially due to telogen effluvium and androgenetic alopecia (male/female pattern baldness)
Burning scalp syndrome consists of a constellation of symptoms which can affect your scalp, alongside hair loss: pain, tenderness, itching, tingling, burning, and/or increased sensitivity to pressure [1]. These can be diffuse and occur all over your head or they can be limited to certain areas and are typically worsened by pressure.
While different people experience this condition differently, the strength of the symptoms is usually proportional with the intensity of their hair loss.
Burning scalp syndrome has been reported most frequently in women with diffuse thinning, especially in those who are experiencing hair loss due to telogen effluvium. Telogen effluvium is not a scalp disease, but an interruption of the hair growth cycle as a response to extreme stress or trauma.
While trichodynia can sometimes cause reddish patches on the skin, due to vascular dilatation, more often than not, it shows no specific scalp modifications.
While researchers believe it is influenced by a multitude of factors, the exact causes of burning scalp syndrome are not yet fully understood by the scientific community. Some scientists have theorised that it is the result of hair follicle inflammation or of an autoimmune response, but there was not sufficient evidence to confirm this [2].
Nutritional deficiencies (e.g. vitamins B12, E and D, folate or zinc) were also suspected to contribute to this problem, but a study conducted on 91 patients with diffuse hair loss and 74 healthy controls revealed no evidence to support this [3].
Ultimately, the most compelling scientific explanation is that psychiatric disorders, such as depression, anxiety, chronic stress and obsessive compulsive disorder are the main factors which contribute to burning scalp syndrome [1] [2] [3]. According to this theory, the syndrome accompanies telogen effluvium and androgenetic alopecia because both of these conditions are influenced by mental distress and they can, in turn, produce further stress for those who face them [4].
The connection between anxiety and hair loss is long documented, just as it is known in the scientific community that depression can cause hair loss. But we are just beginning to understand the way in which these psychiatric conditions affect our experience and interpretation of physical sensations.
Psychological distress seems to play a significant role in our perception of pain and it can make us experience distressing symptoms with little to no underlying physical causes.
This does not mean that the burning pain sufferers are feeling is not real, it only means that due to their psychological condition, they may have a lower threshold for pain and may process sensations differently than those who do not.
Hair loss after Covid-19 has been previously documented, but recent evidence shows that burning scalp syndrome can also be brought on by an infection with this viral disease.
A study [5] performed in 2021 on a sample of 128 former Covid-19 patients with hair loss revealed that a majority of them (58.4%) developed trichodynia. Most started having symptoms during the first month after infection, usually as soon as one or two weeks after diagnosis. In many cases, they also showed signs of telogen effluvium, which points to a stress-related cause for their hair loss.
Researchers believe that even though Covid 19 has been known to produce a variety of neurological symptoms, trichodynia may be a result of the sheer mental distress and anxiety of being sick with a potentially lethal virus and living through a global pandemic [5].
The good news is that in about half of former Covid-19 patients who experienced this syndrome, symptoms only lasted for 4-5 weeks before regressing [6].
While any adult with hair loss can experience Burning Scalp Syndrome, women are significantly more predisposed to develop this condition than men.
A study [7] conducted on 403 patients with hair loss revealed that 20% of the women and 9% of the men were experiencing trichodynia. Researchers explain this through gender-related differences in pain perception and in the prevalence of anxiety.
They also considered the fact that women in their study samples usually had longer and thus heavier hair than men, which might have altered their scalp sensations [1].
Another study [3] performed on 91 patients with diffuse hair loss revealed that while overall, 33% of the subjects reported trichodynia, this was a significantly more common complaint among patients who were experiencing telogen effluvium than those with androgenetic alopecia.
This might be due to the fact that the former is generally stress and trauma induced, which is the same mechanism that can cause burning scalp syndrome.
Finally, since it is likely that trichodynia has psychological and psychosomatic causes, people who suffer from certain mental health conditions, such as depression, anxiety, chronic stress or obsessive compulsive disorder are most likely to develop it [3].
There is no conventional treatment available at this time for burning scalp syndrome.
Most medications that were proposed in time for it (e.g. steroid creams for hair loss, vitamin supplements, etc.) relied on insufficiently proven or since-disproven theories regarding the causes of this condition and presented weak clinical support [1].
The most reliable way to relieve the symptoms of trichodynia is to reduce stress and treat any associated psychiatric disorders (anxiety, depression, etc.) which might be contributing to it.
Burning scalp syndrome does not cause hair loss, even though it sometimes accompanies it. While the intensity of the painful symptoms is, indeed, proportional with the intensity of hair shedding, studies have not found one to cause the other.
In some cases (especially in patients experiencing telogen effluvium), they can both be brought about by the same underlying psychological or psychiatric condition, such as chronic stress, anxiety or depression.
So if you have noticed that your hair has been falling out more than usual, it is important to find the root of the issue.
However, scratching or rubbing your scalp forcefully and repeatedly in an attempt to alleviate your symptoms can lead to hair breakage at the crown, which could contribute to your hair loss problem.
As previously mentioned, burning scalp syndrome does not cause your hair to fall out so reducing hair loss can be achieved in the same way you would if you did not experience this condition:
The duration of the hair loss encountered in people who experience burning scalp syndrome depends on its root source. In some cases, it is easily reversible, in others, it may require treatment.
If you are losing your hair because of telogen effluvium (the most commonly associated with trichodynia), it should be easy to regain the hair loss from stress. As soon as you manage to diminish the psychological pressure you are under and your mental status improves, you should start to also see improvement in strand density, as your hair growth cycle resumes.
However, if you are experiencing hair loss due to androgenetic alopecia, you may need to use hair growth treatment, such as Minoxidil or Finasteride in order to see regrowth. Even so, if you are in the later stages of male pattern baldness, you may not benefit sufficiently from drug therapy alone and could require a hair transplant to increase hair density.
Hair growth is normally painless and should not cause a burning sensation on a healthy scalp. If you are experiencing discomfort, it is much more likely to be due to a medical condition. It is a good idea to see a dermatologist or trichologist if you are experiencing burning, itching, tenderness, redness, swelling or pain on your scalp which will not go away on their own in a few days.
If you have recently spent time under the hot sun without wearing head covering, it is possible that your scalp has suffered mild burns. Just like any other part of your skin, it can be affected by UV radiation unless specifically protected against it.
Although hair thinning is not a common effect of sunburn, summer hair loss is greater in comparison with other seasons, as the heat and dry air cause your hair to become brittle and easy to break.
Common symptoms of sunburn: redness, burning sensation, pain and tenderness of the scalp, small fluid-filled blisters
Hair products such as bleach or hair dye contain harsh substances (e.g. hydrogen peroxide, persulfates, alkalizing agents, etc.). If left on your scalp for too long, they can result in chemical burns which are similar in symptoms with sunburns. Bleach and hair dye can cause hair loss as well if they are overused.
Common symptoms of chemical burns: redness, swelling, burning sensation, pain and tenderness of the scalp, weeping sores.
Repeatedly tying your hair too tightly in ponytails can cause hair loss over time, sometimes accompanied by a tingling or painful sensation to your scalp. Using heavy extensions can cause hair loss as well if worn for a prolonged amount of time. The reason for this is that they pull on your scalp, leading to traction alopecia.
Common symptoms of mechanical tension: hair loss and thinning around the temples and hairline, tenderness, pain, burning or tingling of the scalp.
If you have hit or scraped your scalp, lesions or bruises may not always be visible, as they are hidden by the hair. However, you may experience a tender or burning sensation radiating from the injured spot. Properly disinfecting any laceration to your scalp is important in order to prevent infection.
Common symptoms of scalp trauma: localised redness, bruising or swelling of the injured spot and tenderness of the surrounding skin; bleeding or oozing lacerations
Several conditions, such as diabetes, Sjogern’s syndrome or stroke, can damage the small nerves of your scalp [8]. This can produce a burning or tender sensation which does not improve with topical treatment. However, only a small portion of scalp burning is neuropathic in nature.
Common scalp symptoms of small fibre neuropathy: tingling, burning, tender, numb or itchy scalp, with no visible alterations to the skin.
Caused by damage or pressure to the trigeminal nerve at the base of the brain, this disorder causes sudden bursts of intense pain to one side of the face. While it is not restricted to the scalp, it can involve it, alongside your cheek, jaw, lips,eyes, nose or forehead. An attack typically lasts between a few seconds to minutes [9]. While very painful, trigeminal neuralgia is quite uncommon in the general population.
Common scalp symptoms of trigeminal neuralgia: sudden, intense, shooting, stabbing or burning pain to one side of your face and scalp.
This chronic disease of the central nervous system causes permanent deterioration to the nerves. This can produce a multitude of neuropathic symptoms, including scalp burning or tingling if the nerve endings in the area are affected [10] .
While multiple sclerosis can indeed cause scalp symptoms, it is an unlikely diagnosis if your burning scalp is not associated with its other, more common manifestations (e.g. muscle spasms or weakness, numbness or tingling in the limbs, fatigue, headaches, etc.). It is also a rather rare condition, affecting only 36 in 100.000 people.
Common scalp symptoms of multiple sclerosis: burning pain, tingling, shocking sensations or numbness of the skin on the entire skull or on limited areas of it.
Normally, your skin epidermis regenerates every 3-4 weeks, but in people with psoriasis, it does so much faster: every 3-4 days. This leads to build-ups of excess dead cells which look like a thick, crusty, white deposit on your scalp. If you have this condition, your hair may fall out temporarily in patchy areas during a flare-up, especially if scratched.
Common scalp symptoms of psoriasis: thick, inflamed bald patches, dandruff-like silver-white flakes/scales, burning, itching and soreness of the scalp, bleeding due to cracked or scratched skin [11]
Found predominantly in women, this inflammatory auto-immune condition causes muscle weakness and a distinctive, reddish-purple patchy skin rash. When it involves the scalp (as it happens in 63-82% of patients), it can cause hair loss accompanied by an intense burning and itching sensation [12].
Common scalp symptoms of dermatomyositis: intense burning and itching of the scalp, diffuse alopecia (non-patterned hair loss), a red-purple skin rash, skin scaling.
Caused by an autoimmune response, this condition leads to skin inflammation. With certain varieties of the disease (especially cutaneous lupus), thick, disc-shaped scaly patches, rashes or sores can appear on the scalp (as well as other parts of the body).
They may be accompanied by local discomfort such as pain or burning. The relationship between lupus and hair loss has been scientifically documented [13], as both scarring and non-scarring alopecia (baldness) can develop in time.
Common scalp symptoms of lupus: disc-shaped sores or lesions, pink, raised scaly patches, scarring or dark spots on the scalp, local tenderness, pain or discomfort.
These skin conditions are caused by excessive production of sebum (an oily secretion) from your hair follicles. Accumulated deposits of this substance irritate and inflame on your scalp. A less common but more severe condition called seborrheic dermatitis can cause hair loss alongside its other symptoms.
Common scalp symptoms of dandruff/seborrheic dermatitis: flaky/scaly scalp, itchiness, tenderness, pain, redness, inflammation or rash, hair loss
This type of eczema typically occurs in people with a sensitive skin and who are also prone to allergies and asthma. It is often genetically inherited and researchers believe involves a less effective skin barrier [14]. Patches of dry, itchy skin can appear anywhere on the body, including the scalp and vigorously scratching them can lead to patchy hair loss [15]
Common scalp symptoms of atopic dermatitis: thick patches of very itchy, inflamed, cracked or flaky skin, scalp tenderness and pain, patchy hair loss.
Infections with fungus such as ringworm (tinea capitis) can occur in anyone, but especially in people with a weakened immune system.
They are usually caught through direct contact with the scalp of another infected person, but also through sharing hair-styling instruments, hats or clothes with them [16].
Ringworm can cause your scalp to become inflamed and lead to patchy bald spots.
Common scalp symptoms of ringworm: Round, scaly bald spots with small black dots on your scalp, pus-filled lesions (kerions), redness and swelling, severe itchiness, tenderness, pain.
This condition is frequently caused by bacterial infection or by blocked or irritated hair follicles. Some people can get folliculitis after a hair transplant, if the aftercare is not appropriate or the grafts were not handled and placed correctly. It manifests with inflammation and painful, itchy pustules similar to pimples which form around the follicles.
Common scalp symptoms of folliculitis: red, painful pustules at the root of your hair that crust over in time, scalp burning, tenderness and itchiness.
Also known as contact dermatitis, an allergic reaction occurs soon after your scalp is exposed to certain irritating substances (allergens) found in hair products or in the environment.
Depending on how allergic you are to them, reactions can range from mild (scalp inflammation, redness, minor swelling) to severe (extreme swelling, difficulties breathing or even anaphylactic shock).
This is why it is a good idea to always test the products you use on your hair on a small patch of skin before applying them. Contact dermatitis is temporary, meaning it can last from hours to weeks, depending on your immune system and the allergen you were exposed to.
Hair tests for allergies aren’t usually accurate, so ask your GP for reliable allergy testing if you’re concerned.
Common scalp symptoms of allergic reactions: scalp inflammation, swelling,redness, itchiness, tenderness and/or burning, in some cases temporary hair shedding from affected areas.
Regardless of the type of disorder that made your scalp burn, your best bet in alleviating the symptoms is to treat their underlying cause.
Most of the conditions which result in painful, itchy or burning sensations can be treated or managed under the guidance of a medical specialist. And more often than not, the scalp discomfort will diminish or disappear entirely once its cause is removed or under control.
However, if you are looking for quick temporary relief for your symptoms, you can try the following:
Whenever possible, it is a good idea to see a doctor if you are having any kind of scalp discomfort which does not improve on its own in a few days. The following symptoms generally warrant an appointment with your healthcare provider:
While most scalp conditions are not dangerous to your health and a regular doctor’s appointment will suffice, contact emergency services immediately if you have any of the following symptoms:
If you are experiencing burning scalp and hair loss but are not sure why this is happening, it’s a good idea to get diagnosed as soon as possible. Putting it off can lead to a worsening of your condition and to further damage to your hair, which will be harder to treat and reverse.
To make sure your scalp is in good hands, book a consultation today with one of the world-class hair specialists at the Wimpole Clinic. They will use state of the art equipment to diagnose any scalp disorders and run hair loss blood tests to learn the true cause of your shedding.
And whatever the root of the problem may be, they will recommend the best female hair loss treatment which is tailored to your particular hair and scalp needs.
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