Migraines, headaches, and autoimmune disorders can cause scalp pain, irritation, and inflammation. Sunburns, rashes, wounds, and insect bites also commonly cause scalp tenderness.

Most diagnoses of scalp tenderness clear up on their own or with medication, but some are signs of an underlying condition.

Scalp tenderness may include pain, inflammation, tingling, numbness, irritation, itching, throbbing, and stinging. People may experience several symptoms together.

Some scalp tenderness is caused by conditions affecting the blood vessels, nerves, and tissues below or surrounding the scalp.

Often, there are no visible symptoms. Other times, scalp tenderness is painfully obvious, involving skin peeling, flaking, and scaling.

Studies on scalp sensitivity estimate the prevalence in the general population to be 25–70%, meaning that symptoms are fairly common. Scalp tenderness can accompany common conditions such as headaches, allergies, psoriasis, eczema, and hair loss.

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The following sections describe some possible causes of scalp tenderness and sensitivity.

Skin conditions

Scalp tenderness may occur with skin conditions, such as:

  • rashes
  • sunburn
  • insect bites
  • head lice
  • psoriasis
  • eczema

Many of these conditions cause inflammation, pain, tenderness, skin flaking, and peeling, and can even make the scalp pus or bleed.

Dandruff affects skin areas where natural oils collect. It can cause red, scaly patches on the scalp. While not a sign of poor hygiene or disease, many people seek treatment out of irritation or embarrassment. Rarely, dandruff can also be caused by fungal infection or ringworm.

Scalp psoriasis can lead to scalp tenderness and flaking or crusting skin. Unlike dandruff, the skin is dry with a silvery sheen. Stress, hormones, dry air, or cold weather can trigger psoriasis.

Lichen planus can also cause the scalp to flake or scale. This condition is also usually brought on by periods of stress or as a side effect of medical treatments.

If extreme, many of these conditions can lead to reversible hair loss.

Occipital neuralgia

Scalp tenderness can be a symptom of occipital neuralgia, which involves the occipital nerves that run from the back of the neck to the forehead.

Occipital neuralgia can cause pain that moves throughout the head, neck, and scalp. The scalp may become so sensitive that even a light touch can be painful. The scalp may also go numb.

This form of nerve pain is rare and usually caused by injury or a spontaneously pinched nerve.

Learn more about occipital neuralgia.

Hair loss

Telogen effluvium is a temporary hair loss that may also cause scalp sensitivity.

In a 2022 study involving 317 people with hair loss, 32% reported scalp sensitivity. The hair loss conditions most associated with scalp sensitivity were telogen effluvium and alopecia areata.

In alopecia areata, hair follicles fall out in round clumps from the scalp and sometimes the body.

Alopecia areata presents in patches, while alopecia totalis involves the loss of all hair from the head. Alopecia universalis involves hair loss from the entire body.

In some instances of alopecia, the hair will likely regrow. With other forms, the hair follicle damage is so severe that hair loss is irreversible.

Another hair loss condition that can cause scalp sensitivity is centrifugal cicatricial alopecia (CCCA), which mainly affects middle-aged Black females. Symptoms include hair loss from the top of the head that spreads outward, scalp pain, and itching.

Read about causes and treatments for hair loss.

Other causes of scalp tenderness

Conditions that affect the skin elsewhere on the body can also affect the scalp. These include:

  • acne
  • cysts
  • allergic reactions
  • infections of the skin cells or hair follicle shafts
  • viral diseases that cause skin sores, such as shingles and measles
  • tight hairstyles, headbands, and helmets
  • regular or improper use of hair products such as dyes and relaxers
  • hair dryers, flat irons, and curlers

Brushing or rubbing the hair while it is wet can break hair follicles, causing hair loss and scalp irritation. Over-brushing can also cause problems.

While rare, scalp tenderness can be a sign of more severe health conditions, such as skin cell cancers and melanomas. These conditions normally present themselves as new or changed moles or stubborn sores.

People should talk with a doctor if they experience especially painful, severe, or prolonged scalp sensitivity.

Resolving more persistent or severe conditions causing scalp tenderness may take a few visits to a doctor.

Doctors will typically ask about a person’s medical history, diet, routine, prior injuries, and recent changes.

The doctor may then proceed to examine the scalp. They may also collect a hair follicle or scalp sample to be sent for further testing.

Some doctors may also check body hair patterns.

Treatments for scalp tenderness can vary depending on the underlying cause.

In many cases, the conditions causing scalp tenderness resolve on their own. Many also require basic cleaning and care to ensure that the area heals successfully.

Various over-the-counter products are available, including ointments, antiseptics, and dressing materials.

It is advised that people should discuss long lasting or painful scalp tenderness with a doctor.

Doctors may prescribe a medicated cream or ointment to manage irritation, pain, and external symptoms. Medicated washes, shampoos, rinses, and conditioners may also help treat scalp tenderness.

Home remedies

Home remedies for relieving a tender scalp include:

  • massaging the scalp with the fingertips in circular motions
  • applying cold or heat packs for 10-minute intervals
  • slowly letting down hair that has been held in a tight position for a long period

Stretching and relaxation techniques can also be helpful for scalp tenderness caused by headaches, muscle soreness, and tension.

Following standard care routines can prevent most cases of scalp tenderness. Here are some things to consider avoiding:

  • spending too much time in the sun
  • using hair-damaging chemicals, dyes, or devices
  • tight hairstyles that pull on the scalp
  • using hair products containing harsh chemicals
  • stress

Avoid sharing hair ties and brushes to avoid contracting any contagious infections like head lice or fungus.

Below are some commonly asked questions about scalp tenderness.

Why is my scalp sore and tender to touch?

There are many possible reasons why a persons scalp feels sore and tender to touch, including skin conditions such as psoriasis and seborrheic dermatitis.

Other potential causes of a sore and tender scalp include occipital neuralgia, a type of headache, and alopecia areata.

Less commonly, a sore and tender scalp can point to cancer.

Why is my hair sore at the roots?

If a person’s scalp feels sore near the roots of the hair and is accompanied by hair loss or shedding, this can point to trichodynia as one possible cause. Other causes may include infections or tight hairstyles.

Why is my scalp tender in one spot with hair loss?

A person may experience scalp tenderness and hair loss in one spot with alopecia areata.

This often begins as a single round, smooth balding patch that develops on the scalp. This may also be accompanied by an itching, tingling, or burning sensation where the hair loss has occurred.

Tight hairstyles can also cause tenderness in the scalp and hair loss.

Scalp tenderness and sensitivity can include symptoms such as burning, itching, numbness, and stinging.

Causes include skin conditions such as psoriasis and sunburn. Alopecia areata, telogen effluvium, and CCCA are hair loss conditions that can cause scalp sensitivity.

Some behaviors can contribute to scalp sensitivity, such as wearing tight hairstyles or using hair products that irritate the skin.

Treatment depends on the underlying cause and can include OTC ointments and antiseptics. Doctors may also prescribe medicated shampoos or other formulations to manage symptoms.