A tingling, prickling, or pins-and-needles sensation on the skin is called paresthesia. A wide range of factors can cause paresthesia on the scalp.
In most cases, paresthesia on the scalp is temporary. People may also feel itching, burning, or numbness.
If it lasts for a long time or comes back regularly, paresthesia may result from an underlying nerve disorder or nerve damage.
This tingling sensation on the scalp can arise from a wide range of factors, including:
- autonomous sensory meridian response (ASMR)
- skin irritation
- various skin conditions
- hair lice
- alopecia (hair loss)
- anxiety or stress
- migraine episodes
- nerve issues
- chronic pain syndrome
Paresthesia can also be a side effect of some medications.
This tingling is not always unpleasant. ASMR is a pleasurable tingling sensation that begins in the scalp and moves down the back.
Here, we explore the wide range of factors that can cause a tingling sensation on the scalp. We also describe how a doctor makes a diagnosis and possible treatments.
ASMR is a sensory experience, in which an auditory or visual trigger stimulates a tingling sensation on the skin.
This tends to start in the scalp and move down the neck into the back, following the line of the spine and spreading into the arms, as well. Many people describe it as a pleasurable or relaxing experience.
Not everyone experiences ASMR. For those who do, watching online videos can stimulate the sensation and help with relaxation or sleep.
A common, temporary cause of a tingling scalp is irritation. A trigger for this irritation is often a chemical in a product, such as:
- laundry detergent or dyes
- heat treatments for the hair
- hair dye or bleach
- highly fragranced shampoos or conditioners
- other cosmetic products
Also, when too much shampoo or conditioner remains on the scalp, this can cause tingling and itching, so it is important to rinse the hair thoroughly.
Some people have more sensitive scalps than others. This sensitivity may relate to having fewer oil-producing glands on the scalp, making it drier. Or, it may result from having more sensitive nerve endings.
When a doctor can find no other clear cause of scalp tingling, sensitivity may be to blame.
A range of skin conditions can cause tightness, itching, and a tingling sensation on the scalp. These symptoms often accompany a rash, and they may appear before the rash begins.
Some of these skin conditions include:
- Seborrheic dermatitis. This causes swollen, red patches of skin that may have white- or yellow-crusted scaling. It can also cause itching and scalp tingling. In infants, doctors call seborrheic dermatitis "cradle cap."
- Scalp eczema. Also called atopic dermatitis, eczema causes itchy, dry, thick patches of skin. It is more common in children than adults, and it often affects the nape of the neck.
- Psoriasis. One form, called plaque psoriasis, causes red patches of skin with silvery scales to develop on the body, and scalp psoriasis is a common manifestation.
Certain medications can cause paresthesia, a tingling sensation on the skin, as a side effect.
This does not tend to be serious, and it does not usually require people to stop using the medication. However, consult a doctor if the tingling is extremely bothersome.
Some medications that treat attention deficit hyperactivity disorder, or ADHD, also have this side effect. For instance, lisdexamfetamine (Vyvanse) caused paresthesia in 2% of participants who took it during a clinical study.
Ringworm is a fungal infection that can cause symptoms in areas with hair, such as the scalp. The infection can cause hair loss, in addition to scalp tingling and pain.
Topical and prescription antifungal treatments are available, including antifungal shampoos.
Head lice are small insects that live in a person's hair and feed on blood from their scalp. Their bites can be very itchy.
One of the early signs of head lice is a tingling sensation on the scalp or the feeling of something moving under the hair. A person may also notice itching and painful red areas of skin where the lice have fed.
People can sometimes see the lice or their eggs near the base of hair shafts. Lice have six legs and are black or whitish gray as adults, while the eggs may appear as small white or yellow dots.
Lice are most common among children. They can pass from person to person and are especially likely to spread in kindergartens, day care centers, and other schools.
Alopecia is a blanket term for conditions that cause hair loss. When hair follicles are damaged or irritated, it can cause itching or tingling, as well as areas of hair thinning.
A tingling sensation, or paresthesia, in the scalp is often the result of issues with the nerves, and some people experience nerve-related symptoms due to anxiety or stress.
According to the Anxiety and Depression Association of America, panic attacks can cause paresthesia. This may relate to how blood flow changes in response to psychological stress and may also be linked with stress hormones.
Other symptoms of a panic attack include:
- a rapid heart rate
- chest pain
- difficulty breathing
At the onset of a migraine episode, a person may have a sensory experience called an aura. The sensations may be visual, auditory, or tactile and can include tingling or prickling sensations on the skin.
Visual auras are the most common type, occurring in more than 90% of people who experience auras during migraine episodes. The next most common type of aura involves a pins-and-needles sensation.
Called a paresthesia aura, this sensation travels outward from its origin and generally affects one side of the face or body. People may also experience numbness afterward.
Shingles is a medical condition caused by the varicella zoster virus.
It occurs in people who have previously had chickenpox, which results from the same virus. After chickenpox subsides, the virus lies dormant in the body and can reactivate years later, causing shingles.
Shingles is characterized by a blistering rash. This tends to develop on one side of the face or body — including the scalp — and often on a single strip of skin. A person may experience itchiness, pain, or tingling on the skin
Shingles also causes the following symptoms:
The nerves relay sensory information from the skin to the brain. When this signal is interrupted, people may experience unusual sensations on their skin.
A tingling sensation can arise when there is pressure on the nerves, such as when a person sits in a position that causes their legs to "fall asleep." This is paresthesia, and it goes away when the pressure on the nerve is relieved.
A pinched nerve or nerve injury can cause paresthesia that lasts longer or returns frequently.
Medical conditions that affect the nerves can also cause tingling and numbness in various parts of the body.
Some people with diabetes also experience tingling and numbness. Diabetes can cause small blood vessel damage that leads to nerve damage.
The medical term for this nerve damage is diabetic peripheral neuropathy, and it usually affects the feet, arms, or legs, but it can arise in other parts of the body.
Other symptoms of fibromyalgia include:
- stiff muscles in the morning
- poor sleep
- cognitive difficulties
- widespread pain without an obvious trigger
A doctor will first ask a person about their symptoms, such as when the symptoms appeared and what makes them worse or better. They will also perform a physical exam to look for rashes, bites, burns, and other signs.
If the doctor suspects that a skin condition is causing the tingling, they may take a small sample of skin from the scalp to examine under a microscope. This is called a skin biopsy.
They may also collect some hairs and examine these for signs of affected growth, the presence of lice, or other signs of damage.
If the doctor suspects a condition that affects the nerves, they may perform other tests and assessments.
Treatments for scalp tingling depend on the underlying cause.
It may help to use products that do not contain fragrances or harsh chemicals. Switching to a soft-bristled brush and avoiding heat treatments can also help.
Avoid products that contain the following irritants:
- sodium lauryl sulfate
- sodium laureth sulfate
The labeling for many products refers to sodium laurel and sodium laureth sulfates as SLS.
A doctor can advise about the best treatment when paresthesia results from an underlying condition, such as those involving the nerves or skin, migraine episodes, or infection.
There are many causes of a tingling sensation on the scalp. For most people, this is a temporary symptom, but if it lasts for a long period or arises frequently, it can indicate an underlying medical condition.
Most causes are treatable, and the treatments vary widely.