Scientific Area

Scalp pain

CATEGORIES SCIENTIFIC AREA

Scientific collaboration between Professor Marco Toscani and Dr. Pasquale Fino, Chair of Plastic, Reconstructive and Aesthetic Surgery, Umberto I Health Center – “Sapienza” University of Rome.

Scalp pain and irritation (or trichodynia) are pathological conditions that affect both women (in a greater percentage) and men (in a lower percentage). The pain felt on the scalp, spontaneous or caused by treatment, and in particular around the roots of the hair, may be more or less intense, alternating at times between periods of disappearance, associated with burning, tingling or itching.

Usually, this particular scalp condition does is not located in a specific area and increases when hair is touched or brushed. Often, trichodynia is associated with hair loss. A correlation can be found between telogen effluvium and trichodynia and between seborrheic hair loss and the constant sensation of scalp pain or irritation.
Trichodynia is classified among the allodynia, conditions in which pain is felt on the skin without recognizable external causes or appears to be caused by usually innocuous stimuli. Patients suffering from this condition perceive a burning sensation and irritation on the scalp. The itchiness is so intense that thay are forced to scratch their head. The relief however is very short-lasting.
The reduction of the activation threshold of nerve endings (nociceptors), whose endings spread over the entire scalp (the pilosebaceous apparatus of each hair and the correspondent nerve endings at the level of the skin), seems to have a decisive role in triggering allodynia. The inflammation of the skin activates the nociceptors that secrete neuropeptide P, the neurotransmitter of pain. Individuals who notice this condition tend to scratch their head, pull out their hair hair to feel mild relief, but this leads to hair loss due to trichotillomania.
Although the (aforementioned) chemical process that causes skin inflammation is now known, the causes are still unclear, namely what triggers this process and how the nociceptors act. There is a strong correlation between the emotional component and trichodynia and between trichodynia and hair loss. Nervousness, stress and anxiety are associated with the appearance of scalp pain and itchiness, and with subsequent hair loss.

Another cause that triggers pain is hyperseborrhea, which leads to seborrheic dermatitis and the appearance of pain, inflammation and skin irritation. Another cause is greasy dandruff, which irritates the scalp, damaging follicular activity. Other possible causes of pain are scalp folliculitis and acne that lead to rashes, pain and itchy skin.
During the inflammatory process, the fact that the muscles of the arrector pili of the hair are forced into a strange position for long period of time may cause pain. The arrector pili muscles and the hair follicles may then become inflamed, thereby triggering the inflammatory process of the skin. Another cause of trichodynia may be neuro-muscular inflammation of skin overstressed by the tendency to grind one’s teeth, especially at night (bruxism), with the subsequent contraction of the temporomandibular joint that, with the passing of time, may involve the cranial muscles, causing headaches and trichodynia. Trichodynia should be cared for and countered with trichological treatments that aim to eliminate the underlying causes, such as hyperseborrhea and dandruff. The use of lotions and shampoos that cleanse the skin of impurities and bacteria that cause inflammation and conseuquent pain is recommended. It is also important to use remedies against hair loss.

Suitable specific and personalized therapies should be used only after a careful examination of the hair and a scrupulous skin analysis. The following treatments have proven to be useful:

1) the use of laser treatments that increase the blood capillary vasodilation necessary for providing sustenance to hair bulbs

2) treatments with high frequency rays that clean, cleanse and disinfect the scalp, improving blood supply and stimulating healthy hair growth

3) hair massages that allow follicles to expel a small amount of sebum that accumulates and facilitates the relaxation of the skin and scalp muscles.

Dandruff or pityriasis

Dandruff is a scalp condition that usually arises between the ages of 10 and 25. It may improve between the ages of 45 and 55 or may continue during old age.
Its cause is a result of an accelerated turnover of epidermal cells, which following an increase in migration speed, are unable to reach complete maturity before detaching. Whitish-yellow flakes (masses of corneum cells) form and detach, gathering in patches or often spreading evenly across the scalp.

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Psychogenic alopecia (psychological baldness)

Psychogenic alopecia is a type of hair loss related to stress. Though not yet scientifically explained, this connection is well-known in the experience of those working with the problem. In addition to stress, other causes are personality disorders, states of anxiety and depression, all of which are conditions of acute or chronic stress.

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Premature hair loss

Recent studies have demonstrated that around one in five young men tend to lose their hair prematurely over time.
This problem does not affect only young men but also young women.

In the majority of cases, it is androgenetic alopecia (pattern hair loss) and therefore is hereditary/genetic. However, it is important to remember that often factors of psychological origin like performance anxiety, trauma and emotional stress take over, thereby becoming a source and cause of hair loss from stress.

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Hair loss from trichotillomania

Trichotillomania is a type of hair loss due to voluntary pulling by the patient which often ends up breaking the hair shaft. In general, the patient twists the hair around a finger.
The gesture is occasional when going to sleep or concentrating on a task, but may become repetitive or obsessive.

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Hair follicles and bulbs

A hair follicle is a formation of epidermal origin, anchored in the dermis and consisting of a hair and its sheath.
The formation of hair follicles occurs early. They begin to appear as early as the second month of gestation. These follicles will continue to form for the entire duration of the pregnancy. At birth, the baby will indeed have the entire supply of follicles with which it was genetically equipped and from this moment on, no others will form.

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Brittle hair

Brittle hair is hair that appears opaque and without shininess. It is characterized by glaringly visible damage and deterioration of the shaft.
The causes that lead to the problem of brittle hair may be of endogenous and exogenous origin.

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