Dealing with a Sensitive Scalp? Derms Explain the Causes and Treatments

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A sensitive scalp can be frustrating to deal with, as it often comes with side effects like burning, tenderness, and flaky skin. Beyond that, pinpointing the cause can also be cumbersome (everything from stress to allergies could be the culprit). Luckily, there are several things you can do to address and prevent scalp sensitivity. We tapped two experts to fill us in on everything we need to know about the various causes of a sensitive scalp and treatments.

Meet the Expert

  • Anabel Kingsley is a consultant trichologist and brand president of Philip Kingsley Clinics and Products.
  • Dr. Sara Perkins is a board-certified dermatologist and advisor for Hims & Hers.

What Causes a Sensitive Scalp?

Scalp sensitivity can be caused by various things, from stress or hormonal changes to disease or infection. "Some causes are rare, and others are very common," Kingsley says. "Your scalp contains many nerve endings and blood vessels. When [that microbiome] becomes imbalanced, that's when there's a problem." While many different symptoms can be a sign of scalp sensitivity, here are some of the most common etiologies our experts see:

  • Stress: Let's face it: Stress can wreak havoc on our bodies and health. "[Stress] causes the release of histamine, which can cause your scalp (as well as other skin) to itch," Kingsley explains.
  • Sunburn: "Sunburn is surprisingly common, particularly for those with thin hair or alopecia," Perkins shares. "Sunburn on your scalp will cause irritation and sensitivity."
  • Scalp conditions: If you have pre-existing scalp conditions such as dandruff, seborrheic dermatitis, psoriasis, folliculitis, or atopic dermatitis (eczema), chances are you're already experiencing sensitivity. "Dandruff or seborrheic dermatitis can cause itching and irritation; psoriasis can make your scalp feel 'tight' and uncomfortable; folliculitis, an inflammation of hair follicles, can result in a tender, painful and itchy scalp," Kingsley explains.
  • Allergic reactions: Perkins says an allergic reaction to a new hair product can cause scalp sensitivity. Hair dyes or any other product that is applied directly to the scalp also have the potential to cause sensitivity.
  • Hormonal changes: According to Kingsley, many people find that their scalp becomes sensitive during their menstrual cycle. This is because the hormones fluctuate. Any hormonal changes, including entering menopause, pregnancy, or postpartum, can cause scalp sensitivity due to the hormonal shifts at play.
  • Tight hairstyles: The daily treatment of our strands will affect our scalps' health. "Wearing your hair back too tightly, wearing it up for too long, or using a heavily weighted hair clip" are all examples of styling tendencies that can cause sensitivity.
  • Sleep positions: Kingsley notes that merely sleeping with your head in an awkward position or your hair in an awkward position can cause discomfort or sensitivity when you wake up.
  • Auto-immune diseases: Pre-existing auto-immune diseases such as cicatricial (scarring) hair loss, cicatricial alopecia, or alopecia areata can cause sensitivities like hair loss, inflammation, redness, scarring, or tingling on the scalp. "Some patients can experience significant itching or burn on their scalp without visible skin changes," Perkins tells us.
  • Infections or infestations: "Any infestations, including head lice and scabies, will certainly cause itching and sensitivity," Perkins says. "Fungal infections can as well." Ringworm (tinea capitis), dermatomyositis, or head lice (pediculosis capitis), more commonly seen in children, are some of the most frequently seen infections causing sensitivities such as redness, hair loss, and intense itching.

What Are the Signs of a Sensitive Scalp?

The signs of a sensitive scalp will vary depending on the cause, but they can include itching, burning, flaking, redness, tightness, soreness, or tingling. "Patients will describe scalp sensitivity in various ways," Perkins says. "Sometimes there are no visible signs, and the person only has a feeling or sensation [of discomfort]," Kinglsey says. "The general term for scalp sensitivity without physical signs is trichodynia. It can also be referred to as scalp dysesthesia, and scalp paresthesia depending on the sensations felt and the root cause." In some cases, there are visible signs of sensitivity, such as pus-filled bumps and swelling.

How to Treat a Sensitive Scalp

To treat a sensitive scalp at home, Perkins suggests using haircare products with minimal "added preservatives, fragrance, and sulfates." She tells us that these products can help prevent irritation, particularly for sensitive skin. "If you notice flaking or excess sebum, an over-the-counter dandruff shampoo containing ketoconazole or zinc pyrithione may be helpful," Perkins adds.

Anti-microbial products also help with mild to moderate dandruff. Kingsley suggests Philip Kingsley's flaky scalp range. "More severe scalp conditions, like psoriasis and folliculitis, usually need prescription products," Kingsley notes.

If you have dandruff or a flaky scalp, regularly cleanse with an anti-microbial shampoo, tone daily with a targeted scalp tonic, and use an exfoliating mask once weekly.

When to See a Doctor

It's time to see a doctor when your symptoms are persistent and significantly bothersome. This may mean your scalp sensitivities are distracting you from your work or interfering with your sleep, Perkins says. If hair loss accompanies any other symptoms (general irritation, redness, or inflammation, for example), both experts recommend scheduling a prompt evaluation with your trichologist or dermatologist.

The Final Takeaway

Scalp sensitivity can be caused by several factors and conditions, ranging from stress to auto-immune diseases. Once you know the root of the issue, there are tons of over-the-counter treatments to choose from. However, it is best to seek input from a medical professional who can explain your prescription treatment options for persistent scalp sensitivity.

Ultimately, it's important to remember our scalps deserve just as much TLC as the rest of our bodies. "Skincare shouldn't stop at the hairline," Kingsley says. "Your scalp is your hair's support system." Even if you aren't experiencing sensitivities, giving your scalp extra attention can prevent future issues.

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