Scalp Pain: Differential Diagnosis and When to Seek Care

Scalp pain (trichodynia) has diverse etiologies:

Common Causes

• Tension-type headache: Pericranial muscle tenderness.
• Migraine: Allodynia (pain from light touch) common.
• Sinusitis: Frontal/maxillary referral to scalp.
• Cervicogenic headache: Neck pathology refers to occiput/scalp.
• Dental/ TMJ disorders
• Scalp dermatoses: Seborrheic dermatitis, psoriasis, eczema, folliculitis.
• Neuralgias: Occipital, trigeminal.
• Traction alopecia: Tight hairstyles.
• Stress/anxiety: Muscle tension, central sensitization.

Red Flags

• Sudden severe “thunderclap” headache
• Focal neurologic deficits
• Scalp swelling, erythema, fever (cellulitis, temporal arteritis)
• New onset >50 years (rule out giant cell arteritis)

See a clinician for persistent or worsening pain. Diagnosis guides targeted therapy.