Scalp tenderness is one of those annoyingly vague symptoms that can feel dramatic (“Owmy hair hurts!”) while
being caused by something totally ordinary… or occasionally something you really shouldn’t ignore. Sometimes it’s
skin-level inflammation (think dandruff with attitude). Sometimes it’s nerve sensitivity from a headache disorder.
And sometimes it’s your scalp politely asking you to stop treating it like a stress ball, a hat rack, and a chemistry lab
all in the same week.
The good news: most causes of a sore scalp are common and treatable. The better news: you can often narrow down
what’s going on by noticing how it hurts (burning vs. bruised), where it hurts (all over vs. one spot),
and what else is happening (itching, flaking, bumps, hair loss, headache, fever).
This guide breaks down the most likely causes, what helps, and when it’s time to call a clinician.
What “scalp tenderness” can feel like (and why that matters)
“Tender scalp” is a catch-all phrase. But the specific sensation often points toward a category of causes:
- Sore or bruised feeling when you press or brush your hair: often inflammation, tension, or migraine-related sensitivity.
- Burning, stinging, or raw feeling: common with dermatitis, allergies/irritants, sunburn, or nerve irritation.
- Itchy plus tender: think dandruff/seborrheic dermatitis, psoriasis, lice, folliculitis, or contact dermatitis.
- Sharp, electric, shooting pain along the back/top of the head: can suggest occipital neuralgia or nerve irritation.
- One-sided tenderness with scalp sensitivity near the temple (especially in older adults): a “don’t-wait” red flag condition is possible (more on that later).
A quick self-check: surface problem, nerve problem, or “something else”?
Here’s a practical way to triage your sore scalp at home (not a diagnosisjust a direction):
1) Look at the scalp (yes, actually look)
Use bright light and a mirror (or a helpful friend). If you see flakes, redness, greasy scale, silvery plaques,
bumps, pustules, scabs, or patchy irritation, the tenderness is often coming from a skin or follicle issue.
2) Notice what triggers it
- Worse when brushing hair, shower spray hits your head, or light touch hurts? That “touch equals pain” pattern can happen with allodynia (often migraine-related).
- Worse after a tight hairstyle, extensions, braids, helmet, or heavy hat? Traction and pressure are prime suspects.
- Worse after dyeing, bleaching, new shampoo, dry shampoo, or fragrance products? Think irritant or allergic contact dermatitis.
3) Scan for “whole-body” clues
Fever, spreading redness, swollen lymph nodes, new rash, vision changes, jaw pain when chewing,
or a severe new headache can move this from “annoying” to “urgent.”
Common causes of scalp tenderness (skin + hair-follicle edition)
Folliculitis (inflamed or infected hair follicles)
Folliculitis happens when hair follicles get irritated or infected, creating tender bumps or pimple-like spots.
On the scalp, it can feel like your head is hosting a tiny, angry neighborhood of sore dots. You might notice:
small pustules, crusting, itch, and pain, sometimes worse in areas where you sweat, wear hats, or use occlusive hair products.
Everyday example: You start using a heavy pomade or wear a tight cap for workouts all week. Then you get tender bumps along the hairline or crown. That pattern can fit follicle irritation or infection.
Seborrheic dermatitis (dandruff’s more persistent cousin)
Seborrheic dermatitis often shows up as flaking, greasy scale, redness, and itchcommonly on the scalp.
While it’s famous for flakes, it can also cause soreness and sensitivity, especially if you scratch or the skin barrier gets inflamed.
Flare-ups often worsen with stress, cold/dry weather, and illness (because your scalp loves drama and seasons).
Everyday example: Your scalp is itchy all winter, you scratch without thinking, and now it’s tender in the same spots. That “itch-then-ouch” combo commonly tracks with dermatitis.
Scalp psoriasis
Scalp psoriasis can cause thick scale, plaques, itch, andimportantlyburning or soreness.
Scratching or trying to “power-wash” scale off (with nails, harsh brushes, or aggressive picking) can make tenderness worse and may even contribute to temporary shedding.
Everyday example: You notice thicker scale at the hairline and behind the ears. It itches, you scratch, and now shower water stings the area. That can happen with inflamed psoriatic scalp skin.
Allergic or irritant contact dermatitis (hair products, dye, fragrance, preservatives)
This is a big one. Your scalp can react to hair dye ingredients (including common allergens),
shampoo/conditioner, styling products, fragrance, preservatives, or even “natural” products.
Symptoms can include itching, rash, burning, tenderness, swelling, and flaking.
Some reactions happen quickly; others show up later (because immune systems can be petty and delayed).
Everyday example: Two days after coloring your hair, your scalp feels hot, itchy, and tenderespecially along the hairline and part. That timing is classic for a delayed allergic response in some people.
Tight hairstyles, extensions, and “traction” stress
When hair is pulled tight (ponytails, braids, buns, extensions, wigs, tight headwraps), the follicles and surrounding skin can become inflamed and sore.
The tenderness is often most noticeable at the hairline, temples, and where the hair is anchored or pulled.
If traction is chronic, it may contribute to traction alopecia (hair thinning in pulled areas).
Everyday example: You wear a slicked-back ponytail every day, and by afternoon your scalp feels bruised at the crown. When you take it down, it hurts even more for a bit. That’s traction + sensitivity, not your hair plotting against you.
Sunburn (and other straightforward skin injury)
Scalp sunburn is sneakyespecially along parts and thinning areas. It can cause
burning, tenderness, peeling, and sometimes a “my hair hurts” sensation when you touch it.
Chlorine, salt, and heat can make irritated skin feel worse.
Head lice (especially in kids, but adults aren’t immune)
Lice are best known for itching, but constant scratching and irritation can make the scalp feel sore and tender.
Look carefully behind ears and at the nape of the neck if symptoms suggest lice.
Shingles (herpes zoster) on the scalp
Shingles often starts with pain, burning, itching, or tingling before a rash appearssometimes several days before.
If it involves the scalp, tenderness may be localized and one-sided, and then you may see a blistering rash.
Because shingles can affect nerves and sometimes the eye area depending on location, it’s worth prompt medical attention.
Fungal infection (tinea capitis)
More common in children, tinea capitis can cause scaling, itch, tenderness, and sometimes patchy hair loss.
If you see round patches, broken hairs, or significant scalp scale that doesn’t respond to typical dandruff care, a clinician can help confirm and treat it.
Common causes of scalp tenderness (headache + nerve edition)
Migraine-related scalp allodynia (when “normal touch” hurts)
During a migraine attack, some people develop allodyniapain from things that shouldn’t hurt, like brushing hair,
wearing glasses, or resting your head on a pillow. If you’ve ever had a sunburn where even a shirt hurts, you already understand the vibe.
Migraine allodynia can make the scalp feel tender, sore, or intensely sensitive.
Everyday example: You don’t see a rash or bumps, but your scalp feels painful when you brushplus you have light sensitivity or nausea.
That combo can point toward migraine physiology rather than a scalp skin condition.
Tension-type headache and muscle tightness
Tight neck and scalp muscles can create a “band-like” pressure headache and make the scalp tender to touch,
especially at the temples, crown, and back of head. Stress, poor sleep, jaw clenching, long screen time, and bad posture can all contribute.
Sometimes the scalp tenderness is the loudest symptom, while the “headache” feels more like heaviness.
Occipital neuralgia (irritated nerves at the back of the head)
Occipital neuralgia can cause sharp, shooting, or throbbing pain that runs along the scalp,
often starting near the base of the skull. Some people describe tender spots and scalp sensitivity, sometimes with pain behind the eye.
It can overlap with other headache disorders, which is why a clinician’s evaluation matters when symptoms persist.
Everyday example: You turn your neck a certain way and get a sudden zapping pain that shoots up your scalp,
then the area stays tender. That pattern can fit nerve irritation.
Scalp dysesthesia / “trichodynia” (painful scalp without obvious skin findings)
Some people experience scalp pain, burning, or tenderness even when the skin looks fairly normal.
This is sometimes called trichodynia or scalp dysesthesia and can overlap with stress,
anxiety, sleep disruption, and certain hair-loss patterns.
The key point is that the discomfort is realeven when you can’t “see” itand it deserves a thoughtful workup if persistent.
Less common but important causes (don’t ignore these)
Giant cell arteritis (temporal arteritis) urgent in older adults
If you’re over 50 and develop new scalp tendernessespecially near the templesthis is one of the most important “rule-out” conditions.
Giant cell arteritis is inflammation of blood vessels and can cause headache, scalp tenderness, jaw pain when chewing,
and vision problems. It requires prompt medical evaluation because it can threaten vision.
If scalp tenderness comes with visual symptoms, jaw claudication, or a new severe headache, seek urgent care.
Cellulitis or abscess (spreading infection)
A bacterial skin infection can cause increasing redness, warmth, swelling, pain,
and sometimes fever. If the tenderness is worsening quickly, the area is hot or expanding, or you feel ill,
don’t try to “wait it out.”
What you can do at home (safe, practical relief)
The best approach depends on the likely cause, but these tips help many people without making things worse:
- Be gentle for a week. Skip tight hairstyles, aggressive brushing, harsh exfoliating scalp scrubs, and high-heat styling.
- Audit your products. If symptoms started after a new dye, shampoo, dry shampoo, fragrance spray, or styling product, stop it and simplify.
- Cool compresses can calm irritated skin and reduce the urge to scratch.
- Shampoo strategy: If you have flakes/greasy scale, an anti-dandruff shampoo may help. If your scalp is raw and reactive, consider a fragrance-free gentle cleanser.
- Don’t pick. Picking scale or bumps turns irritation into inflammation into more tenderness (a triple-decker problem).
- Check your “gear.” Helmets, hats, headphones, and headbands can cause pressure points; take breaks and adjust fit.
- Headache clues: If tenderness tracks with light sensitivity, nausea, or one-sided throbbing, treat it like a migraine pattern and talk with a clinician about a migraine plan.
- Neck and posture reset: Gentle stretching, hydration, movement breaks, and sleep support can help when tension is part of the picture.
When to see a doctor (or seek urgent care)
Make an appointment if scalp tenderness:
- Lasts more than 1–2 weeks or keeps coming back.
- Comes with hair loss, scaly plaques, pustules, or worsening rash.
- Doesn’t improve after stopping suspected irritant products and loosening hairstyles.
- Feels like nerve pain (sharp, electric shocks) or disrupts sleep.
Seek urgent care sooner if you have:
- Fever, rapidly spreading redness/warmth, or severe swelling.
- New rash with burning pain (possible shingles), especially near the eye/forehead.
- Vision changes, jaw pain with chewing, or a new severe headacheespecially if you’re over 50.
Experiences: what people often notice (and what it tends to mean)
Below are common real-world experiences people describe. These are “pattern stories,” not medical diagnosesthink of them as a shortcut for recognizing
what category your symptoms might fall into.
Experience 1: “My scalp hurts when I move my hair, but there’s nothing to see.”
This one often shows up during or around migraine attacks. People describe the scalp as “bruised,” and brushing hair feels weirdly painful.
Sometimes they also notice sensitivity to light, noise, or smells, or they feel nauseated. The confusing part is the mirror test: the scalp looks normal.
That doesn’t mean the pain is imaginaryit can be nerve sensitivity (allodynia). A helpful clue is timing: if the tenderness comes and goes with headache
symptoms or after poor sleep and stress, migraine physiology becomes more likely than an infection or allergy.
Experience 2: “It started after I dyed my hair / tried a new shampoo.”
Many people can pinpoint the exact “uh-oh” moment: a new product, a salon visit, a bleach session, or even a fragranced dry shampoo.
They may feel burning, itching, and tenderness along the hairline and part. Sometimes the reaction is immediate; sometimes it takes a day or two.
The scalp can feel tight, hot, or sore to touch. When this happens, simplifying products and avoiding repeat exposure matters, because allergic contact
dermatitis can escalate with repeated contact. If there’s swelling, blistering, or facial/eye involvement, that’s a “get help” signal.
Experience 3: “My scalp is tender in the exact spots where my ponytail sits.”
This is the classic traction story. People who wear tight ponytails, buns, braids, extensions, or wigs often feel tenderness at the crown,
temples, or hairlineespecially at the end of the day. Taking the hair down can briefly make it feel worse (like releasing a rubber band).
Over time, the same pattern can create inflammation and even thinning in stressed areas. The fix is usually not fancy: rotate hairstyles,
loosen tension, take breaks, and give the scalp a recovery window. Your follicles are not lazythey’re just tired of being yanked into productivity.
Experience 4: “It’s itchy, flaky, and now it’s sore because I can’t stop scratching.”
This pattern frequently tracks with seborrheic dermatitis (dandruff), scalp psoriasis, or another inflammatory scalp condition.
The tenderness often comes after the itch, because scratching inflames the skin and creates micro-injuries.
People may notice seasonal flares (winter is a repeat offender), stress-related flares, or buildup that makes the scalp feel “gross” and sensitive.
Gentle care helps, but persistent plaques, bleeding, or painful scale often benefits from dermatologist-level guidance and targeted treatment.
Experience 5: “It’s a sharp zapping pain that shoots up the back of my head.”
This description leans more nerve-related, sometimes consistent with occipital neuralgia or nerve irritation from neck tension or injury.
People may find tender trigger points near the base of the skull; touching or moving the neck can set off pain that radiates up the scalp.
It can be startling and intense, and it may overlap with other headache disorders. If this is your experienceespecially if it’s persistent
it’s worth evaluation. The goal is to rule out other causes and find a plan that addresses nerve irritation, posture, and headache overlap.
Bottom line
Scalp tenderness usually comes from one of three buckets: inflamed skin/follicles (dermatitis, psoriasis, folliculitis, sunburn, lice),
product reactions or traction (dye, fragrance, tight styles), or nerve/headache sensitivity (migraine allodynia, tension,
occipital neuralgia). The fastest wins often come from gentle care, removing triggers, and treating the right category.
But if symptoms are severe, persistent, spreading, or paired with red flags like vision changes or fever, get medical help promptly.
