By | June 10, 2022

Trichodynia represents abnormalities and sensory disturbances in the form of tingling, itching, burning or pain on the scalp, which are usually associated with hair loss in the affected areas. However, no changes can be detected on the scalp. The cause is a tension in the cranial muscles.

What is trichodynia?

The term trichodynia comes from the Greek and means “hair pain”. However, it should be remembered that hair has no nerves and therefore cannot hurt. However, the actual area of ​​pain is the scalp. Hair loss then usually occurs at the affected area. For whooping cough basics, please visit

People who are already suffering from headaches, anxiety disorders or depression are often affected. Furthermore, a connection with stress and mental stress was found. Externally, no changes can be registered on the scalp. Since many doctors are not familiar with this clinical picture, the patients’ complaints are often not taken seriously.

This phenomenon is often dismissed as a mental disorder. However, it has been shown that both hereditary hair loss in men (androgenetic alopecia, AGA) and diffuse hair loss in both sexes (TE) can often be linked to trichodynia. As already mentioned, the symptoms intensify with stress or psychological stress.


Tension in the musculature of the skull was identified as the cause of trichodynia. This tension is often caused by stress, mental stress or concentrated work on the computer. The skull is surrounded by flat muscles and tendons. There are the muscle groups of the occipital muscle (back of the head), the temporoparietalis muscle (on the ears) and the frontalis muscle (forehead).

All three muscle groups are networked with the scalp and are supplied with nutrients and oxygen by the smallest blood vessels in addition to the hair roots. The scalp stretches tautly over the top of the skull, and tension increases with concentration and mental stress. This is expressed in the typical creases that develop over time as a result of frequent characteristic states of tension.

These include frown lines, crow’s feet or transverse forehead wrinkles. The reason for this is the constantly increased muscle tension. However, the severely tense scalp squeezes the fine arterial and venous blood vessels underneath, preventing the adequate supply of nutrients and oxygen to certain areas. As a result, hair roots die and the hair falls out.

At the same time, due to the lack of oxygen in these regions, glucose can no longer be broken down properly. Only degradation to lactic acid takes place. Lactic acid or lactate builds up in the muscles, acidifying the muscle and causing pain. The effect of lactic acid on so-called sore muscles is well known. The tingling and itching is caused by the increased excitation of the receptors of muscle, tendon and skin cells.

These excitements are also the result of severe muscle tension. The constant pressure of the tense muscles also leads to increased irritation of the nerves. This stimulus activity in turn has an intensifying effect on the tension in the muscles. Eventually, a vicious circle develops that is difficult to break without treatment.

Symptoms, Ailments & Signs

It has already been mentioned that trichodynia is characterized by pain, tingling (pins and needles) or itching on the scalp without any organic findings. There is no inflammation or infection in the affected area. In addition to the discomfort on the scalp, the hair falls out in this area.

Both hereditary hair loss (androgenetic alopecia) and diffuse hair loss can be accompanied by trichodynia. Typical are previous stressful situations, mental stress or previous mental illnesses such as depression or anxiety disorders. The discomfort on the scalp does not go away on its own.

On the contrary, they cause further psychological stress, which causes the symptoms to become chronic. Many headache patients often develop trichodynia. Certain forms of headache are also caused by muscle tension.

Diagnosis & course of disease

Trichodynia can be easily diagnosed based on the symptoms. The cause of the muscle tension should be determined through an extensive anamnesis. It is important to find out which specific stressful situations or previous mental illnesses are present. It is also important for the treatment to know whether the underlying hair disease is hereditary or diffuse.


Due to the trichodynia, the patient develops complaints of the scalp. As a rule, those affected suffer from a very unpleasant tingling or itching, which occurs directly on the scalp. The scalp itself is covered by infections or inflammation and can also hurt.

The hair can fall out, so that most of those affected also suffer from aesthetic problems. This often leads to inferiority complexes or a significantly reduced sense of self-esteem. Trichodynia can also cause psychological problems or depression. Furthermore, there is discomfort on the scalp. The patient’s quality of life is significantly reduced by the disease.

As a rule, trichodynia can be treated relatively well with the help of medication. There are no complications or other problems. The hair loss can also be stopped by the medication. However, it cannot be predicted whether a complete cure of the disease will be achieved. In many cases, patients are dependent on long-term use of the medication. However, trichodynia does not lead to a reduced life expectancy of the patient.

When should you go to the doctor?

Since trichodynia cannot heal itself, the affected person is dependent on medical examination and treatment in any case. This is the only way to limit or prevent further complications or symptoms, so that treatment by a doctor is essential. The sooner a doctor is consulted for trichodynia, the better the further course of the disease is usually. A doctor should be consulted for trichodynia if the person affected suffers from severe discomfort on the scalp. This can lead to severe itching or hair loss.

The symptoms do not go away on their own and usually last longer. Headaches can also be caused by this disease. In the case of trichodynia, a dermatologist or a general practitioner can be consulted . It is not uncommon for treatment by a psychologist to be necessary, since this disease can also lead to depression or other mental upsets.

Treatment & Therapy

The basis of the treatment is the release of tension in the skull muscles in order to supply the scalp and hair roots with sufficient nutrients and oxygen again. If this is achieved, the discomfort and pain as well as the hair loss can be partially reversed. The tingling, itching or pain in the scalp can be suppressed for several months.

In many cases, hair growth is possible again. In the so-called AC therapy, muscle-relaxing drugs are administered. After two to three days, the tension is released. As part of this therapy, relief or even the complete disappearance of the symptoms of trichodynia is almost always achieved.

The success of the treatment can last between four and seven months. However, since the effect of muscle relaxants is reversible, after this time the symptoms will start again. Then the therapy has to be repeated.


To prevent trichodynia, the main recommendation is to avoid stress. It is essential to take breaks to relax during strenuous work on the computer or during activities that require a lot of concentration.


Follow-up care for trichodynia, like treatment, is based on the causative hair disease. If necessary, psychological disorders must also be included in the therapy and aftercare. Generally, follow-up care involves controlling the inflammation that was previously causing the patient discomfort. If it has largely subsided, the doctor can prescribe a light painkiller or an anti-inflammatory and then discharge the patient.

If the trichodynia is based on psychological problems such as depression or anxiety disorders, the cause must be determined together with a therapist. The aftercare of a mental illness is lengthy and usually lasts for months or years. Depending on the underlying hair condition, one or more follow-up visits may be necessary. After an acute inflammation, one examination is usually sufficient to assess the patient’s state of health.

The dermatologist checks the scalp and in particular the inflamed areas. If necessary, a tissue sample is taken, which is then examined in the laboratory to determine typical causes such as an overproduction of substance P. If necessary, the patient can then be referred to a therapist, for example in the case of psychological problems due to hair loss or skin changes. The family doctor or a dermatologist takes care of the trichodynia aftercare.

You can do that yourself

In principle, it is advisable to consult a doctor if you have trichodynia. This applies in particular to patients who repeatedly suffer from the typical symptoms. Acutely, those affected can relieve their hair, for example, by doing without a head covering or by loosening braids. Some patients have had good experiences rubbing oils into the scalp. Almond or olive oil are suitable.

Science agrees that trichodynia is usually triggered by psychological aspects. These result from professional or private stress. It is therefore advisable to plan time-outs and avoid stress. Patients who suffer permanently from trichodynia should integrate alternative healing methods into their everyday life. Autogenic training, for example, is suitable for this, as it brings about deep inner peace and concentration. Acupuncture from a naturopath has also brought relief in some cases. Other sufferers rely on a head massage.

Trichodynia has so far been comparatively little researched. Since there are usually no changes to the scalp, patients have to experiment a little to find promising measures. Even doctors don’t have ready-made solutions.