Diagnosis
Sometimes the cause of a burning scalp can be quite obvious, for example when the symptoms first appear after hair colouring or the use of a new shampoo. In other cases, or if the symptoms are severe and persistent, a doctor (first a family doctor, possibly followed by a referral to a dermatologist) should be consulted. This doctor can usually draw conclusions about the origin of the complaints by talking to the patient (anamnesis) and looking closely at the scalp. In some cases, e.g. if a fungal disease is suspected, the use of further diagnostics may become necessary. For example, some skin flakes can be viewed under a microscope or an allergy test can be carried out.
Associated symptoms
Which symptoms accompany the burning scalp depends on the cause of the complaints. If the burning is caused by irritation of the scalp by shampoos or hair dyes, it is often accompanied by redness and itching. Dry scalp also often leads to itching, and fine scaling is also often noticeable.
If shingles (herpes zoster) is the cause, in addition to burning pain, small fluid-filled blisters form on reddened areas of the face and hairy scalp. If the burning scalp is caused by a skin disease such as neurodermatitis, other parts of the body are often affected. In addition to the burning sensation, there is often pronounced itching and skin changes such as redness, scaling and small pimples or blisters.
In addition to a burning sensation of the scalp, itching often occurs in parallel. Both can be signs of irritation of the scalp, as may be caused by aggressive shampoos or hair dyes. Dry scalp, which can be caused by too hot water, heated air or too frequent hair washing, also tends to itch frequently.
Itching and burning are also typical symptoms of a contact allergy, which can be triggered by certain hair dyes. Pronounced itching is also characteristic of a fungal infection of the scalp or skin diseases such as neurodermatitis. In conclusion, it can be said that a burning sensation of the scalp is often accompanied by itching, so that this symptom is not very specific.
The term trichodynia describes sensations such as burning or tingling in the scalp area. This phenomenon is often accompanied by increased hair loss. It is characteristic that the scalp shows no external changes such as redness, scaling or rash.
One cause has not yet been clearly proven; it is suspected to be an excessive production of messenger substances that mediate the sensation of pain (e.g. substance P). Hair loss can manifest itself as congenital hair loss (androgenetic alopecia) or diffuse hair loss (diffuse alopecia). Frequently, the intensity of hair loss does not correlate with the intensity of the sensations (burning, tingling).
This means that if the hair loss is mild, a strong burning sensation can still occur and vice versa. A psychological component also seems to play a role in the triggering. The treatment thus includes the therapy of hair loss (with special preparations) and, if necessary, psychosomatic co-treatment.
A burning of the scalp, which is accompanied by headaches, can have various causes. People with chronic tension headaches are often affected by hair pain (trichodynia). This manifests itself as a burning, tingling or painful scalp and is often accompanied by hair loss.
Patients with hair pain are also more often affected by migraine than average. The exact connections have not yet been clarified.
