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Q: Scalp Ache (Ponytail Syndrome) ( Answered,   2 Comments )
Subject: Scalp Ache (Ponytail Syndrome)
Category: Health > Women's Health
Asked by: downunder-ga
List Price: $10.00
Posted: 06 Apr 2003 04:10 PDT
Expires: 06 May 2003 04:10 PDT
Question ID: 186724
I regularly get what feels like a hair ache on the crown of my head.
It is as though the roots of a clump of hair are aching. What causes
this and how does one treat this.
Subject: Re: Scalp Ache (Ponytail Syndrome)
Answered By: nancylynn-ga on 06 Apr 2003 09:08 PDT
Hello downunder-ga: 

You asked:

"I regularly get what feels like a hair ache on the crown of my head.
It is as though the roots of a clump of hair are aching. What causes
this and how does one treat this."

Your title says "Ponytail syndrome," but you don't mention in your
question that you pull your hair taut. I assume you meant you have
that sort of sensation, even when your hair isn't pulled taut.
(Otherwise the pain would have gone away once you removed the rubber
band or hair ribbon!) So I went hunting for possible causes of your

I first tried searching under "ponytail syndrome" and found that the
pain is caused by hair breakage in the "forehead region." See "Kevis
Hair Rejuvenation":

But I suspected this is more likely a medical problem. "Trichodynia"
is a catch-all term for hair pain, and there's some current research
and debate regarding its possible causes and significance.

Some people who've experienced hair pain, have also suffered hair
loss. But studies searching for a possible link suggest hair pain
doesn't mean baldness is definitely in your future.

A 2002 summary, "Hair pain (trichodynia): frequency and relationship
to hair loss and patient gender," by Willimann B, Trueb, posted at the
National Library of Medicine's site:

concerns a 2002 study that examined whether trichodynia may be a
predictor of hair loss and concluded: "The symptom neither allows
discrimination of the cause nor correlates with the activity of hair
loss. A higher prevalence of female patients might be connected to
gender-related differences in pain perception in relation to anxiety."

This January 16, 2003 report from Stop Hair Loss Now, "Hair Pain Does
Not Correlate to Hair Loss":

offers encouraging news that hair pain may NOT be a portent of
eventual hair loss.

I realize you hadn't mentioned you were having hair loss, but since
you may come across that theory, I wanted you to be aware of it.

I finally had some success when I searched WebMD, where I found an
article, "Super-Sensitive Nerves Play Key Role in Migraine Pain." The
April 2000 article is posted at:{5FE84E90-BC77-4056-A91C-9531713CA348}

Here's some excerpts: "The most interesting part of the study was when
I asked patients 'Does your hair hurt? Do you feel pain from your
earrings or glasses or water in the shower; can you shave without
pain?'" lead investigator Rami Burstein, PhD, tells WebMD."

"Stephen Silberstein, MD, director of the Jefferson Headache Center in
Philadelphia, calls the research a major advance in understanding
migraines. Silberstein, who was not involved in the study, tells WebMD
that the findings confirm something physicians long suspected. '. . .
[F]or a long time we have been hypothesizing what happens in people
during a migraine attack -- we've been saying maybe it is
sensitization, but nobody ever demonstrated it is true," he says. "It
tells us why migraine sufferers suffer pain everywhere, why their hair

Incidentally, WebMD's search engine didn't recognize the term
"trichodynia," so I found that article by typing "hair pain."

I found a brief article -- sorry, I lost the link -- that notes that
the study of hair pain is in its infancy; the phenomenon is not that
well understood at this time, but research is in progress.

The consensus from the material I have read strongly suggests that you
MUST tell your doctor about your hair pain. If he/she dismisses your
symptoms, seek a second opinion.

You will likely be referred to a neurologist and a dermatologist and,
from what I've read, you should be examined by one or two specialists.
Obviously, the treatment will be based on the diagnosis. (If it is
early stage migraine, there are several new, very effective
prescription drugs that may help you.)

Beyond popping over-the-counter pain medications -- which may not be
addressing your pain, as it is --  it doesn't appear that you can
remedy this problem without expert medical guidance.

But I do suspect you have "super-sensitive nerves," and the pain you
feel in your hair is very real pain that requires medical attention.

Search Strings: "hair pain"
                "trichodynia cause treatment"

I hope that my research has helped you, and I certainly hope you
receive an accurate diagnosis very soon.

Clarification of Answer by nancylynn-ga on 06 Apr 2003 10:24 PDT
It occurred to me that I should try a search using the term "scalp

At Discovery Health I found a comprehensive page on "Scalp Problems":

The possible causes of scalp pain listed at the site range from
allergies to cold weather to autoimmune disorders. Smoking can even
produce scalp pain. This site will also give you a good idea of how a
diagnosis is made and possible treatments.

This may be "referred pain" you're experiencing. The Online "Ear, Nose
and Throat Clinic" has a brief discussion of that topic at:

The Q & A notes that, for instance, sinusitis may cause pain at the
back of the head.

Again, you really need to report this discomfort to your doctor.

I hope you feel better soon!

Subject: Re: Scalp Ache (Ponytail Syndrome)
From: voila-ga on 06 Apr 2003 11:35 PDT
Besides the excellent information provided by nancylynn, you might
also consider the substance P factor.  As mentioned, this research is
still in its infancy so you would need to seek a specialist in this

"The cause of burning scalp syndrome is not understood and has not
been researched in any detail. However, there is some preliminary
research and much speculation that changes in the production and
activity of neuropeptides in the skin may play a role. There is some
evidence of an interaction between neuropeptides produced by nerve
cells in the skin and the hair follicle cycle. In particular, skin and
hair follicle concentrations of a factor called "substance P"
fluctuate in tune with the growth and rest of hair follicles.
Substance P can initiate pain sensations. In principle, it may be that
as hair follicles are adversely affected in a hair loss disease and
more of the follicles enter a telogen resting state the levels of
substance P or similar neuropeptides in the skin significantly

It would probably be prudent for you to see a board-certified
dermatologist who specializes in hair.

Best of luck to you,
Subject: Re: Scalp Ache (Ponytail Syndrome)
From: voila-ga on 06 Apr 2003 11:36 PDT
Oops, forgot to give you the link for this information.

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