Article by Grace Gold, Allure, December 12, 2017

If you’ve ever experienced it, you know what we’re talking about: painful hair. And no, it’s not just your imagination playing tricks—doctors say the ache is a very real condition, with several common causes. 

The science behind the pain originates in the scalp. “What’s happening is inflammation coming from blood vessels in the scalp is flooding the nerves in the hair follicles and causing them to ache,” explains New York City dermatologist Debra Jaliman. “The pain in the follicle is indistinguishable from the strand, so it truly feels like your hair is hurting,” she adds. 

Tight hairstyles are among the worst perpetrators. High ponytails, cornrows, buns, braids, and updos can all pull and even damage follicles, leading to hair pain, says Lars Skjoth, founder of Harklinikken, a Denmark-based brand that specializes in products to help hair loss and thinning. He suggests wearing these rigid styles no more than a couple times a week, and when you do, not to leave them in all day and night.

“Pay attention to this kind of hair pain—it can be a warning about coming hair loss,” cautions Skjoth. Jaliman agrees and says there’s an official term for it, “traction alopecia,” which is gradual balding from follicles damaged by too-tight locks. She recommends that patients prone to hair pain use only soft cloth hair ties (no grippy elastics!) and opt for loose styles instead of anything that pulls at the scalp. Refrain from sleeping with your hair tied up or otherwise “setting” overnight, as the tension can also tug for hours and result in pain.

Dry shampoo, the beloved bestie for women on the go and workout fiends, is becoming a bigger factor in hair pain due to overuse, says Jaliman. Extending the life of a blowout or using it to buy an extra wash-free day once in a while is fine, but depending on it as a regular replacement for washing your hair can cause residue to cake into follicles. “Most people use way too much and spray it all in the scalp instead of on the strands, too,” says Jaliman. Bacteria can then thrive, especially if they mix with sweat, potentially causing a cascade of inflammation, itching, and pain.

And when it comes to cleansing, hair can be as fussy as Goldilocks; it doesn’t want to be underwashed, but don’t overwash it either and throw the entire pH balance off—that can be yet another cause of painful hair. Constant cleansing dries out the scalp and may even induce a flaking condition like seborrheic dermatitis, which is a chronic state of inflammation, according to Jaliman. Skjoth suggests Harklinikken Balancing Shampoo which balances the scalp and uses oat and mustard-seed extracts to cleanse the scalp naturally.

Another notorious cause of hair pain may be your regular date with hair dye or bleach, which Jaliman knows all about firsthand. “I had premature graying very young, and after so many years of coloring, I developed an intolerance and my hair would hurt whenever I got a touchup,” she says. The dermatologist turned to a chemistry solution; she has her colorist mix a Sweet’N Low packet into the dye to change the pH level to better suit the scalp without affecting the color, and she no longer feels the burn. Unfortunately, the trick doesn’t work with bleach, which can cause such high levels of irritation (especially when left on too long) that Jaliman has prescribed topical steroids to quell the fury for patients with unwavering blonde ambition.

Hair pain is actually a more common—and peculiar—occurrence for those who suffer from migraine headaches. For those afflicted with this excruciating headache condition, the cause is different. “The phenomenon is referred to as allodynia and is present in up to two thirds of migraine sufferers,” explains physician Brian Mitchell Grosberg, who serves as director of Hartford HealthCare Headache Center in Hartford, Connecticut. With allodynia, normally non painful stimuli—like brushing your hair, wearing a hat or a loose ponytail, and feeling water wash over your hair in the shower—become painful. Lying down on the side of the headache can make the scalp feel especially sore and tender, too. “It’s the result of repeated firing of nerve cells in the brain that are involved in the process of migraine,” says Grosberg. Tight hairstyles can certainly be a first contributing step to migraines, though hair that hurts can also happen separately, as part of a migraine attack that is brought on by other triggers.

Data has shown that the best chance of giving migraine sufferers relief with triptans—a class of migraine-specific medications—is taking it early in the attack, before the process of allodynia becomes established, says Grosberg. And if your hair hurts when you get a migraine, you should tell your doctor because it’s a risk factor for developing more frequent attacks, he adds. Grosberg advises working with a headache specialist (you can find one by searching the Migraine Research Foundation database) to ensure your treatment is optimally tailored for the type of migraines you’re having.

Here’s the bottom line: Whether your hair pain stems from styling, hair-washing habits, or migraines, Jaliman recommends letting your hair down as often as possible, since follicles need R&R time to decompress and rejuvenate, just like you.