By Angelica Bottaro 

Updated on May 16, 2023

 Medically reviewed by Casey Gallagher, MD

Scalp pain and tenderness can be caused by dermatitis, scalp and hair follicle infections, or psoriasis. Other causes of scalp pain or soreness include sunburns, headaches, and hair extensions, as well as certain pain or inflammatory conditions.

In addition to a sore scalp, some of these conditions can also lead to other symptoms, like an itchy scalp, hair loss, irritation, dry skin, and red bumps. Treatment may depend on the specific cause of your scalp pain.

This article discusses what causes a sore scalp. It also covers associated symptoms and treatment options, including home remedies.

Verywell / Jessica Olah

Dermatitis

Dermatitis can cause dry skin, redness, and itchiness, including on the scalp. It can be caused by genetics, an overactive immune system, allergies, and irritating substances.¹

 What Is Eczema on the Scalp

Treatment

Treatment depends on the type of dermatitis. In some cases, it may be as simple as avoiding contact with an irritant or allergen.

In other cases, such as seborrheic dermatitis, treatment may involve over-the-counter (OTC) or prescription shampoos that contain ingredients such as topical corticosteroids (like fluocinoline), selenium sulfide, or tea tree oil.²

Infections

A scalp infection is causesd by a pathogen, including viruses, fungi, parasites, or bacteria. These causes of scalp irritation and soreness can include:³

• Folliculitis, an infection of the hair follicles

• Furunculosis, affecting both hair follicles and their glands with oily and waxy substances

• Carbunculosis, which occurs when boils (painful pus-filled bumps) form and group together underneath the skin due to an infection

An infection of the hair follicles can lead to symptoms of pain, itching, and irritation.

Treatment

Treatment depends on the type of scalp infections. It can include Keflex (cephalexin), taken orally, or the topical antibiotic cream Bactroban, along with a mild cortisone cream to help relieve symptoms.⁴

If parasites (like lice or ticks) are the cause, your healthcare provider may use dimeticones.⁵ Antifungals can come in both oral and topical formulas, such as fluconazole, if the cause is a fungal infection.⁶

Centers for Disease Control and Prevention. Treatment for ringworm.

For a mild case of folliculitis, home remedies such as an antibacterial cleanser or anti-itch creams can help. More severe cases will need antibiotics. If boils or carbuncles (clusters of boils) form on the scalp, you will have to get them drained by your healthcare provider.

Psoriasis

Scalp psoriasis affects roughly 80% of people diagnosed with psoriasis, a condition that causes red, itchy, and scaly patches on the skin.⁷ The scalp is usually one of the first areas to be affected by these dry skin symptoms, which can become painful.⁸

 Is Psoriasis Hereditary?

Treatment

Scalp psoriasis can be treated with options that include:⁹

• Topical corticosteroids: Certain medicated shampoos and other over-the-counter products containing salicylic acid can be helpful in the treatment of scalp psoriasis.

• Dithranol: This medication controls the growth of skin cells so they do not multiply faster than they can shed.

• Vitamin D analogs: Vitamin D may help slow the growth of skin cells.

Phototherapy uses ultraviolet light to slow the growth of skin cells, and also can be used to treat scalp psoriasis.¹⁰

Sunburn

A sunburn can cause skin damage to the scalp, leading to pain and irritation. Other symptoms of a sunburn include:¹¹

• Redness on the scalp

• Swelling

• Blisters

• Dry and peeling skin

If the burn is particularly severe, you may also experience weakness, confusion, faintness, dehydration, and shock.

Treatment

In most cases, sunburns can be treated at home. You can alleviate pain on your scalp by taking a cool shower or applying a cool, wet compress to your head. OTC pain relievers such as Advil (ibuprofen) or Tylenol (acetaminophen) and a moisturizing cream with aloe may help with the pain.¹¹

You may want to avoid using certain shampoos or hair products that could cause further irritation. Products that contain benzocaine or similar ingredients ending in "caine," such as topical pain relievers, should be avoided since they can cause irritation.¹²

Can a Sunburn Cause Hair Loss?

Sunburns on the scalp can be serious, but it is unlikely that they will lead to hair loss. If the skin does peel, you may lose some hair. However, once the area heals, those hairs will grow back.

Tension Headache

Tension headaches are the most common types of headaches. They typically occur behind the eyes and in the neck area.

People who have tension headaches often describe the sensation as feeling like a tight band is wrapped around their heads. Pain that occurs during a tension headache can be a cause of scalp tenderness.¹³

Treatment

The first course of treatment for tension headaches is usually OTC pain relievers such as Aleve (naproxen). Many people with this type of headache self-treat at home, but people with recurring tension headaches may need a prescription for the tricyclic antidepressant amitriptyline.¹⁴

Home remedies to help treat a tension headache include:

• Hot and cold therapy: Using a hot or cold compress on the area can help relieve the pain of a tension headache.

• Relaxation techniques: Deep breathing, meditation, and listening to soothing music can help reduce the stress associated with tension headaches.

 How Headaches Are Treated

Temporal Arteritis

Temporal arteritis is characterized by the inflammation and constriction of the temporal arteries (blood vessels) near the temples. It is a rare condition that typically affects adults over age 50. It is more often found in people assigned female at birth than in those assigned male.

Temporal arteritis is considered an emergency because it can lead to vision loss.¹⁵ Scalp tenderness is among the symptoms, which may be vague and vary among individuals.

 Diagnosis and Treatment of Giant Cell Arteritis

Treatment

Temporal arteritis can be managed with medications. The first-line treatment is glucocorticoids, such as the medication prednisone, which can help reduce inflammation in the body.

Is Temporal Arteritis a Health Emergency?

Temporal arteritis, also referred to as giant cell arteritis or Horton’s arteritis, is a medical emergency that requires immediate medical help. If it is left untreated, it can lead to serious health complications that can be life-threatening.¹⁶ 

Fibromyalgia

Fibromyalgia is a pain disorder affecting the soft tissues. The exact cause is unknown, but contributing factors may include abnormal processing of pain messages within the central nervous system, chemical imbalances, and genetics.

Fibromyalgia causes chronic and widespread pain, including on the scalp, along with digestive issues and other symptoms.

 The 8 Types of Fibromyalgia Pain

Treatment

Treatment is focused on improving symptoms and overall quality of life, including treatment of conditions that typically arise alongside fibromyalgia such as:¹⁷

• Sleep disorders

• Obesity

• Depression

• Psychological issues

To help cope with the pain, a variety of medications can be used, such as:¹⁸

• Gabapentinoids to inhibit certain neurotransmitters (chemical messengers in the brain) that cause pain.

• Sedatives to help people with fibromyalgia sleep better.

• Antidepressants: Certain selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are used for fibromyalgia pain.

• Tricyclic compounds: Medications that contain both an antidepressant and a muscle relaxant may also be used to help lessen pain throughout the body.

Treatment may also include self-care, like stress management techniques or exercise.

Does Fibromyalgia Affect Your Hair?

Fibromyalgia affects the whole body and can cause changes that can lead to hair loss. Typically, the hair loss isn't permanent and is more prevalent during times when a person with fibromyalgia is under a significant amount of stress.

 Overview of Fibromyalgia Hair Loss

Hair Extensions

Hair extensions are used to add fullness or length to a person’s hair. They can cause scalp discomfort for a variety of reasons (their weight or related chemical irritation among them) and are linked to headaches and hair loss.¹⁹

Treatment

The treatment for scalp pain brought on by hair extensions is simply having them removed. There is no other way to relieve the pressure on the scalp than to take them out. It's possible that trying a different type of hair extension could help, especially for people who experience scalp discomfort due to an allergic reaction.

When to See a Healthcare Provider

If you experience symptoms such as a severe headache or a rash that appears on other parts of your body as well as your scalp, you should see your healthcare provider.

Any scalp soreness that does not go away within one to two weeks should be further investigated by a medical professional. This includes soreness caused by dermatitis, psoriasis, fibromyalgia, and recurrent tension headaches. Some are chronic conditions that require ongoing management.

Temporal arteritis is a life-threatening condition and needs to be treated promptly at the first sign of symptoms.²⁰

What Healthcare Provider Specializes in Scalp Soreness?

A dermatologist can treat skin conditions that cause scalp sensitivity. For fibromyalgia, you may meet with a rheumatologist. For tension headaches you may be referred to a neurologist. It depends on the cause, so check with your primary care physician about your symptoms first.

Summary

Skin conditions including dermatitis, infections, and psoriasis can affect the scalp and cause tenderness. Other diseases that affect the head or blood vessels in the area such as tension headaches and temporal arteritis can also lead to scalp tenderness.

Systemic conditions like fibromyalgia can cause scalp pain. Sometimes sunburns and hair extensions that are too tight or heavy can irritate the scalp as well.

Treatment to reduce scalp pain depends on the cause. Prevention can include taking good care of your scalp, like brushing your hair gently, changing shampoos if you suspect that your current one is irritating your skin, and ensuring that all hair products are completely rinsed from your hair.