Scalp dysesthesia

Scalp dysesthesia is a cutaneous condition characterised by pain and burning sensations without objective physical examination findings.[1]:64 The pain sometimes is described as burning. Often there is an underlying psychosomatic cause, such as stress, depression or anxiety.[2]

Scalp dysesthesia
Other namesTrichodynia
SpecialtyDermatology

Only a few studies have been conducted on this condition. A theory behind the condition is that nerves innervating scalp hair follicles send pain messages back to the brain when the follicle no longer has a hair in it, in a similar way to phantom limb pain. Another theory is that people who have this condition (sometimes called "ponytail syndrome") have super-sensitive nerves in their scalp.


In a recent study it was hypothesised that the unpleasant sensations experienced in scalp dysesthesia are the result of a sensory neuropathy secondary to cervical spine dysfunction and chronic tension of the pericranial muscles. 16 patients were treated with a physiotherapist‐designed exercise protocol, 10 patients experienced a subjectively satisfying improvement and four had complete resolution of symptoms.[3]


A possible treatment is to halt hair loss in the patient, however it is important to understand and address any underlying psychologic comorbity.

Use of antidepressants in treatment has been described.[4]

See also

References
  1. James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
  2. Kivanc-Altunay, Ilknur; Savas, Canan; Gokdemir, Gonca; Koslu, Adem; Ayaydin, Esber Baki (September 2003). "The presence of trichodynia in patients with telogen effluvium and androgenetic alopecia". International Journal of Dermatology. 42 (9): 691–693. doi:10.1046/j.1365-4362.2003.01847.x. PMID 12956679.
  3. Laidler, Nicholas K.; Chan, Jonathan (2018). "Treatment of scalp dysesthesia utilising simple exercises and stretches: A pilot study". Australasian Journal of Dermatology. 59 (4): 318–321. doi:10.1111/ajd.12807. ISSN 1440-0960. PMID 29577244.
  4. Hoss, D.; Segal, S. (Mar 1998). "Scalp dysesthesia". Arch Dermatol. 134 (3): 327–30. doi:10.1001/archderm.134.3.327. PMID 9521031.


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