Painful scalp. What could be causing this?

Discussion in 'Open Topic (General)' started by Little Star, Nov 15, 2010.

  1. Little Star

    Little Star New Member

    My scalp is sore, and I don't know why. I did have Telogen Effluvium (and lost about half my hair) which came to an end about a month ago. It was shortly after that time that my scalp began to hurt. I have heard of people experiencing scalp pain/itchiness during TE but never after it ends so I am at a loss for what could be occuring.

    My scalp appears normal most of the time although it is very sensitive and can become inflammed looking if I aggravate it i.e. put a product on it that it doesn't like. I never had sensitive scalp prior to or during TE so I am so confused. My family thinks I'm crazy because I complain of my sore/burning scalp but they can't see anything wrong. I can't get into the derm for another month and in the meantime I am freaking out.

    My hair is definitely not falling out anymore (my derm confimed this as well) and I can feel/see new regrowth.

    The only thing I can think of that might have caused this is topical steroid use. I did have a very minor case of Seb. Derm during my TE which eventually went away on it's own. But my doctor insisted that I use topical steroids to treat it to prevent inflammation from the dermatitis. I used them as directed for about a month, but they did not seem to help the condition. I haven't used the topical in about three weeks, which would coincide with the time my scalp started to hurt. Could steroids cause an aggravated scalp, even weeks after you discontinue use?

    Any ideas or thoughts would be appreciated!
  2. pilar

    pilar Member

    Hi Little Star:

    My TE also came to an end about 1.5 months ago and I also had some scalp pain and itching. I saw a derm in September (when TE was coming to an end) and she saw inflammation and dandruff scales. I've never had scalp issues in my life and since coming off the pill (that I was on for only 2 months) I was hit with TE and a mild case of Seb Derm. My derm prescribed Nizoral 2% and a steroid lotion to apply once a day for 7 days. I ended up using the lotion for 8 days and now the pain is completely gone. Some of the redness and scales are still there, but slowly diminishing with the use of the Nizoral 2%.

    Besides the steroid, did your derm prescribed a medicated shampoo?

    I also never had a sensitive scalp, but since going through TE it seems that my scalp has become very picky. If I use the same products I used before all of this happened, my scalp becomes itchy and painful. I've had to try out a lot of products and find which ones don't aggravate my scalp. My derm told me that during TE and TE recovery, your scalp is a lot more sensitive than it ever was. So many follicles were shocked into the telogen phase and I guess this has an effect on the entire scalp.

    What shampoos are you using now?
  3. Little Star

    Little Star New Member


    THANK YOU SO MUCH FOR RESPONDING. I was starting to think I was crazy. Not that I wish this torture on anyone, but it is good to know that someone else has experienced this. I have tried numerous anti-dandruff shampoos including Nizoral, T Gel and now Head & Shoulders. I was on the steroid meds for about a month. I was on Clobetasol, which is very potent, and I am worried I may have irritated my scalp with its use. My dermatologist did not tell me that it is one of the most potent topical steroids nor did he tell me that I should not use it for more than two weeks at a time. My dandruff cleared up on its own but I know my scalp must still be inflamed if it's hurting like this. I find it weird that this didn't start until after the TE stopped.

    Currently I use baby shampoo because it is pretty gentle on my scalp. If I notice any flakes, then I use the Head & Shoulders.

    Even with the flakes and inflammation you have noticed do you have regrowth? I am fairly certain I can feel a lot of it (it feels kinda spiky when I run my hands over my scalp) and I see some as well. But I'm worried that if this pain continues my hair will fall out again.
  4. pilar

    pilar Member

    Little Star:

    You're definitely not crazy! Going through TE and all these scary scalp sensations will sometimes make you feel that way...but it all seems pretty common.

    I was also prescribed a pretty strong steroid (can't remember the name) but it was similar to Clobestol (Clobex). My derm said that there was an inactive ingredient in Clobex that could possible aggravate the Seb Derm even more so she prescribed another one. So I wonder if that's what you're experiencing now - irritation from the inactive ingredient in Clobestol? After the 2nd-3rd day of applying the steroid, the pain and itching went away. I was also told by my derm that since the inflammation on my scalp wasn't too bad, that she only wanted me to use it for 7-10 days tops. She said it could be used up to 4 weeks, but that was for severe cases of inflammation.

    A month ago I tried Head & Shoulders and it seemed to irritate my scalp. My scalp became really itchy and red. I think my scalp reacts to the Pyrithione zinc. Have you tried prescription strength Nizoral? The 2% seemed to work a lot better than the over the counter 1%.

    Yes, even with the scales and inflammation I have noticed re growth. I've noticed that I've lost some of the new growth, but my derm says this is normal, especially after TE. She said sometimes the follicles need a few runs to get it right. But I also wonder if the inflammation if having an effect on those new hairs. Right now I'm using a Tea Tree Oil shampoo and Nizoral 2% twice a week. This routine seems to be working really well and slowly getting rid of the redness and scales.
  5. Little Star

    Little Star New Member

    Yes, it is normal to lose some of the new growth. My derm said the same thing. As my TE was coming to an end I wasn't losing any long hairs, but a bunch of the baby hairs were coming out, and my derm said not to worry. I dry my hair over the sink every morning upside down to see what I lose, and now I'm not even losing the baby hairs any more. You should notice the loss of new growth decrease and then eventually stop as time goes on.

    My pharmacist friend also said Clobetasol has a lot of inactive ingredients in it that could be irritants so perhaps that is the problem. But it seems weird that the irritation would continue 3 weeks after discontinuing use. I would think that if that was causing my issues, I would have experienced it while using the steroid, which I didn't. I have read that inflammation can sometimes worsen once you stop steroid meds so perhaps that's the issue. I know people with psoriasis who have told me it gets way worse once they stop steroids. I may go refill my prescription and try it on my scalp tonight to see what happens. I put a call into my dermatologist, and I am hoping he gets back to me today with an answer. I need some relief from this! My scalp has gone from being mildly sensitive to sore to the touch in certain areas. I will ask him about Nizoral prescription strength when he calls as well.

    I also read somewhere that an Apple Cider Vinegar rinse is good for infection/inflammation of scalp. I think I might try that. Like you, I have to be very careful what I put on my scalp because even products I used in the past now make my scalp extremely irritated. I put Jojoba Oil on it the other night which I have used several times before with no problems, and my scalp turned bright red and broke out in little red bumps. And Jojoba Oil is supposed to have anti-inflammatory properties! It's just incredible how sensitive my scalp has become since TE.
  6. pilar

    pilar Member

    From what I've read (and told by my derm) is that you don't want to use steroids too frequently. When I first saw her at the end of September, the inflammation on my scalp wasn't too bad and she didn't want to prescribe a steroid lotion. She wanted me to continue using the over the counter Nizoral which had been working at the time. Then I went and used Clarifing shampoo, Nizoral, T/Sal, Head & Shoulders and dyed my hair...all in 4 days. That completely irritated my scalp and then I needed steroids. But from what I've heard, they shouldn't be used too often.

    Yes, I have also read about Apple Cider vinegar and a friend of mine that suffers from Seb Derm has done the rinses. For her it worked at first and then she noticed it was making her scalp itchier. I've bene tempted to try it, but the routine I'm on right now seems to be doing the trick. It's usually when I go chaning it that my scalp suffers.
  7. Little Star

    Little Star New Member

    I am a little annoyed with my derm because I feel he jumped the gun in prescribing steroids to me. My Seb. Derm was very mild, and I was not experiencing much scalp pain, just a little itching. He basically put the fear into me and said I needed to use it because if I didn't my Seb. Derm could cause hair loss. I have since learned that only severe Seb. Derm can do that. It seems like since coming off the steroids things have gotten worse. I sincerely hope he didn't make things worse by having me on Clobetasol for that long. I just don't know what to do at this point. If one of the most potent steroids didn't help my inflammation, what will?
  8. pilar

    pilar Member

    Me too! When I first saw my derm, my scalp was only itchy and I had some tingling. But I didn't have any scalp pain and that's why she didn't think a steroid was necessary. It wasn't until I totally irritated my scalp by using products I wasn't suppose to that she thought a steroid was necessary. But even then, she only wanted me to use it once a day, for 7-10 days. No more than that.

    My derm also said that only severe cases of Seb Derm actually cause hair loss. But she does think that in my case, the Seb Derm did contribute to an increase in shedding. She said that during TE, our scalps are already really sensitive. So having a Seb Derm flare up, even if it's mild, will have an effect on our scalp/hair. It wasn't until I started using the Nizoral that the shedding started to decrease.

    For me, I think the Nizoral 2% has helped with the Seb Derm and also the inflammation. I used the steroids for 8 days and then stopped. Even though the steroid got rid of the itching and pain, I still had a lot of redness on my scalp. Since then I'm still using the the Nizoral 2%, twice a week and the redness is slowly decreasing (the scales too).

    I don't remember the name of the steroid I was prescribed, but I'll look for it when I get home and post it here. My friend that also has Seb Derm was prescribed Capex shampoo. This is also a steroid but a VERY mild one. Maybe you can ask for something like this.
  9. Little Star

    Little Star New Member

    I think I will ask for a more mild steroid. I am now so terrified to put anything on my scalp that I will probably have a heart attack when I have to apply it. lol

    I will let you know how everything goes, and if I ever get some relief from this. Good luck with your issues as well and please keep me posted.
  10. Little Star

    Little Star New Member


    One more question: did you experience a burning/tingling sensation when your scalp was at its most sensitive? I am feeling this pain, but my scalp is not red at all.

    Luckily I got my dermatologist appointment moved up to next week. I am so very worried about all this mainly because I fear a return of the shedding, and I have so little hair left as it is.
  11. pilar

    pilar Member

    Oh yeah! The second time I saw my derm after irritating my scalp with all thos medicated shampoos and then dyeing it - my scalp was sore to the touch and it burned and tingled. It was awful. It was a constant reminder of the hair loss. Around the 2nd-3rd day of the steroid, the pain, burning, tingling and itching began to disappear. For me all of the irritation was right on the top part of my scalp. Even just moving my hair in the area would cause some pain. I have a feeling that the Clobestol irritated your scalp instead of helping it. I know it's been 3 weeks since you discontinued it, but you just never know.

    For me, even with the pain/burning/itching, it didn't seem to affect me shed. I think being in TE recovery, it might take a lot more for the scalp issues to affect your shed. It's great that you got an appointment next week!

    The steroid that I used (and worked well) was Diprolene 0.05% - this is just as strong as Clobestol but the inactive ingredients have a smaller chance of aggravating your scalp and especillay Seb Derm prone scalps.

    It also wouldn't hurt to ask for a prescription for Nizoral 2%. I've been using this twice a week for almost and a month and my scalp seems to feel better and better every day. Nizoral has also been shown to help with hair growth, so there's an added bonus.

    When is you appointment? Please keep us posted. Good luck!!!
  12. Little Star

    Little Star New Member

    Hi Pilar,

    Thank you for posting that. I was an anxious mess today. I don't know if I can make it to next Wednesday (when my appt. is) without going crazy.

    I did the math, and I actually only used the steroid for two weeks (which is a relief as I originally thought I overused them). But I do think they are to blame for irritating my scalp as it was not this bad until after the steroid use.

    I called my derm today because I couldn't stand the burning feeling. I am a huge hypochondriac and googling all the possible causes of this pain is not helping as people only post the worst case scenarios. Sigh.

    Please tell me this pain is not permanent!
  13. pilar

    pilar Member

    The pain is DEFINITELY NOT permanent! I know when you're going through it, it feels like it's never going to end or get better. But rest assured that it will! Like I said before, when I first saw me derm, even though I had some inflammation and itching, she didn't think steroids were necessary. She was scared that it would cause more harm. It wasn't until I irritated my scalp and had redness, inflammation, pain and burning that she thought it was necessary. It's a shame that your derm prescribed it prematurely. I know you're weary about steroids, but I would talk to your derm about Diprolone and see what he thinks. It's the steroid I used for 8 days and by the 2nd day the burning, tingling and pain was gone!

    I went crazy for the first 10 months of this looking stuff up online and looking back on it now, it was a huge mistake. It always seems like people go online and post when things are bad, and when things improve, they go on with their lives - especially with hair loss. I would recommend staying away from the internet and looking stuff up. Yeah it's good to educate yourself, but also be aware that a lot of the stuff you're going to find are worse case scenarios. I remember when all this started, I thought the shedding would never stop and that I'd always be shedding over 200 hairs a day. I even imagined myself bald by now! It's been 14 months since I went off the pill and a year since TE set in and here I am with thin hair (but not noticeable to most) and a lot of re growth. Oh and a comfortable scalp that continues to improve each day.

    Things will get better!!!!
  14. Little Star

    Little Star New Member


    I hope you are right. In the back of my mind I know that there must be something out there that can help calm my scalp down, but my anxiety is really causing issues. I'm unable to relax, can't sleep, can't focus at work. I just focus on the burning sensation and obsess. :(

    At this point I am almost afraid of my derm. I really feel he was being negligient in prescribing that potent a steroid twice a day for seb. derm. He didn't warn me not to use them past two weeks (I figured that out through my own research) and he also didn't give me instructions on how to use them (didn't warn me not to put on a wet scalp, which I did occasionally, did not tell me how much to use on what size area, etc.) If I hadn't done my own research I would probably still be dumping a ton of that crap on my head excessively. I am almost afraid to listen to future medical advice from him and may go to my GP tomorrow for his opinion.

    The burning sensation was so irritating to my nerves today that I had a major panic attack and told my mom I wanted to be taken to the ER because I felt like I might have a nervous breakdown. My anxiety is out of control! Sorry to rant to you. I am just so scared and frustrated and completely worn out from the anxiety I am experiencing. I appreciate your support and quick responses to my posts and questions.
  15. pilar

    pilar Member

    When I first noticed the hair loss back in November 2009, I suffered from a 3 days long panic attack. I coudln't sleep and eat. I finally saw my doctor and was put on anti-depressants and anti-anxiety meds. Once I found out this could also cause hair loss, I decided to wean myselff off. I was on them for 2.5 months. So I can totally understand how all of this is sending you into panic mode.

    Don't be scared of your derm. This time around you're going in there with a lot more knowledge. Be honest with him and let him know what you think. Don't let him dismiss you and make sure he explains everything to you and how it's going to help you.

    You don't have to apologize about your rant. I've been there and I know how it feels. All of this can be very overwhelming and even with the support of our family and friends, it's kinda hard to really find people that understand.
  16. Little Star

    Little Star New Member

    I have been on anti-anxiety medication for four years. Can't be without it or I have intense panic attacks. They also recently put me on a mood stabilizer. I was terrified to go on the mood meds for fear it would make my TE worse, but I was in such a bad state my doctor insisted. Luckily, my TE stopped while taking them so they haven't produced any unwanted side effects. I worry all the time about using medications and the effect it has on my hair. It's amazing how paranoid about everything TE makes you.

    You said your TE stopped about 1.5 months ago and that you notice regrowth. I do as well, but my scalp still has thin spots. I am assuming with time those will thicken back up? I'm sure a month isn't enough time to grow enough hair in areas that were affected the most, but just curious what your hair looks like right now. Do you still have thin areas?
  17. pilar

    pilar Member

    I think if you've been on them for 4 years and even before TE, you should be fine. I have 2 very close friends that have been on both anti-depressants and anti-anxiety meds and their hair is fine. I think when we're hit with TE we just become a little (or A LOT) more paranoid about possible triggers.

    Oh I still have thin spots! My derm told me that with TE, follicles will stay dormant for longer than the normal 2-3 months. So I think a lot of the re growth that is now 3-4 inches is from the hair I lost a year ago. My hair loss was very diffuse but it seems worse on the sides and top. I think it will take a while for those thin spots to fill because I'm still shedding the normal 50-100 hairs a it's basically a catch up game.

    Even though my hair is still thin, my Derm thinks that by January I should see A LOT more re growth since it takes a little longer for those affected follicles to start producing healthy hairs. And from what I've read (and derm agrees), it seems like 3-6 months after TE stops, you will start to see significant re growth.

    I saw my derm in September and then in October when the hair loss was finally back to normal and I remember telling that I was worried because my hair felt like it was at it's thinnest. She said I can't expect for tons of re growth as soon as shedding stops. It will take some time.
  18. Little Star

    Little Star New Member

    That is reassuring. I suspected as much but wanted to hear your experience. My derm told me the same thing (maybe he does know what he's talking about). He said in February I will notice significant regrowth that will be visible to my eye. He also told me a couple of months ago that in December he would be able to see "buds" on my scalp which I assume is a term for hair follicles that are just starting to grow but are not long enough to be visible. So, hopefully he notices those at my appointment this Wednesday.

    I will let you know how everything goes, what he says about my scalp pain, etc. Please keep me posted on your recovery as well as it sounds like we're on the same time schedule for recovery. We can recover together! It's going to be a lengthy process, that's for sure. Do you have long hair or short hair? Mine is long so it's going to be awhile before it's back to normal.

    PS: I also wanted to mention to you that your Seb. Derm was probably the result of stopping the BC. I just made the connection. I stopped Yasmin for about three weeks while I was going through TE, and about a month after that I got acne and the Seb. Derm developed. Since BC controls oil production, it would make sense. I also think my Seb. Derm and acne only cleared because the hormones in the BC kicked back in once I started taking it again.
  19. Little Star

    Little Star New Member


    I also wanted to ask you if your derm thinks you will make a full recovery i.e. get all your hair back despite the issues with inflammation/irritation?
  20. pilar

    pilar Member

    My derm also mentioned the "buds" last time I saw her! She was looking closely at my scalp and said "I see some baby buds coming in but you won't be able to notice them for another few months". I didn't bother to ask her exactly what she meant by buds, but it sounded good to me! LOL

    A few weeks ago I also took a close-up of my scalp and a friend that is also recovering from TE saw pictures and mentioned "black dots". She said those dots are the follicles starting to sprout hairs and in a few months I'll be able to see them. She said she saw the same thing when her hair started to grow back.

    When I saw my derm a month ago, she mentioned seeing a lot of re growth, but saying that I still had a ways to go. That's why she wanted to me in January and by then I should have siginificant re growth. I'm actually seeing her next Tuesday as a check-up for my Seb Derm. The scalp discomfort is gone and the redness and scales are about 90% gone. So I'm just going in for her to take a look and tell me she sees more "baby buds"! :)

    She also agrees that going off the pill prob caused the Sed Derm. For me it actually flared up 8 months after stopping the pill. She said it could of been caused by the change in hormones, oil production and stress. She said during severe stress (like what I experienced) your immune system suffers...and that's a perfect combo for Seb Derm to show up. I have always had an oily scalp but NEVER had scalp issues until going off this pill (only on it for 2 months) and during TE. It's clearing up nicely after a month of Nizoral 2% (twice a week), so I'm hoping I'll be in the clear after this.

    Are you still on Yasmin?

    Yes, my derm believes that I will make a full recovery! She just told me that I have to be patient and that it's going to take some time. She said inflammation on the scalp makes it harder for the follicles to bounce back from TE, but they will once you take care of the inflammation. For me, even with the inflammation I had a month ago, I still have a lot of re growth.