One of the million dollar, catch 22 questions with hair loss accompanying a painful scalp is this: Is the condition that is affecting the scalp also causing the hair loss or is the hair loss affecting the scalp and hair follicles and therefore causing the pain? I'll try to answer this question in the following article.
Painful Scalp Issues That Typically Come Before Hair Loss: First, I'll go over some conditions that often come just before the hair starts to shed and thus contribute to or cause the hair loss. Any condition that can cause inflammation, scaling, or bumps on the scalp can also cause hair loss. Examples of such conditions are:
Run Of The Mill Folliculitis Or Irritation: Sometimes over time we can develop sensitivities to harsh shampoos or hair products. Ingredients like sodium lauryl sulfate (or sls) are commonly used in these products but can also be extremely harmful to folks who are sensitive. Typically, you'll get a rash or little red bumps for less severe cases and deep red boils for severe cases.
The first treatment to this is to stop exposing your scalp to the irritant. Then, you'll need to soothe and heal the scalp because if you don't, some severe cases will progress to scarring or permanent damage to the follicle. Sometimes, dermatologists will prescribe antibiotics in these cases, but I would use condition here because abuse of this or an over reliance will create resistance to treatment down the road or will sometimes contribute to yeast overgrowth (discussed more below.) I advocate trying natural remedies first and then becoming more aggressive if you need to.
Overproduction Of The Scalp: (The Yeast, Sebum, Oil Cycle): Sometimes, the scalp goes in to overdrive and over produces oil and sebum. This in turn can cause yeast overgrown as the yeast feeds upon too much oil. Sometimes, the yeast is the result of yeast overgrowth internally. Some people can tolerate very little carbs or yeast causing foods. Other times, the yeast is the result of antibiotic or medication reactions.
Other times, medical issues (genetics, PCOS, adrenal burn out, or too much testosterone or cortisol) can put oil production into over drive and the normal amount of yeast on your scalp multiplies. This will often present itself with flaking. Sometimes, the flakes are sort of yellowish in color and have an oilier texture.
Ringworm Or Infections Of The Scalp: Infections of the scalp (bacteria, ringworm, etc.) can present themselves for a variety of reasons. Sometimes, you'll find these issues on other areas of your body and sometimes not. You'll often see red patches, swollen blisters, or black colored dots or patches. This is often accompanied by itching and pain. There are some over the counter products for this (many contain the ingredient miconazole), but sometimes you will need a dermatologists prescription. Remember too that these conditions can be contagious to others so you need to be aggressive about treating them.
Psoriasis And Dandruff: So many people believe that these conditions are caused by a dry, flaky scalp, but often the opposite is true. What generally happens is that there is too much oil and sebum, but the shampoos and products that you are using are too harsh and over drying. As a result of this dryness, the scalp becomes tight, itchy, and flaky. However, the flakes here are often white rather than yellow. There are many over the counter shampoos for this, but be careful that what you're using isn't drying out your scalp or irritating it even more. This is a cycle that can be hard to stop. I often prefer natural ingredients like tea tree oil and others.
Painful Hair Follicles That Comes After Shedding And Hair Loss: Burning Scalp Syndrome: Often with telogen effluvium (hair shedding) comes a red, pink, or inflamed scalp that may be painful, may itch or tingle, and be very tight. This is often the result of the shedding process rather than an preexisting issue on your scalp. Many hair follicles are dying off at one time causing a reaction at the site of this loss. Also, regrowth can often cause some itching and tingling.
Some dermatologist will tell you that burning scalp syndrome is psychological, but I beg to differ. All you need to do is look at the redness of your scalp and you will have a different answer. Once the shedding stops, so too should the scalp pain. It's important to do what you can to cut back on the inflammation and to soothe, but stimulate the scalp. Again, many natural ingredients are very effective for this (oatmeal, rosemary, chamomile, etc.)Painful Hair Follicles on the Scalp With Hair Loss - Causes and Treatments
How do I know all of this? Because I lived it. In my quest to end my hair loss, I looked at my shedding triggers, my iron, my thyroid, my adrenals, my hormones, and my scalp's health. It was a long, hard, frustrating journey which all but wrecked my self esteem but I finally found something that helped quite a bit. You can read my very personal story at http://stop-hair-loss-in-women.com/