Scalp Symptoms: The 6 D's

The 6 D’s of Scalp Symptoms.

Scalp symptoms are common in many different types of hair and scalp disorders. A broad approach is needed by the physicians in order to properly diagnose the condition. Here is a list of some of the most common reasons for individuals to have scalp symptoms.

1. Diseases/Disorders of the scalp 

A variety of inflammatory scalp disorders can trigger symptoms including scalp psoriasis, seborrheic dermatitis, scarring alopecia, dermatomyositis, tinea capitis, sunburns, irritant and allergic contact dermatitis. Common hair loss conditions such as androgenetic alopecia, telogen effluvium and scarring alopecia are also associated with burning in some cases.

2. "Dysesthesias" 

As mentioned above, the scalp dysesthesias are a group of conditions that give physical symptoms in the scalp without any other unusual findings at the time of examination.  The cause of scalp dysesthesias is not clear. One study suggested that a high proportion of women with scalp dysesthesias had cervical spine disease. It seems that patients worsen with stress and improve with anti-depressants (venlafaxine, amitriptyline). Many respond to gabapentin.  The burning scalp syndrome (similar to burning mouth syndrome) is a variant of scalp dysesthesia. Sensitive scalp syndrome may also be as well.

3. Depression and Other Psychological Issues.

·     There is a well-known relationship between the brain and the skin. Stressful life events are a well-known trigger to scalp itching, burning and other symptoms. Scalp symptoms are more common in patients with a host of psychological and psychiatric diagnoses including depression, anxiety, post-traumatic stress disorder and schizophrenia.

4. Drugs 

Drugs can trigger scalp symptoms including itching, burning, and pain. This includes both topical drugs and oral medications. Topical medications containing alcohol are frequent triggers or scalp burning. Topical calcipotriol, minoxidil topical steroids, and a host of anti-dandruff shampoos can trigger symptoms. Oral medications, including cyclophosphamide can trigger scalp symptoms like burning. 

5. Damaged Nerves  

Scalp symptoms may be a result of damage to nerves. As mentioned above, cervical spine disease may be one such condition. But diabetes, multiple sclerosis, and stroke can all give scalp symptoms.  

6. Deprivation of Sleep 

Sleep deprivation has been associated with a range of cutaneous symptoms including scalp itching, burning and pain