Scalp Pain (Trichodynia)

Dilated Blood Vessels Frequently Seen in Trichodynia

“Trichodynia” is a somewhat poorly defined term that generally refers to hair pain. To learn what trichodynia really feels like, I encourage physicians I teach to wear a hat (especially a heavy helmet) for many hours and then feel what it’s like when one removes the hat and proceeds to move their hair from one side to the other. The unpleasant experience is ... trichodynia! (and it hurts!). There are many potential causes of trichodynia and so anyone with these symptoms needs careful evaluation. Scarring alopecias, alopecoa areata, telogen effluvium, stress, anxiety, depression all can cause trichodynia.

A study by Willimann and Trueb (in 2002) showed that dilated blood vessels seen in the scalp were strongly associated with trichodynia. The reasons still are not entirely clear but may be related to the release of the neuropeptide known as “substance P.” Substance P is a potent vasodilator and may explain (at least partly) the blood vessel dilation sometimes observed in patients with trichodynia.

REFERENCE

Willimann B, et al. Hair pain (trichodynia): frequency and relationship to hair loss and patient gender. Dermatology. 2002.