WHISTLER SCALP DYSESTHESIA CLINIC
Our Whistler clinic sees patients with scalp pain syndromes and dysesthesias. The scalp dysesthesias are a group of conditions in which scalp symptoms occur despite the lack of clinical evidence of anything looking wrong with the scalp. These including patients with itching, burning and pain. It is important to rule out subclinical hair and scalp disorders in anyone with scalp symptoms. A variety of inflammatory scalp disorders can trigger scalp symptoms including scalp psoriasis, seborrheic dermatitis, scarring alopecia, androgenetic alopecia, telogen effluvium, dermatomyositis, tinea capitis, sunburns, irritant and allergic contact dermatitis.
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1. What types of hair loss are the most common causes of scalp symptoms like itching, burning and pain?
There are many reasons for scalp symptoms including:
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, amitrytyline). 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 calcipqotriol, 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
2. How types of treatments are available for scalp symptoms ?
The type of treatment depends on the diagnosis. The scalp dysesthesias may respond to tricyclic and SSRI type antidepressants, topical and oral gabaepentin, doxepin. Referral for psychological, medication, biofeedback may be beneficial.
3. Why are the dysesthesias hard to treat?
We are still learning a lot about dysesthesias and similar pain syndromes. We don't understand all the complex factors responsible for these conditions in the present day and age. Sometimes we are successful in treating these conditions. Othertimes, we are not.
