Should I worry if my hair falls out and my scalp hurts?

Sometimes I hear from people who are dealing with sudden and severe hair loss. One day, they wake up to notice tons of hair falling on their clothes, or coming out in their comb, or clogging the shower drain. As if this wasn’t bad enough, they sometimes experience scalp pain during this process. They often wonder if there is some medical problem that is the root cause of this.

I recently heard someone say, “I woke up this weekend and there was tons of hair on my pillow. When I showered and washed my hair, a lot more came out. I was hoping things would go back to normal in a day.” or two, but this has not been the case. Not only is the shedding as bad as ever, for the past few days my scalp has been so sore. It almost beats like a heartbeat. I have had seasonal shedding before, but it always passed quickly and never caused my scalp pain. Could it be the result of a medical problem that I need to be concerned about? Could there be something wrong with me?

I’m certainly not a doctor, and if you have medical concerns, you should see one. But I can tell you that sometimes with a hair loss condition called telogen effluvium (TE), it’s not uncommon to have scalp pain. This can happen for a couple of reasons. First, when you have ET, many of your hair follicles enter the resting or shedding phase of their life cycle at the same time. This is not the normal way things work on a normal head of hair. When your hair is shedding normally and going through its typical cycle, only about 5 percent of your total strands are in this shedding phase at any one time. But when you have TE, many more can go into the shedding phase, which means many will call at once. This process can cause inflammation. As a result of this, you can get that sore scalp we’ve been talking about.

Now, with that being said, there are medical problems that can have hair loss and a sore scalp as symptoms. Again, I’m not a doctor, but just a few examples are thyroid, endocrine, or autoimmune issues to name just a few. As I said before, if you think you might have a medical problem, talk to your doctor. Telogen effluvium (TE) is not always the result of disease. It can also be due to stress, hormonal changes, weight loss, anesthesia, or childbirth. As you can see, in these cases, there is really nothing medically wrong. But your body has gone through changes that have reset your hair cycle.

How to soothe a sore scalp: Anti-dandruff shampoos can help reduce some of the inflammation and provide some pain relief. Aloe vera juice that is dropped on the scalp with an eyedropper can be quite soothing. Tea tree and emu oils are also popular options. Just be careful that whatever you do isn’t thick enough to clog the hair follicles.

People often ask me how long they are going to have to put up with a sore scalp. There is no easy answer to this. Sometimes you continue to have scalp problems as shedding and hair loss continue and sometimes you only see it in the early phases of ET. Unfortunately, some people who have chronic telogen effluvium (the kind that lasts longer than 3 months) seem to have the highest instances of scalp pain, but this is just my unscientific observation. For many, scalp problems are a passing thing that ends up with TE. And for others, it becomes a recurring problem.