Scalp dysesthesia

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Scalp dysesthesia is a cutaneous condition characterised by pain and burning sensations without objective physical examination findings.{{cite book |author1=James, William D. |author2=Berger, Timothy G. |title=Andrews' Diseases of the Skin: clinical Dermatology |publisher=Saunders Elsevier |year=2006 |isbn=978-0-7216-2921-6 |display-authors=etal}}{{rp|64}} The pain sometimes is described as burning. Often there is an underlying psychosomatic cause, such as stress, depression or anxiety.{{cite journal |last1=Kivanc-Altunay |first1=Ilknur |last2=Savas |first2=Canan |last3=Gokdemir |first3=Gonca |last4=Koslu |first4=Adem |last5=Ayaydin |first5=Esber Baki |title=The presence of trichodynia in patients with telogen effluvium and androgenetic alopecia |journal=International Journal of Dermatology |date=September 2003 |volume=42 |issue=9 |pages=691–693 |doi=10.1046/j.1365-4362.2003.01847.x|pmid=12956679 }}

Only a few studies have been conducted on this condition. A theory behind the condition is that nerves innervating scalp hair follicles send pain messages back to the brain when the follicle no longer has a hair in it, in a similar way to phantom limb pain. Another theory is that people who have this condition (sometimes called "ponytail syndrome") have super-sensitive nerves in their scalp.{{cn|date=July 2021}}

In a recent study it was hypothesised that the unpleasant sensations experienced in scalp dysesthesia are the result of a sensory neuropathy secondary to cervical spine dysfunction and chronic tension of the pericranial muscles. 16 patients were treated with a physiotherapist‐designed exercise protocol, 10 patients experienced a subjectively satisfying improvement and four had complete resolution of symptoms.{{Cite journal|last=Laidler|first=Nicholas K.|last2=Chan|first2=Jonathan|date=2018|title=Treatment of scalp dysesthesia utilising simple exercises and stretches: A pilot study|journal=Australasian Journal of Dermatology|language=en|volume=59|issue=4|pages=318–321|doi=10.1111/ajd.12807|pmid=29577244|issn=1440-0960}}

A possible treatment is to halt hair loss in the patient, however it is important to understand and address any underlying psychologic comorbity.{{cn|date=August 2021}}

Use of antidepressants in treatment has been described.{{Cite journal | last1 = Hoss | first1 = D. | last2 = Segal | first2 = S. | title = Scalp dysesthesia | journal = Arch Dermatol | volume = 134 | issue = 3 | pages = 327–30 |date=Mar 1998 | doi = 10.1001/archderm.134.3.327| pmid = 9521031 | doi-access = free }}