Trichodynia Revisited

January 2021 in “ Skin appendage disorders ”

Ralph M. Trüeb, Michela Starace, Bianca Maria Piraccini, Hudson Dutra Rezende, Maria Fernanda Reis Gavazzoni Dias

trichodynia telogen effluvium androgenetic alopecia neuropeptides gabapentin botulinum toxin nonirritating shampoos Botox

Studysummary This review discusses the complex causes of trichodynia and reports no clinical results; the authors call for more research into neural and immune interactions in scalp conditions.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document reviewed trichodynia, a condition with painful scalp sensations often linked to hair loss, and found it to be associated with various hair loss conditions like telogen effluvium and androgenetic alopecia, as well as psychological disorders. A significant study with 403 patients showed no correlation between trichodynia and the degree or type of hair thinning. The document suggests that neuropeptides may play a role in the condition, and that the term trichodynia might not adequately describe the diverse causes of scalp discomfort. Various treatments, including nonirritating shampoos and medications like gabapentin, have been used with varying success, and botulinum toxin treatment is considered promising. The document emphasizes the need for further research into the neural and psychosomatic aspects of hair and scalp conditions and clarifies that trichodynia does not necessarily indicate active hair loss. No conflicts of interest or funding were reported for the study.

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Research cited in this study

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research The Role of Sleep in Telogen Effluvium and Trichodynia: A Commentary in the Context of the Current Pandemic

6 citations , January 2021 in “Journal of Cosmetic Dermatology”

This article discusses the potential association between stress, poor sleep, and telogen effluvium during the COVID-19 pandemic, highlighting the possible role of substance P, but reports no new clinical results.

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27 citations , December 2020 in “Experimental Dermatology”

This study reported that COVID-19 was causally associated with postinfectious hair shedding, which varied with disease severity, but hair completely recovered.

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3 citations , August 2020 in “Journal of The American Academy of Dermatology”

This study observed that patients with scalp dysesthesia frequently exhibited cervical spine degenerative changes, which localized predominantly in the lower cervical spine, and reported modest symptom improvement with neuropathic pain medications and physical therapy.

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30 citations , January 2020 in “Journal of The American Academy of Dermatology”

This review reports no new clinical results but discusses fibrosing alopecia in a pattern distribution as a distinct scarring alopecia with characteristics of both androgenetic alopecia and lichen planopilaris.

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56 citations , August 2019 in “Clinical, Cosmetic and Investigational Dermatology”

This essay discusses telogen effluvium, the issues surrounding its diagnosis and differentiation from other forms of hair loss, and emphasizes the need for empathetic patient care; it reports no new clinical findings.

research Telogen Effluvium With Dysesthesia Has Lower B12 Levels and May Respond to B12 Supplementation

3 citations , November 2018 in “PubMed”

This study identifies a specific subtype of Telogen Effluvium associated with scalp dysesthesia, such as itch or burning, in the absence of any inflammatory scalp disorder or medication association.

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14 citations , August 2018 in “Frontiers in Cellular and Infection Microbiology”

This study found that dengue virus infection caused inflammation and cell death in human hair-follicle dermal papilla cells, which may contribute to increased hair shedding observed during the epidemic in Taiwan.

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15 citations , May 2016 in “Archives of Dermatological Research”

This study found significantly higher levels of the protein ULBP3 in patients with alopecia areata incognita compared to other hair loss conditions and healthy controls, suggesting ULBP3's potential as a diagnostic marker for AAI.

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26 citations , December 2015 in “International Journal of Dermatology”

This abstract reviews the symptom of trichodynia, a painful scalp sensation linked to hair loss, and highlights its potential connection to inflammation but reports no new research findings.

North American Virginian Witch Hazel (Hamamelis Virginiana): Scalp Care and Protection for Sensitive Scalp, Red Scalp, and Scalp Burn-Out

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11 citations , January 2014 in “International Journal of Trichology”

This study observed that patients using Erol(®) Energy shampoo and tonic reported improved symptoms of scalp irritation and rated product tolerance as good to excellent.

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9 citations , January 2013 in “Acta dermato-venereologica”

The conclusion is that "trichoknesis" should be recognized as a separate condition from trichodynia, characterized by itching instead of pain.

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33 citations , November 2012 in “JAMA Dermatology”

In this study, 14 out of 15 women with scalp dysesthesia also had cervical spine disease, and gabapentin improved symptoms for some patients.

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60 citations , October 2009 in “Dermatology”

This article proposes a hypothesis for alopecia areata hair loss patterns and provides epidemiological evidence supporting distinct hair loss characteristics between general cases and those with androgenetic alopecia; it presents no new clinical results.

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46 citations , September 2003 in “International Journal of Dermatology”

This study found that trichodynia is common among patients with telogen effluvium and androgenetic alopecia, and it often coexists with psychological issues like depression and anxiety.

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48 citations , January 2002 in “Dermatology”

In this study, hair pain (trichodynia) was reported by a significant portion of patients with hair loss, but it did not correlate with the cause or activity of the condition.

Indications for a Brain-Hair Follicle Axis: Inhibition of Keratinocyte Proliferation and Up-Regulation of Keratinocyte Apoptosis in Telogen Hair Follicles by Stress and Substance P

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125 citations , September 2001 in “The FASEB Journal”

This study demonstrated that stress inhibited hair growth in mice, likely through substance P-dependent activation of immune cells, highlighting a brain-hair follicle connection.

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16 citations , February 2001 in “PubMed”

This study found that allergic contact dermatitis of the scalp may cause telogen effluvium, leading to mild to moderate hair loss in some patients.

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63 citations , March 1998 in “Archives of Dermatology”

This study describes a new condition called scalp dysesthesia in 11 women, most of whom experienced symptom improvement with low-dose antidepressants.

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234 citations , December 1996 in “Journal of The American Academy of Dermatology”

The authors concluded that chronic telogen effluvium in middle-aged women presents distinct clinical and histological features that differ from androgenetic alopecia and acute telogen effluvium.

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43 citations , July 1994 in “Archives of Dermatology”

This study found that the prevalence of personality disorders in individuals with androgenetic alopecia was significantly higher than in the general population, irrespective of gender.

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309 citations , May 1993 in “Journal of The American Academy of Dermatology”

This study concluded that horizontal sections of scalp biopsy specimens provide more diagnostic information for male pattern androgenetic alopecia than vertical sections and can predict hair regrowth potential following topical minoxidil therapy.

The Importance of Adequate Serum Ferritin Levels During Oral Cyproterone Acetate and Ethinyl Estradiol Treatment of Diffuse Androgen-Dependent Alopecia in Women

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83 citations , April 1992 in “Clinical Endocrinology”

This study found that treatment with cyproterone acetate and ethinyl oestradiol increased hair density in women with diffuse androgen-dependent alopecia, particularly when serum ferritin levels were above 40 μg/l.

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124 citations , August 1990 in “British Journal of Dermatology”

Diffuse alopecia in women may be related to androgens and iron deficiency, and basic hormone and nutrient screening is useful.

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666 citations , September 1977 in “British Journal of Dermatology”

This article presents a classification system for stages of female-pattern androgenetic alopecia to aid early diagnosis and mentions existing systems for rare male-pattern cases, but reports no new clinical results.