Update on Trichodynia, a Challenge for Dermatologists

Trichodynia, characterized by scalp pain often associated with various types of alopecia, remains a therapeutic challenge for dermatologists. Initially described in 1996 in patients with telogen effluvium, it is now linked to androgenic alopecia, scarring alopecia, alopecia areata, trichotillomania, and chemotherapy-induced alopecia. It is also frequently associated with psychiatric conditions like depression and anxiety, particularly in women. The pathogenesis is unclear but may involve substance P, psychiatric comorbidities, and perifollicular inflammation. Diagnosis is clinical and exclusionary, with no specific treatments available. Potential therapies include botulinum toxin A, antidepressants, neuromodulators, propranolol, corticosteroids, and topical cannabinoids. More research is needed to develop effective treatments.