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What causes tenderness on scalp?

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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

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Posted on Tue, 5 Aug 2014 in Skin Hair and Nails
Question: Hello. I have noticed that my entire scalp is tender to the touch. I have had it for a while, but can't remember exactly when it started. I don't know if it is relevant, but I have had migraines once a month since February of 2014. My doctor ordered an mri of my head and I had this done yesterday. I didn't mention my sore scalp to my doctor though. Also I have cervical spondylosis (degenerative disc disease since 2002). I have had chronic/persistent pain in my neck since early October 2013. I am not as concerned about the soreness of my scalp but after researching online read that it could be a symptom of a more serious disorder. I don't have any other symptoms other than moderate soreness when I touch or massage my scalp though.
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Answered by Dr. Shafi Ullah Khan 3 hours later
Brief Answer:
neurological cause needs management

Detailed Answer:
Thank you for asking
Tender to touch scalp is a presentation of many etiologies like neurological issues as migraines occipital neuritis etc or skin manifestation like dermatitis specially seborrheic dermatitis or a vascular complain like arteritis specially giant cell arteritis an inflammation of scalp arteries or it may be hair related like follicular is etc.
Your case with history of migraine and cervical spondylitis makes it more likely of neurologic origin and it's resolution might be connected with management of these possible factors.
Seek a rheumatologist opinion for management of spondylitis and a neurologist for migraine assistance. And also sorting out of any etiology if present other than that.
Here are some tips that will help migraine.


avoid factors that precipitate a migraine attack (eg, lack of sleep, fatigue, stress, certain foods, use of vasodilators).use a daily diary to document the headaches. This is an effective and inexpensive tool to follow the course of the disease.discontinue any medications that exacerbate your headaches.
Biofeedback, cognitive-behavioral therapy, and relaxation therapy, occipital nerve stimulators,FDA recent approved Cerena Transcranial Magnetic Stimulator (Cerena TMS), are some non pharmacological approaches which help the migraines.
SOme CAM (complementary and alternative medicine) techniques have been proved effective too.Biofeedback and behavioral therapy, herb butterbur (Petasites hybridus),riboflavin (vitamin B2), magnesium, and feverfew,coenzyme Q10 (CoQ10),Melatonin,Body work - Eg, chiropractic, massage, and craniosacral therapy,Nutritional/herbal supplements - Eg, vitamins and herbs,Acupressure and acupuncture, yoga etc are some of the level 1 recommendations by XXXXXXX college of neurology for these migrainous headaches.
Some dietary triggers which trigger migraine need to be avoided.Common dietary triggers include the following:

Alcohol - Particularly wine and beer
Caffeine overuse or caffeine withdrawal
Chocolate
Aspartame - eg, NutraSweet and Equal
Monosodium glutamate (MSG) - May be found in Asian food, canned soup, frozen or processed foods, and the seasoning product Accent
Fruits - Citrus fruits, bananas, avocados, and dried fruit
Nuts - Peanuts, soy nuts, and soy sauce
Tyramine, a biogenic amine that accumulates in food as it ages, may provoke migraine. Sources include the following:

Dairy - Aged cheese
Meat - Bacon, sausage, luncheon meat, deli meat, pepperoni, and smoked or cured meat
Pickled foods
Heavily yeasted breads - Eg, sourdough
Vinegars - Especially wine vinegar
Some types of beans

exercise for migraine prevention (40 minutes 3 times weekly for 3 months) has been proved effective.,Tonabersat,Transient receptor potential vanilloid type 1 antagonists,Prostaglandin E receptor 4 receptor antagonists,Serotonin 5HT1(F) receptor agonists and Nitric oxide synthase inhibitors are some of the novel managements for the migraines these days.
I hope you see the depth of it. Discuss all the possible options with your doctor and let them select what is best for you. COnsult your neurologist and hope for the best.
I hope it helps. Don't Forget To close the Discussion please.
May the odds be ever in your favour.
Regards XXXXXXX


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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