What is trichodynia?

woman looks at bald spot in mirror
Does our society have a bias against bald or balding women? See more pictures of skin and scalp problems.
© iStockphoto.com/ampyang

In March 2009, beauty queen Tara Wheeler (Miss Virginia 2008) vowed to shave her head if she raised $500,000 for pediatric cancer research. Why $500,000? That was the bounty set by pageant officials, who told Wheeler that if she was going to lose her hair, she better raise a whole lot of money [source: Roberts, Argetsinger]. Wheeler fell short of her goal and wasn't allowed to shave her head until her reign ended. When her mother finally shaved her head in September 2009, tears fell from Wheeler's eyes. How could they not? Hair is a defining part of a woman's appearance, and it's hard to imagine a beauty queen without lovely locks on which to pin a crown.

But the fact that a bald beauty queen is so hard to imagine is precisely why Wheeler shaved her head. On her fundraising page, Wheeler spoke of visiting children cancer patients and being touched by the girls who lost their hair to their treatments, only to face ridicule at school for their baldness [source: St. Baldrick's]. Wheeler hoped to show these girls that beauty comes from within and is more than just clothes, makeup or hair.


Such a lesson might be hard to learn in this society. A woman's identity is tied up in her hair, to the point that a "bad hair day" can be legitimate cause for feeling down. Women invest in their hair with regular salon appointments, expensive styling tools and enough product to fill the Grand Canyon. Thus, it's quite a shock to the system when a woman begins to lose her hair; the American Academy of Dermatology estimates that 30 million women in the United States alone deal with serious hair loss each year [source: Bouchez]. Causes include genetic predisposition to hair loss, hormones, underlying medical conditions, stress and childbirth.

Male or female, losing one's hair can hurt our pride and vanity. But could it physically hurt? Some people who experience hair loss, particularly women, complain about pain in the hair and the scalp, a condition known as trichodynia. On the next page, we'll examine their claims.


Is Trichodynia Real?

frustrated woman combing hair
Combing hair can exacerbate the pain of trichodynia.
© iStockphoto.com/Casarsa

Very little is known about trichodynia, despite the fact that studies show that it's fairly common. One study found that as many as 34 percent of female patients who experience hair loss complain of trichodynia, which manifests itself as pain and discomfort in the scalp and hair [source: Willimann, Trueb]. The pain increases when the scalp is touched or the hair is combed. Men also complain of trichodynia, but not to the extent that women do. However, that may be because men as a gender are prepared for going bald and are less likely to see a doctor about losing their hair. One researcher has also hypothesized that women may perceive pain differently [source: Willimann, Trueb].

Researchers have tried to determine if trichodynia is a side effect of a certain type of hair loss. People with androgenetic alopecia lose their hair due to genetic factors, while people with telogen effluvium experience a disruption in the hair growth process for various reasons, like environmental factors and childbirth. Hair loss related to androgenetic alopecia is usually permanent, while hair regrows when caused by telogen effluvium once the precipitating factor, such as stress or a medication, is removed. A 2003 study published in the International Journal of Dermatology reported that while trichodynia is common in both major types of hair loss, it's slightly more common in people with telogen effluvium [source: Kivanc-Altunay et al.].


Whether baldness occurs due to genetic or environmental reasons, it's usually a stressful experience. Some researchers have tied trichodynia with the anxiety that women feel over losing their hair, claiming that it's a somatoform disorder that has women confusing their mental anguish with physical symptoms [source: Harth et al.]. Trichodynia often presents itself in conjuction with depressive disorders, obsessive disorders, anxiety disorders and body dysmorphic disorder.

The pain may not just be in people's heads, though. One researcher claimed that it may be due to inflammation of follicles, or to increased presence of neuropeptide P on the scalp, which may have something to do with the degree to which a person feels the inflammation [source: Willimann, Trueb].

At this point, treatment for trichodynia is tailored to the person. If doctors link the symptom with depression over losing one's hair, they may prescribe anti-depressants. If the hair loss is caused by telogen effluvium, doctors may direct their efforts to addressing the underlying factor behind the hair loss.

For more on scalp conditions, see the links on the next page.


Lots More Information

Related HowStuffWorks Articles

  • Bouchez, Colette. "Women and Hair Loss: The Causes." WebMD. Dec. 16, 2003. (Sept. 22, 2009)http://www.webmd.com/skin-problems-and-treatments/hair-loss/features/women-hair-loss-causes
  • Braun-Falco, Otto. "Dermatology." Springer. 2000. (Sept. 22, 2009)http://books.google.com/books?id=HkOty7O_KlkC&printsec=frontcover&source=gbs_navlinks_s#v=onepage&q=&f=false
  • Harth, Wolfgang, Uwe Gieler, Daniel Kusnir, Francisco A. Tausk. "Clinical Management of Psychodermatology." Springer. 2008. (Sept. 22, 2009)http://books.google.com/books?id=NHnEMdgKJbIC&printsec=frontcover&source=gbs_navlinks_s#v=onepage&q=&f=false
  • Kivanc-Altunay, Ilknur, Canan Savas, Gonca Gokdemir, Adem Koslu and Esber Baki Ayaydin. "The presence of trichodynia in patients with telogen effluvium and adrogenetic alopecia." International Journal of Dermatology. 2003.
  • McAndrews, Paul J. rev. "Telogen Effluvium and Other Effluviums." WebMD. July 1, 2005. (Sept. 22, 2009)http://www.webmd.com/skin-problems-and-treatments/hair-loss/effluviums
  • "Miss Virginia 2008 cuts her hair off to help children with cancer." WDBJ. Sept. 22, 2009. (Sept. 22, 2009)http://www.wdbj7.com/Global/story.asp?S=11178584
  • Roberts, Roxanne and Amy Argetsinger. "Miss Virginia's Good News/Bald News Fundraising Plea." Washington Post. March 16, 2009. (Sept. 22, 2009)http://voices.washingtonpost.com/reliable-source/2009/03/rs-missvirginia16.html
  • Shapiro, Jerry. "Hair Loss: Principles of Diagnosis and Management of Alopecia." Informa Health Care. 2001. (Sept. 22, 2009)http://books.google.com/books?id=shP_ZfPRrUkC&printsec=frontcover&source=gbs_navlinks_s#v=onepage&q=&f=false
  • Tara Wheeler Shavee Information. St. Baldrick's Foundation. (Sept. 22, 2009)http://www.stbaldricks.org/participants/shavee_info.php?ParticipantKey=2009-339663
  • Tosti, Antonella, Bianca Maria Piraccini. "Diagnosis and Treatment of Hair Disorders: An Evidence Based Atlas." Taylor & Francis. 2005. (Sept. 22, 2009)http://books.google.com/books?id=_FtwkHHXf8oC&printsec=frontcover&source=gbs_navlinks_s#v=onepage&q=&f=false
  • Willimann, Barbara and Ralph M. Trueb. "Hair Pain (Trichodynia): Frequency and Relationship to Hair Loss and Patient Gender." Dermatology. June 13, 2002.