I recently received correspondence from someone who was reasonably certain that her hair loss and shedding was due to an underlying thyroid problem. However, in addition to the hair loss, he was also experiencing scalp problems. Most of the time, he was tight and itchy. But other times, he also experienced some pain and itching. He had read about the symptoms of hair-related thyroid problems and, although he had learned that hair loss was common, he had been unable to find anything on the corresponding scalp problems. He wanted to know if the scalp problems could be related to the thyroid problems or if they were separate things entirely. I will discuss more about this matter in the following article.

Thyroid problems can lead to telogen effluvium (TE), which in turn can affect your scalp: Scalp problems are not as commonly discussed as a symptom of thyroid problems, although hair loss often is. But, this does not mean that one has nothing to do with the other. Hormonal changes, disorders, or insufficiencies (such as hyper or hypothyroid) can often lead to a condition called telogen effluvium in which hair follicles transition from the growing to the resting stage, resulting in they are shed in large quantities.

Because so many follicles are affected at the same time, inflammation can certainly occur and this in turn gives rise to that pain, itching and tingling I am often asked about. Thyroid problems are not directly causing these problems. The TE is what is causing this, but the hormonal issues caused the TE. So in that sense they are certainly indirectly related. You will often see this condition referred to as “burning scalp syndrome.”

Androgens and hair growth are other issues that can cause tingling, itching, or pain in the scalp: There are a few other things associated with this cycle that can also cause scalp problems. Sometimes when you are at the end of the TE, you will start to regrow a large amount of hair. As those follicles become active again and begin to grow again, you may feel this on your scalp.

Also, sometimes there is an underlying androgen problem or increased androgen sensitivity that the hormonal problem is exacerbating or uncovering. Androgen sensitivity is probably (other than TE) the most common cause of scalp problems and discomfort, so it’s a good idea to consider this possibility as well if you haven’t already ruled it out.

How can you make your problem scalp feel better?: The first step to getting some relief is to see if you can determine why this is happening. If this is due to androgens, there are ways to decrease your sensitivity. It may make sense to try topicals to achieve this before turning to drugs or herbs. If the scalp problems are due to hormonal telogen effluvium, the initial TE will usually have to run its course. (Usually you can try to prevent future shedding by managing the thyroid problem.)

In the meantime, you can and should address inflammation. There are many topicals that can soothe and begin to heal the scalp, as well as stimulate new growth. However, be careful not to use an anti-inflammatory that could clog the follicles you want to stimulate at this time. Tea tree oil and emu oil both work well, but they often need to be diluted and combined with other things to minimize this risk.