The simultaneous experience of a burning scalp and noticeable hair shedding signals underlying inflammation. This inflammation can range from mild, reversible irritation to severe conditions that threaten permanent hair follicles. Because the causes vary significantly—from simple product reactions to complex autoimmune disorders—a professional assessment is necessary to accurately identify the source and begin appropriate treatment. The burning sensation itself, sometimes called trichodynia, often indicates that the inflammation is disrupting the normal hair cycle.
Inflammatory Reactions and Contact Sensitivities
Many cases of scalp burning and increased hair shedding originate from contact with external irritants or allergens. Inflammation damages the scalp’s protective barrier, which can prematurely push growing hairs into the shedding phase, known as telogen effluvium.
Allergic contact dermatitis occurs when the scalp develops a delayed hypersensitivity reaction to a specific chemical ingredient. Common culprits include paraphenylenediamine (PPD) in hair dyes, certain preservatives, or fragrances.
Irritant contact dermatitis is a more common, non-allergic reaction that arises from direct damage to the skin barrier. This is frequently caused by overly harsh ingredients, such as strong sulfates, or highly alkaline products like bleaches and relaxers. Leaving product residues on the scalp can also sustain low-grade inflammation. Removing the offending product typically allows the inflammation to subside and the hair cycle to normalize.
Infectious Sources of Scalp Pain
When a burning scalp and hair loss are accompanied by pustules, crusting, or distinct scaly patches, a microbial infection may be the cause. The resulting inflammation damages the hair follicle structure, often leading to patchy hair loss caused by the physical destruction or fracture of the hair shaft.
Tinea capitis, commonly known as ringworm of the scalp, is a fungal infection. The non-inflammatory type may resemble severe dandruff with broken, short hairs (“black dots”). The highly inflammatory type, called a kerion, appears as a painful, boggy mass with pus discharge. This severe reaction can lead to permanent hair loss if not treated promptly with oral antifungal medication.
Folliculitis involves the inflammation of one or more hair follicles, often due to a bacterial infection, most commonly Staphylococcus aureus. It manifests as small, painful, red bumps or pus-filled lesions resembling acne around the hair shaft. While usually temporary, severe or chronic cases can cause scarring that results in small, permanent bald spots.
Recognizing Signs of Scarring Hair Loss
The most serious causes of a burning scalp and hair loss are primary cicatricial alopecias, or scarring hair loss. These autoimmune disorders cause inflammation that permanently destroys the hair follicle’s stem cells, replacing the follicle with scar tissue. Because this destruction is irreversible, early diagnosis and treatment are necessary to halt progression.
Lichen planopilaris (LPP) is a common form that presents with scalp pain, burning, and itching. It is characterized by localized patches of permanent hair loss, often with perifollicular erythema (redness around the follicle opening). Another distinct sign is peripilar desquamation, a fine scale adhering tightly to the hair shaft.
Frontal fibrosing alopecia (FFA) is a variant of LPP that primarily affects the frontal hairline, causing it to recede symmetrically. It is also frequently associated with the loss of eyebrow hair. A defining feature of scarring alopecia is the complete absence of follicular openings within the affected bald patch, indicating the hair follicle has been fibrosed.
Discoid Lupus Erythematosus (DLE), a form of cutaneous lupus, also causes scarring alopecia. DLE lesions appear as well-demarcated, coin-shaped patches of hair loss with central atrophy, scaling, and color changes. Because the different forms can clinically overlap, a definitive diagnosis often requires a scalp biopsy to examine the inflammation pattern.
Immediate Action and Professional Assessment
While waiting for a professional appointment, several immediate steps can be taken to soothe the burning sensation and prevent further irritation. Avoid all forms of mechanical trauma, including aggressive brushing, tight hairstyles, and scratching, as these worsen inflammation and increase hair shedding. Heat should also be avoided, meaning no hot showers, blow dryers, or styling tools near the scalp.
Gentle cooling measures can help reduce acute burning and tenderness. Applying a cool compress or using very mild, fragrance-free shampoos may offer temporary relief. Do not apply products like oils, ointments, or home remedies, as they can interfere with a later diagnostic examination or worsen a potential infection.
The complexity of these symptoms requires an evaluation by a medical professional specializing in skin and hair disorders. A dermatologist, particularly one with a subspecialty in hair (a trichologist), is the appropriate specialist. They will use diagnostic tools, such as a physical exam, a hair pull test, and potentially a biopsy, to pinpoint the exact cause. Given the risk of permanent hair loss associated with inflammatory and scarring conditions, self-diagnosis and delayed treatment are not recommended.