The sensation of burning on the top of the head may present as a persistent warmth, a sharp sting, or a tingling, prickling sensation that seems to originate just below the skin surface. Medically, these abnormal sensations are often grouped under the terms scalp dysesthesia or paresthesia. Understanding the cause requires looking beyond surface irritation to consider inflammation, nerve function, and environmental factors.
Neurological and Nerve-Related Causes
Burning sensations that feel deep, electrical, or sharp are frequently linked to irritation or damage within the nervous system. A common cause is Occipital Neuralgia, a condition involving the occipital nerves that travel from the neck, up the back of the head, and into the scalp. When these nerves become inflamed or compressed, the pain is often described as piercing, throbbing, or electric-shock-like, radiating upward to the top of the head or behind the eye. This pain is neuropathic, stemming from the nerve itself rather than a skin problem. Simple movements like brushing hair or resting the head on a pillow can sometimes trigger this intense discomfort.
Dermatological and Scalp Conditions
When the burning sensation is accompanied by visible signs of irritation, such as flaking or redness, a dermatological condition is a likely cause. Seborrheic Dermatitis, often known as severe dandruff, is a common inflammatory condition characterized by greasy, yellowish scales and underlying red skin, resulting from a reaction to a naturally occurring yeast. Scalp Psoriasis is another inflammatory condition that causes a burning feeling due to rapid skin cell turnover, presenting as raised patches covered by thick, silvery-white scales. Folliculitis, the inflammation or infection of the hair follicles, also causes a surface burning sensation. This condition appears as small, pimple-like red bumps or pustules that can be tender to the touch and cause localized pain.
External Triggers and Environmental Factors
Acute, temporary burning sensations are often caused by external irritants or environmental exposure. A severe sunburn on the scalp is a common cause, leading to an immediate burning feeling, tenderness, and sometimes peeling skin. Allergic Contact Dermatitis is a reaction where the scalp becomes inflamed due to contact with substances like hair dyes, harsh chemicals in shampoos, or styling products. The burning or stinging usually occurs hours to a day after exposure, often accompanied by redness, itching, and scaling. Physical tension can also trigger discomfort, as extremely tight hairstyles like braids or ponytails constantly pull on the hair follicles and surrounding nerves, causing inflammation that resolves when the hairstyle is loosened.
When to Seek Medical Help
While many cases of burning scalp are due to minor, temporary irritations, certain signs indicate the need for professional medical evaluation by a dermatologist or neurologist. A sudden onset of severe, debilitating pain, or a burning sensation that lasts for several weeks without improvement from home care, warrants a doctor’s visit. It is important to seek help if the burning is accompanied by specific “red flag” symptoms. These concerning signs include new or spreading numbness or weakness in other parts of the body, changes in vision, unexplained fever, or a rash that is spreading rapidly or oozing pus. Diagnostic testing may include a physical examination, a skin biopsy to rule out inflammatory diseases, or nerve block injections to pinpoint the source of neuropathic pain.