A tender spot on the head is a common, localized discomfort, often feeling like a bruise even when no injury is apparent. This sensation is defined as a specific area of pain or heightened sensitivity on the scalp that hurts when touched, brushed, or pressed. The causes for this kind of tenderness can vary widely, ranging from minor, surface-level issues to more complex conditions involving nerves and deeper structures. Understanding the origin of this pinpointed pain is the first step toward finding relief, as the source can be dermatological, musculoskeletal, or neurological.
Scalp and Skin-Related Causes
Many instances of localized tenderness originate directly on the skin of the scalp, usually stemming from inflammation or minor physical trauma. A simple, forgotten bump or bruise is one of the most common culprits, causing localized pressure and soreness that can persist for several days. Prolonged pressure from tight headwear, such as helmets or headbands, or even hairstyles that pull the hair tightly can also cause a specific area to become tender.
Inflammatory skin conditions are another frequent source of pain, with folliculitis being particularly relevant. Folliculitis occurs when hair follicles become inflamed, often due to a bacterial or fungal infection, leading to the formation of small, red, and sometimes pus-filled bumps that are painful to the touch. The inflammation creates a localized pressure, resulting in a tender spot that may resemble a pimple or small boil.
Other dermatological issues, such as contact dermatitis, can also cause sensitivity. This condition results from an allergic reaction or irritation from substances like certain hair products, dyes, or shampoos. Psoriasis or eczema plaques on the scalp can also create intensely tender spots due to the underlying inflammation, scaling, and dryness.
Pain Stemming from Muscle Tension
Tenderness on the scalp can often be a form of referred pain originating from tense muscles in the neck, jaw, and shoulders. This occurs because the nerves that supply sensation to the scalp are closely intertwined with the muscles and structures of the head and upper neck. Tension headaches are a prime example, often causing a feeling of tightness or pressure that can make the scalp, temples, and back of the neck tender to touch.
Muscles in the neck and upper back, like the trapezius, can develop localized areas of tightness called trigger points or muscle knots. These knots can then project pain upward to the head, causing soreness or tenderness on the scalp, even though the issue lies lower in the musculoskeletal system.
Temporomandibular joint (TMJ) dysfunction also frequently contributes to localized head tenderness. Stress or clenching can cause the jaw muscles to become chronically tight, and this tension can radiate pain to the temples, the side of the head, and occasionally the crown.
Specific Nerve and Blood Vessel Conditions
A tender spot on the head can point to irritation of the nerves or inflammation of the blood vessels supplying the scalp. Occipital Neuralgia is a neurological condition characterized by pain that starts at the base of the skull and radiates up toward the scalp, often affecting one side. This pain is caused by the irritation or compression of the greater and lesser occipital nerves, which extend from the upper neck into the back of the head.
The symptoms of Occipital Neuralgia are distinctive, including sharp, shooting, or electric shock-like pain, and often an extreme sensitivity of the scalp in the affected area. Simple actions like brushing hair or lying on a pillow can trigger the pain. The tenderness is localized along the nerve’s path, starting near the neck and moving toward the top of the head.
A less common, but serious, cause of localized tenderness is Temporal Arteritis, also known as Giant Cell Arteritis, which involves inflammation of the arteries along the temples. The inflamed temporal artery often becomes tender and sometimes visibly swollen or throbbing. This vascular inflammation can cause a new, persistent headache, jaw pain that worsens with chewing, and potential vision changes, making immediate medical evaluation imperative.
When Localized Tenderness Requires Medical Attention
While many causes of scalp tenderness are benign and resolve quickly, certain accompanying symptoms serve as red flags that warrant prompt medical consultation. Any sudden onset of severe, explosive pain, often described as the “worst headache of your life,” should be evaluated immediately. Tenderness accompanied by a fever, unexplained weight loss, or persistent fatigue suggests a systemic issue that requires urgent attention.
Vision changes are a particularly concerning symptom, especially when paired with tenderness over the temples, as this may indicate Temporal Arteritis, a condition that can lead to permanent vision loss if not treated rapidly. Furthermore, if the localized tenderness follows a significant head injury, or if the pain intensifies, throbs, or pulsates and does not improve with routine care after several days, a healthcare provider should assess the situation. Persistent numbness, weakness, or scalp pain that makes simple activities like sleeping or hair care intolerable also necessitates professional guidance for diagnosis and management.