Why Is My Head Tingling
About 150,000 people in the U.S. receive a trigeminal neuralgia diagnosis every year. People assigned female at birth (AFAB) are more likely to develop it than people assigned male at birth (AMAB). Most cases develop after age 50. Trigeminal neuralgia very rarely affects children.
Trigeminal Neuralgia
Trigeminal neuralgia is a chronic pain disorder that causes intense pain attacks in your face. It happens when your trigeminal nerve is damaged or irritated. Several treatment options can help relieve pain, ranging from medications to surgical procedures.
Overview
Trigeminal neuralgia (TN) causes episodes of intense facial pain that can disrupt your everyday activities.
What is trigeminal neuralgia?
Trigeminal neuralgia (TN) causes episodes of intense facial pain that can disrupt your everyday activities. It typically happens when a blood vessel puts pressure on your trigeminal nerve near your brainstem. This nerve provides sensation to your head and face. Trigeminal neuralgia is a type of neuropathic pain.
Trigeminal neuralgia isn’t life-threatening, but it can be life-altering. Activities as simple as chewing, talking, smiling and brushing your teeth can trigger brief bouts of intense pain, making TN both a physical and emotional condition. TN is typically chronic (long-term) but several treatments can help manage your symptoms.
Another name for trigeminal neuralgia is tic douloureux.
How common is trigeminal neuralgia?
About 150,000 people in the U.S. receive a trigeminal neuralgia diagnosis every year. People assigned female at birth (AFAB) are more likely to develop it than people assigned male at birth (AMAB). Most cases develop after age 50. Trigeminal neuralgia very rarely affects children.
Symptoms and Causes
What are the symptoms of trigeminal neuralgia?
The main symptom of trigeminal neuralgia is sudden, intense pain in your face — usually on one side. The pain may be an electric shock-like or stabbing sensation. You may also have facial muscle spasms during the attacks. In between pain attacks, you may feel the following sensations:
- Burning.
- Throbbing.
- Numbness.
- Dull achiness.
There are two main forms of trigeminal neuralgia based on how you experience symptoms:
- Paroxysmal TN: You experience painful episodes that are sharp, intense and sporadic. During an episode, you may feel pain and/or a burning sensation in your face that can last anywhere from a few seconds to two minutes. Though there will be pain-free breaks in between episodes, this can continue for up to two hours.
- TN with continuous pain: This type is less painful and intense, but the pain is more frequent. You feel constant pain, notably stabbing and/or burning sensations, along with persistent aches and pains. With atypical trigeminal neuralgia, you may have more difficulty managing the symptoms.
Typically, trigeminal neuralgia is unilateral, meaning it only affects one side of your face. In rare cases, it can affect both sides of your face (bilateral) but not at the same time. In some cases, trigeminal neuralgia can get worse over time with longer and more frequent pain attacks.
Trigeminal neuralgia symptom triggers
It’s mostly simple activities that require you to move or touch your face that can trigger painful TN episodes, including:
- Shaving, putting on makeup or washing your face.
- Eating and drinking.
- Brushing your teeth, flossing and using mouthwash.
- Talking and smiling.
- Applying any pressure to your face, especially to your cheek or jawline.
- Encountering a light breeze or gust of wind on your face.
The pain attacks rarely occur during sleep.
What causes trigeminal neuralgia?
In general, pressure on or damage to your trigeminal nerve causes TN. Healthcare providers categorize trigeminal neuralgia based on the specific cause:
- Primary (classic) TN: This type happens when a blood vessel (usually the superior cerebellar artery) pushes on part of the trigeminal nerve root (nerve compression). It’s the most common cause.
- Secondary TN: Secondary TN happens when another condition damages or affects your trigeminal nerve, like multiple sclerosis (MS), a tumor or arteriovenous malformation. People with secondary TN are more likely to be younger and have pain on both sides of their faces. Only 15% of TN cases are secondary.
- Idiopathic TN: Providers diagnose idiopathic TN when there’s no clear cause of your facial pain after doing diagnostic tests.
What are the risk factors for trigeminal neuralgia?
Factors that may increase your risk of developing TN include:
- High blood pressure.
- Smoking.
- Aging.
- Female sex.
- Having a biological family history of TN.
Why Is My Head Tingling?
A sensation of tingling on the top of your head can be caused by skin conditions, skin sensitivities, medications, anxiety, migraines, and more.
Known as paresthesia , this common experience may feel like a tingling, prickling, burning, or itching sensation on the scalp. You’ve probably experienced this pins and needles sensation when your arm or leg “falls asleep” after sitting or lying in one position for too long.
Treatment for a tingling scalp will depend on the underlying cause.
Causes
Some people may have recurrent or ongoing (chronic) paresthesia caused by injury, medication, skin sensitivities, or a health condition that affects the central nervous system. Determining the cause of your tingling scalp is essential for getting proper treatment.
Some people worry a tingling scalp could mean a stroke. A tingling scalp can have many different causes, so check with your healthcare provider for a diagnosis. For any of the following symptoms of a stroke, call 911 for immediate medical help:
- Sudden confusion
- Difficulty speaking or understanding speech
- Sudden numbness or weakness on one side of the body
- Problems with balance or controlling muscles
- Sudden difficulty with vision
Several factors can cause persistent tingling on the head and scalp.
- Skin Sensitivities: One of the most common causes of tingling scalp is sensitivity to environmental factors, such as ultraviolet (UV) rays from the sun, cosmetics (e.g., shampoo, hairspray, and other hair products), and pollutants. Some hair care products and other cosmetics contain chemicals and fragrances that can cause skin irritation. A 2021 study found that sensitive skin is linked with a sensitive scalp, and women are likelier to experience sensitive scalps than men.
- Atopic dermatitis: Often called eczema, atopic dermatitis causes red, dry, itchy patches of skin on the scalp and other parts of the body. Scratching and itching can break the skin and may lead to infection.
- Folliculitis: This is an inflammatory disorder that affects hair follicles on the scalp and can lead to a tingling scalp. It can cause small red bumps and skin lesions on the scalp and hairline that may lead to burning, itching, and tingling. Common causes are bacterial, fungal, and viral infections.
- Psoriasis :Scalp psoriasis is characterized by patches of dry, scaly skin on the scalp. It may look like dandruff or appear as crusted, thick plaques all over the scalp. It can also cause plaques on the forehead, back of the neck, and skin surrounding the ears. Scalp psoriasis affects at least half of people living with psoriasis.
- Seborrheic dermatitis : One of the common types of eczema affecting the scalp and hairline, seborrheic dermatitis can cause red, scaly, itchy, thick patches on the scalp. It may also appear on other body parts near the scalp, such as eyebrows, hairline, eyelids, and nose.
- Medications: A side effect of certain medications (e.g., anticonvulsants, chemotherapy drugs, blood pressure medicines, psychotropics) may cause a tingling scalp. This can occur when medications cause injury or damage to the peripheral nervous system (nerves outside the brain and spinal cord).
- Alopecia: An autoimmune disorder called alopecia areata causes irritation and damage to hair follicles. This leads to hair loss that often comes out in small, quarter-size patches. Many people with alopecia may experience tingling and itching sensations before hair loss occurs.
- Anxiety/stress: When under stress, your body releases stress hormones that ready your body for the “fight or flight” response. This rush of stress hormones to the brain leads to blood flow being directed to areas that can help you escape the perceived threat and may lead to tingling in other body parts. One study found that anxiety can lead to hyperventilation (taking in too much oxygen), which can also cause scalp tingling.
- Migraine headaches: Many people have a sensory experience, known as an aura, at the onset of a migraine that can cause sensory and visual disturbances. Some aura migraines cause a “pins and needles” tingling sensation on the skin and may affect the scalp. Migraines also affect blood flow into the head and scalp, which can cause paresthesia and other sensations on the scalp.
- Giant cell arteritis (GCA): This is a common blood vessel disorder in older adults (ages 50+). It causes inflammation in arteries that leads to poor circulation. Symptoms of GCA include headaches, visual disturbances, arm and jaw pain, and scalp tenderness.
Other Health Conditions
Although less common, these underlying health conditions may cause tingling on the scalp:
- Diabetes
- Head lice
- Hormonal fluctuations
- Infection
- Multiple sclerosis
- Nerve damage
- Occipital neuralgia
- Scalp infections (e.g., tinea capitis )
- Seizures
- Stroke
- Weather factors (e.g., wind, heat, cold)
- Autonomous sensory meridian response (ASMR)
What Is ASMR?
Autonomous sensory meridian response (ASMR) is a sensory experience to audio or visual stimuli that trigger a tingling sensation that often begins in the scalp and moves down the back of the neck and spine. Those who experience ASMR often say it is a pleasurable sensation that promotes feelings of calm relaxation.
What Does a Tingling Scalp Feel Like?
Paresthesia of the scalp can feel different from person to person. Common sensations include:
- Burning
- Itching
- Numbness
- Pins and needles
- Prickling
Diagnosis
Healthcare providers will diagnose your tingling scalp based on your medical history and symptoms. They will do a physical examination, which may involve testing your reflexes and muscle function. To identify the underlying cause, they may order tests, such as:
- Blood tests
- A nerve conduction study
- Imaging tests, such as computed tomography (CT) scan or magnetic resonance imaging (MRI)
Treatment
Treatment for a tingling scalp varies depending on the underlying cause. If a skin condition is affecting your scalp, your healthcare provider may suggest special shampoos, topical creams, or prescription medications.
If an underlying medical condition is causing scalp tingling, your healthcare provider will diagnose the condition and recommend suitable treatments.
Home Remedies
Scalp tingling is often temporary and may go away on its own or through the use of home remedies and lifestyle modifications, such as:
- Avoiding hair products that contain added fragrances
- Doing a skin patch test before using new cosmetics (e.g., shampoo, conditioner).
- Getting plenty of sleep to help reduce stress/anxiety or improve other health conditions
- Exercising regularly to help with stress/anxiety and improve other health conditions
- Making time for relaxation (e.g., breathwork, meditation, yoga, walking)
- Maintaining good standing, sitting, and sleeping posture
- Reducing stress
- Visiting your healthcare provider for regular check-ups
When to See a Healthcare Provider
See your healthcare provider if your tingling scalp:
- Lasts for several days or longer
- Is interfering with your day-to-day life
- Is accompanied by other symptoms, such as hair loss, headaches, or pain elsewhere in the body
Summary
A tingling feeling in the scalp (paresthesia) can occur for many reasons, including anxiety, ASMR, chemical irritation, medication, migraines, nerve compression, skin sensitivity, and underlying health conditions. See your healthcare provider if you have ongoing scalp tingling. They will perform a physical examination and run tests to determine the cause and recommend appropriate treatments.
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