What causes burning scalp syndrome?
While researchers believe it is influenced by a multitude of factors, the exact causes of burning scalp syndrome are not yet fully understood by the scientific community. Some scientists have theorised that it is the result of hair follicle inflammation or of an autoimmune response, but there was not sufficient evidence to confirm this [2].
Nutritional deficiencies (e.g. vitamins B12, E and D, folate or zinc) were also suspected to contribute to this problem, but a study conducted on 91 patients with diffuse hair loss and 74 healthy controls revealed no evidence to support this [3].
Ultimately, the most compelling scientific explanation is that psychiatric disorders, such as depression, anxiety, chronic stress and obsessive compulsive disorder are the main factors which contribute to burning scalp syndrome [1] [2] [3]. According to this theory, the syndrome accompanies telogen effluvium and androgenetic alopecia because both of these conditions are influenced by mental distress and they can, in turn, produce further stress for those who face them [4].
The connection between anxiety and hair loss is long documented, just as it is known in the scientific community that depression can cause hair loss. But we are just beginning to understand the way in which these psychiatric conditions affect our experience and interpretation of physical sensations.
Psychological distress seems to play a significant role in our perception of pain and it can make us experience distressing symptoms with little to no underlying physical causes.
This does not mean that the burning pain sufferers are feeling is not real, it only means that due to their psychological condition, they may have a lower threshold for pain and may process sensations differently than those who do not.