Differential Diagnosis for Pain Combing Hair
- Single most likely diagnosis
- Traction alopecia or hair pulling/scalp sensitivity: This condition is often caused by excessive hair pulling or tension on the hair follicles, leading to pain when combing or brushing hair.
- Other Likely diagnoses
- Dandruff or seborrheic dermatitis: Inflammation and flaking of the scalp can cause discomfort and pain when combing hair.
- Scalp psoriasis: Similar to dandruff, the inflammation and scaling associated with psoriasis can lead to pain when combing.
- Hair tangles or knots: Severely tangled hair can cause pain when trying to comb it out.
- Folliculitis: Inflammation of the hair follicles, often due to infection, can cause pain and discomfort when combing hair.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Scalp cellulitis or abscess: Bacterial infections of the scalp can cause severe pain, redness, and swelling, and if left untreated, can lead to serious complications.
- Meningitis: Although rare, meningitis can cause scalp pain and stiffness, and is a medical emergency.
- Rare diagnoses
- Trichotillomania: A psychological disorder characterized by compulsive hair pulling, which can lead to pain and discomfort when combing hair.
- Loose anagen syndrome: A rare condition where hair is easily pulled out, leading to pain and discomfort when combing.
- Scalp lymphoma: A type of cancer that can cause pain, itching, and discomfort on the scalp, including when combing hair.