Ever feel like your hair hurts?
“Hair-triggered migraine” or “ponytail migraine” starts as an external compression headache that may develop into a full migraine attack. These migraines are caused by a stimulus outside your head – i.e., hair being pulled too tight or wearing restrictive headwear. Ponytail migraine or ponytail headaches are common conditions classified as a kind of allodynia: pain from a stimulus that should only produce sensation.
Today, Sarah Alexander-Georgeson talks about hair as a migraine trigger and how to avoid aggravating a sore or sensitive scalp.
I've always had a sensitive scalp prone to extreme soreness. My mum and nan would be careful brushing my hair as a child because the slightest tug was agony. Of course, I wasn't a child that complained about pain – I dealt with it so often - but if anyone pulled my hair, it wasn't long before the tears spilled over.
Related: Understanding Migraine – Prodrome and Postdrome
But what does this have to do with migraine?
Well, I started getting migraines in my early teens, but I always wore my hair in a ponytail. I hated having my hair in my face as it was long, thick, and constantly getting in the way.
When I'd get home from school, I used to race through the door in a rush to get my ponytail down. My scalp felt like it was on fire - every strand of hair hurt as it pulled at my skin and caused a world of pain. But, when I unwound that tight hair bobble every evening, the relief was instant.
How tight hairstyles or heavy hair can trigger migraine
At the time, I hadn’t heard of “ponytail migraine” or of hair as a migraine trigger. In fact, I never considered that tying up my hair had anything to do with my pain issues. But, as I got older, I stopped wearing my hair back due to having far too many migraines.
I later found out this could be allodynia, which can mean feeling pain at the softest touch. I always wear my hair down, now – but I’ve noticed even this relaxed style can affect the soreness of my scalp.
Now for a short, science-y bit:
Although there aren't any nerves in your hair, scalp tenderness links to extremely sensitive nerves running from the back of the neck to the forehead. When a tight style, like a ponytail, it triggers a sensation of tightness in too many of these nerves and you can get a horrible, grinding headache.
If you suffer from migraine, as I do, the stress and sensation of this pain can trigger a full attack – hence “ponytail migraine”. I wised up and stopped wearing my hair in a ponytail a long time ago, but my thick, heavy hair often pulls on these sensitive nerves anyway.
If you feel the onset of a ponytail migraine, the first thing to do is take your hair down. Gently massage your sore scalp, and focus on breathing deeply. This won’t guarantee you’ll avoid a migraine, but the relief can instantly lower your stress levels.
Unfortunately, allodynia isn’t only triggered by tight hairstyles. Anything that adds weight to your hair can cause a sore scalp, like getting your hair wet or adding leave-in hair products.
Nowadays, for example, the only time my long hair is a migraine trigger is when I need to wash it. The build-up of grease adds even more weight to my hair, inflaming the nerves and causing scalp pain. When this happens, I can't even touch my head, never mind brush my hair. It's like every strand is a needle-point digging into my skin.
My boyfriend washes my hair twice a week, which is enough. I avoid using any product, as it builds quickly and defeats the purpose of not adding extra weight. That said... I adore dry shampoo. I swear it works wonders for a quick refresh, and it doesn't aggravate my sensitive scalp.
Experimenting with hairstyles to manage migraine attacks
I've experimented with some up-dos over the years, just in case I need my hair out of my eyes. I find a loose bun on top of my head works best. Using a scrunchie prevents pulling, as the hair doesn’t wrap around or get caught in a tight bobble.
Migraine also prevents me from wearing many hairbands, clips, or anything restrictive, like a sleep mask. Like a tight hairstyle, restrictive headwear can cause an external compression headache depending on your scalp’s sensitivity.
Related: How Migraine Takes Away My Control
At first, I worried I couldn’t wear hats again, as I consider them a key accessory in my wardrobe. I went through months of trial-and-error, testing out different hat styles and seeing which ones I could withstand. Thankfully I’ve found a few – and taking off a hat is much easier than pulling out a ponytail!
As well as hats and hairstyles, I’ve also experimented with different haircuts. Before I knew how much my hair triggered scalp pain and migraine attacks, I asked my hairdresser for a “pixie cut” around twelve years ago.
My hairdresser cut away my long locks and shaved one side of my head. I wore my hair like this for about five years and soon noticed quite a change in my migraines. Of course, they didn't totally disappear, but my hair was so short it didn't aggravate my scalp sensitivity. What a relief!
Finding the right “pain-free” haircut
But the hairdressers wasn't entirely pain-free. Every few weeks, I needed to go back for a trim and a colour. If you've ever had your hair dyed or highlighted, you know how strong those chemicals are. My head would swim, and my eyes would stream.
When the hairdresser would lead me to the sinks for a shampoo, I braced myself for another migraine attack. I know some people love having their hair washed by a professional - but I hated resting my head on the sink, as the hard edge would dig into the base of my skull.
Related: Me, My Mum, and Migraine
Eventually, I spoke to the hairdresser about my discomfort. Now, whenever I go there, they roll up a towel into a makeshift neck-rest. I've never had a problem since.
Anyway, I noticed I had fewer migraines with shorter hair, but I didn't put two and two together as to why. However, it soon became noticeable when I decided to grow my hair out again. Although it's been the root of some suffering, I love how long hair looks on me, and I was getting bored of the same style.
It didn't take long for the scalp pain to start again or for the return of the ponytail migraine. I deliberated about re-cutting my hair but forgot how much of a genius my hairdresser was.
When I explained that I wanted to keep my hair long but wasn't sure how, he cut in hundreds of messy, grungy layers while keeping the length. I was in love - it exactly matched my style, and the layers meant it was light enough to not trigger hair-related migraine attacks. I can see myself keeping it this way for a very long time.
7 tips to prevent your hair from triggering migraine
So, if your hair is also a migraine trigger, here are my top tips to keeping your style pain-free:
- Don't wear any tight styles like ponytails, buns, braids... they look pretty, but they're not worth the sore head or scalp tenderness a few minutes on.
- Avoid getting hair extensions, even if you regret a haircut choice. Hair extensions are heavy and will aggravate scalp sensitivity.
- Don't wear anything restrictive on your head, like hairbands, sleep masks, or tight hats.
- Get plenty of layers chopped into your hair. You'll have both volume and a wonderful sense of weightlessness.
- Book appointments to have your hair thinned at least once every few weeks.
- Use dry shampoo to refresh between hair washes.
- Experiment with different styles and accessories to see what's both pretty and pain-free!
Hair is a surprising migraine trigger and, unfortunately, there isn't any blanket advice I can offer on how to make things better. It would be easy to tell people to "cut their hair short", but many people don't find short hair flattering on themselves. I also don't think short hair is my style anymore, but long hair can really take its toll.
Related: The Problem with Putting On a Brave Face with Migraine
On the plus side, getting my hair cut so often keeps it in great condition, and I don't ruin the texture with too-tight hair bands or greasy product. A super-loose bun with a scrunchie causes me no problems, and I can quickly put it up or take it out, depending on the style I want that day. Knowing my hair is a migraine trigger, I’m very careful with how I treat my sensitive scalp!
I suggest you experiment until you find what works for you. If you're afraid of getting a "pixie crop", try trimming off a few inches and seeing if that helps. A classic bob also never goes out of style! Think of the compliments you could get for a chic new haircut, and you won't have to answer to a migraine every other day.
I know hair is important to many people - but don't sacrifice your health for the sake of high-maintenance, celebrity style. Trust me – you’ll feel much better!
NPS-IE-NP-00315 October 2021