[Translated article] Dermatology Update on the Challenging Trichodynia

Area of Science:

• Dermatology
• Trichology
• Pain Medicine

Background:

• Trichodynia is scalp pain often associated with hair loss conditions like alopecia.
• Initially described in telogen effluvium, it's now recognized in androgenic alopecia, alopecia areata, and scarring alopecia.
• Psychiatric comorbidities, particularly in women, are frequently observed alongside trichodynia.

Purpose of the Study:

• To review the current understanding of trichodynia, including its causes, clinical presentation, and diagnostic approaches.
• To explore potential pathogenetic factors such as substance P, inflammation, and psychological influences.
• To summarize existing and alternative therapeutic strategies for managing scalp pain in alopecia patients.

Main Methods:

• Literature review of studies on trichodynia and associated conditions.
• Analysis of clinical presentations and reported diagnostic criteria.
• Compilation of current and experimental treatment options.

Main Results:

• Trichodynia presents as scalp pain or discomfort, frequently accompanying various forms of alopecia.
• Pathogenesis may involve substance P, perifollicular inflammation, and psychiatric comorbidities.
• Diagnosis is primarily clinical and based on exclusion.

Conclusions:

• No specific therapies for trichodynia exist, presenting a therapeutic challenge.
• Potential treatments include botulinum toxin A, antidepressants, neuromodulators, and corticosteroids.
• Further prospective studies are needed to establish effective treatment protocols for trichodynia.