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Migraine Comorbidities: Cutaneous Allodynia

If you’ve ever cringed in pain at the idea of pulling back your hair, washing your hair and scalp or shaving during a migraine attack or at any other time, you may have been dealing with a condition called cutaneous allodynia.

Cutaneous allodynia is commonly associated with migraine disease. The term is basically a fancy way of describing pain on the skin or scalp that results from exposure to something that doesn’t ordinarily cause pain.

According to a 2008 research survey conducted by the National Headache Foundation, among people with migraine, cutaneous allodynia is more common among women and those with more frequent headaches, higher body mass indexes and who are disabled or depressed. Whether these factors are causes or effects or simply correlations, we don’t know at this time.

The appropriate treatment for someone living with cutaneous allodynia varies from patient to patient.

For those living with migraine and cutaneous allodynia who only experience cutaneous allodynia during migraine attacks, the evidence suggests many patients can successfully treat both issues with triptans.

As is true with treatment of migraine generally, taking a triptan as soon as possible once an attack is imminent is advised for those who also deal with cutaneous allodynia.

Unfortunately, for patients who experience cutaneous allodynia even when not having a migraine attack, triptans are much less likely to help treat it.

For those patients who cannot successfully or safely use triptans, COX inhibitors are considered a good option. COX inhibitors are a special type of NSAID that avoids the stomach issues commonly associated with frequent use or misuse of NSAIDs. At this time the only medication available on the market in the US in this category is Celebrex. Two others, Vioxx and Bextra, were removed from the market in the early 2000s. Additional COX inhibitors are currently being developed.

Researchers studying the relationship between cuttaneous allodynia and migraine have been able to learn some important things about the common processes that occur in the body with both conditions. Both seem to involve something known as central sensitization. This simply means that the body starts to treat being in pain as its normal, default state, rather than the state of not being in pain.

For those who live with cutaneous allodynia, what helps you cope?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

1. “Definition of Cutaneous Allodynia,” last modified June 14, 2012, http://www.medterms.com/script/main/art.asp?articlekey=25196. 2. Charles Matthews, “Effective Treatment of Migraine: New Research on Cutaneous Allodynia,” last modified May 15, 2010, http://aboutheadaches.blogspot.com/2010/05/effective-treatment-of-migraine-new.html. 3. Maury Breecher, “Central Sensitization and Cutaneous Allodynia Implication on Migraine Treatment,” accessed July 31, 2012, http://www.clinicalneurologynewsnetwork.com/conferences/dhs/Burstein_Allodynia_2_26_08.html. 4. Carol Eustice, “What Are COX-2 Inhibitors?,” last modified June 16, 2006, http://arthritis.about.com/od/cox2inhibitors/g/cox.htm. 5. Serena Gordon, “Skin Pain, Sensitivity Rises With Migraine,” last modified April 24, 2008, http://abcnews.go.com/Health/Healthday/story?id=4713683&page=2#.UBh3hETYPQo.

Comments

  • Ohlemontine
    4 months ago

    Omg, now I have the technical term for what I feel! When I have a migraine, I cant stand to be in my own skin! I tend to explain is as feeling like I have whiskers/fur in my veins and can feel the blood flowing through my veins through all this fur. It’s a terrible skin crawling feeling and I want out of my skin. I also have VERY dry skin so my skin catches on a lot of different fabrics, and it’s awful on a normal day, but when I have this going on, its excruciating and unbearable. I also get the hair hurting thing. I always thought that maybe I just had my ponytails too tight, but no matter how much I loosened them I would have issues until I let my hair down, but then I would have to figure out how to keep it off my shoulders, cheek, throat, etc… and if anyone touches the area by my neck, I automatically feel like I’m being choked, even if it’s just an inadvertent brush of a finger or something, though that might be unrelated.

  • ZonaDanger
    7 months ago

    Om-goodness I totally didn’t realize this was a real thing. This happens to me all the time! My hair is killing me today and i also get the burning skin sensation other places if I am really bad. I had no idea this was migraine related! I about jumped through the ceiling last visit when the neurologist touched my head. I have mornings where I will change clothes like 18,000 times because my skin feels uncomfortable.

  • ChronicallyEverything
    2 years ago

    OMG! THANK YOU!!!!! I didn’t know this was a thing, but I have it and it makes me crazy!!! My child can’t touch me sometimes because it’s so bad! I can’t sleep some nights because it’s so terrible! My skin is so sensitive that the slightest sun exposure feels like a full and blistered burn! Sorry for the excessive punctuation, but OMG!!!! I cant believe i found this on a migraine site!!!! Thanks so very much!!!

  • DonnaFA moderator
    2 years ago

    Hi ChronicallyEverything! No worries about the punctuation, we’re just so glad that the article helped you feel validated!! It can feel isolating when you feel your symptoms are “out of left field”. But as you can see, you’re absolutely not alone. For me, my scalp hurts when I move it in a direction other than the direction it normally lays, and sometimes it’s being able to feel each individual hair entering my scalp like little acupuncture needles :-/ Thanks for being part of the community. We’re glad you’re here! – Warmly, Donna (Migraine.com team)

  • Joanna Bodner moderator
    2 years ago

    ChronicallyEverything, I am SO happy to hear that this article has provided you some comfort in knowing that you are not alone in experiencing this symptom! We are so thrilled to hear that you found our site too! We sure hope you continue to find it useful! If you are active on Facebook, feel free to visit our page there too. Welcome to our community! -Joanna (Migraine.com Team)

  • Candy
    4 years ago

    I have extreme hair pain anytime I have a migraine. I often know when I am getting one, because my hair will start hurting long before my migraine starts. It also continues to hurt long after the migraine goes away. I’m fortunate that I don’t have the skin pain on the rest of my body. I have my hair cut extremely short, but am trying to grow it long again. I don’t know how long I’ll be able to stand it before I cut it off again.

  • Meggietye
    5 years ago

    WOW…you mean there is name for this craziness??? I have one shirt, super soft with seams I can’t “feel” and the fabric is whisper soft. I have worn it for 4 mths (June/July/Aug & Sept) with no underwear. I only sleep in flanalette blanket sheets…heavier than regular flanalette sheets, and I sleep naked. I buy the flanalette sheets thru the Sears catologue. I often just take off my clothes during the day and just climb between the sheets they are so comfortable.I find that a Tylenol 3 really really helps with the skin pain.

    I cut a lot of my hair off this summer because I couldn’t stand the feeling. I barely wash my hair 4x a mth,if that, and I use dry shampoo before we go out. IF we go
    out.

    I can stand a firm pressure, like a hug, but not the “softer” pressure of clothing & hair…man it does hurt doesn’t it??!! I have had migraines for 20 yrs chronically but this has been the worst season for the allodynia. I have lost my career and am on disability and just have to get back to walking and yoga around this craziness…somehow.

    I am doing everything the Godsend book, “The Migrine Brain” is suggesting I do
    and my morning migraines have been cut by HALF. It costs 11.00….order it from your library or amazon. I have learned more about migraine in 2 weeks from this neurologist than I have in 20 yrs with doc appointments and the Internet. who knew lying in bed in the morning with my neck on an angle was triggering blistering migraines?? Who knew sudden & strong peeing or runny nose, sinus filling pain, sneezing, itchy ears or yawning etc meant a migraine had begun and run don’t walk to get your meds to head it off??!! who knew if you were a caffeine drinker to get some in in the first hour of awakening, eat protein with it, don’t hit the snooze button etc etc etc.???
    This is THE ” how to manage migraine book”. I have bought 6 and given 5 away.

  • 192dhao
    2 years ago

    I totally understand! I really don’t like to sleep naked but sometimes am simply left with no choice. I have spent months looking for the right seamless underwear that’s less irritating. I almost always wear my clothes inside out in my house to reduce the irritating areas. I actually need a sign on the inside of my front door – stop! Check your clothes!!! Just so I don’t embarrass myself in public.
    And I get it all over. Like I mean ALL over. It’s horrendous. Some days I just want to skin myself like a rabbit I really think that would be much more pleasant than what I go through every day

  • lulabelula
    5 years ago

    after developing CRPS/RSD in my left temple from botox injections for chronic migraine, i could no longer take the pain my (already pretty short) hair was causing. i could barely touch it to wash or style, and forget trying to cover the gray. three months after I got the CRPS, i had a friend help me shave my head. my mom hates it, and asks me every time i see her when i’m going to grow it back. i tell her i will grow it back when it hurts less to have hair than not have it. she doesn’t like that it makes me look “sick.” I AM SICK! my husband thankfully doesn’t care, although my sons don’t love it. they want their normal mom back. and i want her back too. but i’ve gotten used to being bald. I forget how i look to other people, but that isn’t what matters. it feels so much better to be bald. the tricky thing is finding that low-pain time in order to shave it. the actual shaving really hurts – but i’ll take the 10 minutes of shaving pain over the constant hair pain.

  • DebbyJ56
    6 years ago

    I am always on a quest for the perfect sheet set for our bed! Must be soft, not pilly, no ridges, the list goes on. I never wear a pony tail. People ask me why I never wear my hair “up”. I tell them it hurts my head. The look at me like I’m nuts. i have had daily migraines for over seven yrs. now. I can’t wear pj’s, the drive me nuts. I can’t even think about underwear. I can tolerate the right bra. When I worked,and wore dresses, I used to stop at the ladies room on the way out and take my pantyhose or under garment off before I got in my car to go home. I’ve even removed them while driving! i have to wear soft clothes. No wools, cashmere, unless I wear a very thick cotton underneath. Sometimes I HAVE to wash my hair for relief if my hair feels heavy and my scalp is in too much pain. No one can touch my face, it’s too sensitive. I’ve had this for a very long time but four yrs ago a new Neurologist diagnosed it. I also have fibromyalgia, and ready a web page, many of those sufferers have this also.

  • Meggietye
    5 years ago

    Debbie, are you still on a quest for soft sheets? I use, from Sears Catologue, the flanalette blanket sheets. They wash and dry in the dryer like a dream and a super soft. I have allodynia and take Tylenol 3 ( the prescription Tylenol with codeine). I find with my neck pain I use my pillows for reading/tv then just throw them on the floor for the night and sleep either face down on the soft sheet ,or with my bamboo blanket folded under my head. I have 2 bamboo blankets & they are the softest things I own…think we picked them up at Walmart, I couldn’t rest well without them.

    Best wishes!

  • lori
    7 years ago

    Great article, Diana. I have had long thick curly hair and it killed me. I put up with it for years, I go to my shoulders then back down. You know, the see-saw effect. I always threatened to shave my head when it hurt so bad, but could never take the jump. At the end of July, my hair was the longest it had every been. It was past the middle of my back and I was putting off going to the hairdresser for a color touch up because I didn’t want all the pain that is associated with it. I called, but my hairdresser was out for three weeks. But I couldn’t do it any more. It was going to be me or the hair that was leaving, so at the end of July, I shaved my head. The hairdresser did a cute pixie cut on me that I just knept asking to get shorter because I don’t want my curls to take over. I asked my mom a couple weeks ago if she would shave my head for me. I no longer have a job due to my migraines, so I have no income. Getting a haircut is going to be difficult. My mom said she wouldn’t shave my head. Today, I had just got home from my weekly trip to the library (don’t go after school lets out) and was resting before I took some meds. A headache was coming and I couldn’t stop it, but I just didn’t have the energy to find the box. I laid down and kept moving my head around for a comfortable spot and I was mad that my hair hurt and I couldn’t get comfortable. My mom who is totally against shaving my head offered to shave my head tonight or tomorrow. She wants there to be heair, but I just want the stubble. That’s all. Do I think I will get asked out if I shave my head, probably not, but I don’t care. All I care about is getting rid of the pain.

  • 192dhao
    2 years ago

    Pretty hard to go out with anyone when your hair has got you in that much pain too!
    I also have thick curly hair. I have always kept it really long but about a year ago I got it cut short. My instructions to the hairdresser were ‘must still be able to tie it up when I need to. I am on disability but occasionally make wedding cakes and other big celebration cakes for people. You really must be able to get your hair out of the way no matter how much it hurts. She cut it so short that only now can I get most of it in a hair tie… if i use plenty of bobby pins but geez they hurt when you’ve already got a hairache!
    The longer it grows the more it’s starting to hurt again so I am really trying to gather the courage to just shave it off.
    I find I get most relief when im actually in the shower with the water running through it on a very gentle trickle. Its still ok wet but when its dry it becomes unbearable

  • terri
    7 years ago

    Cool! There’s a name for that! There’s times when moving my hair is strangely painful. When i say my hair hurts, my family laughs at me. Now i’m gonna whip out that lovely word, and make ’em look it up. The weird part is that at the same time, my scalp seems like it has gotten “thicker” if that makes any sense. I’ll try the warm/hot water to see if it works any better, but usually when i’ve got a headache that’s not totally incapacitating, i’ll dunk my head under an ice cold shower. It’s probably the shock of that cold water, but it seems to turn the pain down a bit.

  • 192dhao
    2 years ago

    Do you get psoriasis at all? Or weird skin patches? I get quite bad psoriasis pop up randomly all over my body but it’s worse under my hair. The patches where that is flared up are kinda chunky and crusty and amplify the hair ache about 57 billion percent

  • tucker
    7 years ago

    Hair headaches here too. It’s interesting that my skin “hurts” all over my body when I first get a cold or flu-like symptoms too. I’ve tried to explain to my doc that my hair/head feels “hot” and tender but I don’t think she gets it.

    I was talking with a man one day and he said he burned his head one time putting it in a pot of boiling water to relieve the pain! OMG! That is extreme! I ice the back of my neck/head but top is too sensitive. Usually w/a heating pad under my upper back/shoulders to help those spasms-sigh…..

  • kaitjackson
    7 years ago

    I’ve had “hair headaches” since I was a kid. When they became an almost daily occurrence last December, I had no idea it was related to migraine (which I didn’t know I had). Aside from the Fioricet my neurologist prescribed, which doesn’t always take all the pain away, I’ve found a HOT, HOT, HOT shower with water beating on my scalp helps at least temporarily.

  • Ellen Schnakenberg
    7 years ago

    kaitjackson – I find that heat is a help for me as well. The hotter the better. I do have to be careful though not to burn myself. I have had this happen before and that isn’t pleasant either. Take care, but I hope you feel better soon as well.

  • CG
    7 years ago

    Ice is my best friend in trying to escape chronic daily headache with migraine. It likely numbs the sore spots on my scalp as it relieves some pain, hopefully (along with all the strategies I use plus meds). I keep several ice packs in the freezer to rotate as they melt and lose their effectiveness. Sometimes though the ice packs are too heavy and they cause the allodynia spots to hurt worse.

  • caryd26
    6 years ago

    It’s ice for me as well. I recently found ice “helmets” on Amazon and I bought two so I can swap them out. They’re not as cold as I ‘d like them to be, but they do feel good.

  • janiceclemens
    7 years ago

    The thought of putting my hair in a ponytail makes me just want to cry. I really should wear it up at work byt I just can’t as it just makes the headaches worse. At least I know now that I am not crazy and I am not alone in this.

  • tinamontgomery
    7 years ago

    I’m glad to know that I’m not the only person who feels this. My family looks at me like I’m crazy when I say my hair hurts or my sheets bother me. I just try to take my medicine and will myself to sleep to get over the headache and this allodynia.

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