Ponytail Headaches: Is Your Hairstyle Triggering Migraine Attacks?

Ever feel like your hair hurts? 

"Hair-triggered migraine" or "ponytail migraine" starts as an external compression headache. The migraines are caused by a stimulus outside your head – i.e., hair being pulled too tight or wearing restrictive headwear. Ponytail headaches are common, and they're classified as a type of allodynia: pain from a stimulus that should only produce sensation. 

Today, Sarah Alexander-Georgeson discusses her hair as an unexpected migraine trigger. She also shares her top tips to avoid a sore or aggravated scalp!

I've always had a sensitive scalp prone to extreme soreness. My mom and grandma would carefully brush my hair as a child because the slightest tug was agony.

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 touching 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 a 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 because I had too many migraines. 

Now for a short, science-y bit: 

Scalp tenderness links to the extremely sensitive nerves that run from the back of the neck to the forehead. 

A tight style, like a ponytail, triggers a sensation of tightness in too many of these nerves, and you can get a horrible, grinding headache. The stress and relentlessness of this pain can trigger a full migraine attack – hence "ponytail migraine." 

I later discovered this could be allodynia, which can mean feeling pain at the softest touch. If you feel the onset of a ponytail migraine, the first thing to do is take your hair down. 

Now that I keep my long locks in a more relaxed style, my hair is a migraine trigger only when I need to wash it. The grease build-up adds more weight to my scalp, inflaming the nerves and causing pain.

I wash my hair twice a week and refrain from using any product, as it builds quickly and defeats the purpose of not adding extra weight.

Experimenting with hairstyles to manage flare-ups 

I've experimented with some up-dos when I need my hair out of my eyes. A loose bun on top of my head works best. Using a scrunchie (a fabric-coloured hair elastic) prevents pulling, as the hair doesn't wrap around or get caught in a tight bobble. 

Sleep masks or wearing anything restrictive near the head or face can cause a migraine. I can’t stand the feel, and the irritation soon turns to pain.  

At first, I worried I couldn't wear hats again. Despite how my illnesses make me feel, I like to look good, and hats are essential accessories in my wardrobe. I underwent months of trial and error, testing 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. As well as hats and hairstyles, I've also experimented with different haircuts. Around 12 years ago, I asked my hair stylist for a "pixie cut." This was long before I knew how much my hair was a migraine trigger for me and how much it hurt my sensitive scalp.

The stylist removed 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 going to the salon wasn't entirely pain-free. I needed to return for a trim and a colour every few weeks. I braced myself for another migraine attack when going to the basins for a shampoo. 

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. I tried to find distractions from the pain, but there’s not much you can do when someone’s touching your head.

Eventually, I spoke to the stylist about my discomfort, and they responded by rolling up a towel as a makeshift pillow for my neck.

I had fewer migraines with shorter hair, but I did not put two and two together about why. However, it soon became noticeable when I started growing my hair again. I deliberated about re-cutting my hair but forgot how much of a genius my stylist was. 

When I explained that I wanted to keep my hair long but was not sure how, he cut in hundreds of messy, grungy layers while keeping the length. I was in love - it matched my style, and the layers meant it was light enough to not trigger hair-related migraine attacks. I want to keep this look for a very long time.

7 tips to prevent your hair from triggering a migraine 

So, if your hair is also a migraine trigger, here are my top tips for keeping your style pain-free: 

1. Don't wear tight styles like ponytails, ballerina buns, or braids... they look pretty, but they're not worth the sore head or scalp tenderness a few minutes on. 
2. Avoid getting hair extensions, even if you regret a haircut choice. Hair extensions are heavy and will aggravate scalp sensitivity. 
3. Don't wear anything restrictive on your head, like hairbands, sleep masks, or tight hats. 
4. Get plenty of layers chopped into your hair. You'll have both volume and a wonderful sense of weightlessness. 
5. Book appointments to have your hair thinned at least once every two months. 
6. Use dry shampoo to refresh between hair washes. 
7. Experiment with different styles and accessories to see what's pretty and pain-free! 

The takeaway 

Hair is a surprising migraine trigger, and, unfortunately, I can't offer any blanket advice on improving the situation. 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 take its toll. 

On the plus side, getting my hair cut so often keeps it in excellent condition, and I don't ruin the texture with too-tight hair bands or greasy products. 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 cautious about how I treat my sensitive scalp!

Haircut and style are a huge deal to many people - but don't sacrifice your health for a high-maintenance, celebrity chop. Trust me – you'll feel much better!  

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Date of preparation: August 2023
D: COB-GB-NP-00187 (V1.0) / T: COB-GB-NP-00227 (V1.0) / M: COB-GB-NP-00207 (V1.0)