scalp dysesthesia scalp dysesthesia scalp dysesthesia is a cutaneous condition characterised by pain and burning sensations without objective physical examination findings.: 64 the pain sometimes is described as burning. often there is an underlying psychosomatic cause, such as stress, depression or anxiety. scalp dysesthesiaother namestrichodyniaspecialtydermatology only a few studies have been conducted on this condition. a theory behind the condition is that nerves innervating scalp hair follicles send pain messages back to the brain when the follicle no longer has a hair in it, in a similar way to phantom limb pain. another theory is that people who have this condition (sometimes called "ponytail syndrome") have super-sensitive nerves in their scalp. in a recent study it was hypothesised that the unpleasant sensations experienced in scalp dysesthesia are the result of a sensory neuropathy secondary to cervical spine dysfunction and chronic tension of the pericranial muscles. 16 patients were treated with a physiotherapist‐designed exercise protocol, 10 patients experienced a subjectively satisfying improvement and four had complete resolution of symptoms. a possible treatment is to halt hair loss in the patient, however it is important to understand and address any underlying psychologic comorbity. use of antidepressants in treatment has been described.