Contrary to what some may believe, ponytail headache syndrome is not some obscure neurosis. The condition is a recognised medical condition. Wearing a tight ponytail would normally cause no discomfort, but in migraine sufferers who have developed a highly sensitive scalp, wearing a tight ponytail can cause discomfort and pain.

With Ponytail Headaches, It Is Important To Treat The Pain First

These headache and migraine sufferers may develop sensitivity of the scalp from all the pain that they experience. This means that things that normally would not cause pain or discomfort, start to cause problems. So when the  hair is pulled into a tight bun or ponytail, or even  a sufferer who has a weave or extensions, this will pull the nerves in the scalp. The pulling of the nerves will further activate the sensory nerves. This may result in the headache itself, or it could be the beginning of a headache.

With ponytail headaches, it all comes down to an oversensitive scalp. The hair shaft itself and the hair outside of your head is not pain-sensitive, but the scalp they are embedded in has a lot of pain-sensitive nerves around it. If a ponytail pulls back on the hair follicles, it can irritate a sensitive scalp.  This external traction headache, then, falls under the category of headaches and pain relating to the scalp.


Dr. Elliot Shevel, is South Africa’s pioneer in the field of migraine surgery and the Medical Director and Founder of The Headache Clinic.  He explains that “other signs of scalp hypersensitivity may be discomfort with combing or brushing the hair, shaving, showering, or wearing glasses or earrings – things that are not normally painful. “

Dr. Shevel confirms that if one does suffer from scalp hypersensitivity – the medical term is cutaneous allodynia – then treating the cause for the overload of pain signals to the brain should come first – i.e. treating the headaches. When the original source of the most significant contributor to the pain is successfully treated, the allodynia subsides along with it.

Can a heavy or tight ponytail cause a headache in a person who does not fall into the above category?  Dr. Shevel thinks not. “I have never seen anyone who got a headache from wearing a heavy  or tight ponytail, who did not already suffer from headaches  and certainly it is not in the medical literature.”

How To Treat A Ponytail Headache

Dr. Shevel says if you are a sufferer, then it obviously makes sense to stop wearing a ponytail, or similar tight hair style like a weave.  However, it is important not to ignore the condition itself and seek the correct professional help if headaches prevail.

He adds, that most patients can be treated for headaches and migraine conditions without the use of drugs, which often have unpleasant or harmful side-effects. “Emphasis must be on diagnosing the original source of the pain, and then directing treatment in a focused manner at the origin of the pain.”

If you enjoyed this, read more on how to treat the common headache here.






Gisèle Wertheim Aymes

Gisèle is the owner of the Longevity brand and a self-proclaimed health hedonist. When she is not working, you'll find in her in a yoga class or active in the great outdoors. Gisèle is passionate about health and sharing information. You can follow her @giselewaymes on Twitter and Instagram or read her Linked-In profile for full bio details.

The content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.