Allodynia is a type of pain or discomfort caused by things that don’t usually hurt, such as soft clothing or a light touch. Migraine is one of several conditions known to cause allodynia.

Research suggests that between 40 percent and 70 percent of people living with migraine experience this symptom, and about 20 percent report severe skin pain.

Allodynia is also linked to more frequent and more severe migraine attacks. Because of this, it’s important to tell your doctor if you notice skin pain during an attack.

Below are some key facts about allodynia, including:

• What causes it
• What it may feel like during a migraine attack
• Ways it may be treated or managed

What Is Allodynia?

Allodynia happens when your nervous system becomes extra sensitive to pain. The brain may shift into a state called central sensitization (when the nervous system becomes overactive and more responsive to pain signals). In this state, even gentle touch can feel painful or uncomfortable.

This increased sensitivity happens because your body may react as if you’re in danger, even when you’re not. Your nervous system has trouble telling the difference between something harmful (like touching a hot pan) and something safe (like washing your hands in warm water or brushing your hair).

Health experts describe three types of allodynia:

• Tactile (static or dynamic) allodynia — Pain from touch or pressure, such as a hug
• Mechanical allodynia — Pain from something moving across your skin, such as clothing
• Thermal allodynia — Pain from mild temperature changes, such as walking into an air-conditioned room

Sometimes allodynia is categorized by where the pain is located: on the head (called cephalic allodynia) or anywhere but the head, called extracephalic allodynia. You may also hear the term “cutaneous allodynia,” which means the pain is felt in the skin.

According to research in Frontiers in Neurology, risk factors for allodynia among people with migraine include:

• Being female
• Living with anxiety or depression
• Using certain headache medicines too often
• Experiencing frequent migraine attacks

Developing migraine at a younger age, or having other pain conditions, like irritable bowel syndrome, may also increase the risk of allodynia. Some studies also link it with a higher body mass index (BMI, a measure of body size based on height and weight).

What Does Allodynia Feel Like?

People with migraine-related allodynia often say their hair hurts. The pain gets worse if anything touches or moves your hair, like a pillow or a breeze. This makes it difficult to get comfortable, as some MyMigraineTeam members explained:

• “It gets so bad my hair hurts. I can’t lie down comfortably, and when my head is pounding, that’s all I want to do.”
• “Allodynia kicked in. My hair hurt, and the flow of air from the vent was killing me.”

“It gets so bad my hair hurts. I can’t lie down comfortably, and when my head is pounding, that's all I want to do.”

— A MyMigraineTeam member

Other people say allodynia makes their skin hurt, itch, sting, or burn. With migraine, these sensations often affect the scalp. However, they can spread to other areas like the neck and shoulders.

Here are some ways MyMigraineTeam members describe allodynia symptoms:

• “My allodynia seems focused around my neck, chest, upper shoulders, and upper arms. It’s the strangest thing. It’s not severe, but it is a distraction.”
• “My scalp sometimes itches, and other times it hurts before, during, and/or after attacks.”
• “I have allodynia, and it hurts even when my hair is clean sometimes. But it’s less likely if I can keep it washed every few days.”
• “Allodynia makes my hair hurt, but I also get needles stabbing my head at times.”

If you’ve ever had a bad sunburn, you have an idea of what allodynia can feel like.

“My scalp sometimes itches, and other times it hurts before, during, and/or after attacks.” — A MyMigraineTeam member

What Does Allodynia Mean for Migraine?

Experiencing allodynia during migraine attacks puts you at an increased risk of chronic migraine. Chronic migraine is diagnosed when someone has at least 15 headache days per month over at least three months.

The relationship between migraine frequency and chronic migraine goes both ways: Having chronic migraine also increases the risk of allodynia.

Allodynia is also associated with more severe migraine attacks. Some people don’t notice allodynia in the beginning stages of a migraine attack, but may develop it as the attack becomes more severe. In other cases, allodynia occurs early on as a tell-tale sign that the migraine attack will increase in severity.

One MyMigraineTeam member related: “When I get a needle feeling in my skin, I know it’s going to be a long attack and a higher intensity migraine.”

“When I get a needle feeling in my skin, I know it’s going to be a long attack and a higher intensity migraine.”

— A MyMigraineTeam member

There’s also some evidence that people with allodynia tend to take more acute medications (such as ibuprofen, naproxen, or acetaminophen) than people without allodynia. However, they report less success with these medications.

Taking too many pain medications may increase the risk of a medication overuse headache, also called a rebound headache. Medication overuse headaches increase the number of headache days and can become chronic.

Track what medications you take and their effectiveness in a headache diary and share the results with your migraine specialist. They can recommend a more effective treatment plan if needed.

How Can You Relieve Allodynia Pain?

Treating migraine early — or preventing attacks — may help reduce allodynia symptoms. Common options include oral medications (taken by mouth) and injections.

Some people living with migraine may also benefit from topical treatments (applied to the skin), especially if other options aren’t a good fit.

In some cases, treatments like Botox may help reduce sensitivity in people with chronic (long-lasting) allodynia.

Oral Medications

Acute treatments — including triptans, antiemetics (anti-nausea medications), and over-the-counter pain relievers — work best when taken at the first sign of migraine symptoms.

Keeping a headache diary may help you identify your early symptoms and triggers. Talk with your doctor about which medications may help specific symptoms, including allodynia.

If you have frequent migraine attacks, your doctor may recommend preventive medications. These treatments can reduce how often attacks happen and may help limit the need for pain relievers.

Some medications originally used for other conditions — such as depression, anxiety, high blood pressure, or seizures — may also help prevent migraine. Examples include topiramate and valproate (also called divalproex).

Injections

Some research suggests that Botox injections may help improve allodynia symptoms. Botox is an approved treatment for chronic migraine and works by blocking certain nerve signals involved in pain.

These injections are typically given every 12 weeks in multiple areas around the head, neck, and shoulders.

Other types of nerve block treatments may also be an option if Botox isn’t right for you.

Topical Treatments

If allodynia continues despite preventive treatment, topical medications such as capsaicin or lidocaine may provide some relief.

Because some creams or ointments can feel uncomfortable to apply, talk with your doctor about whether patches may be a better option.

Desensitization

Some people may benefit from graded desensitization (a therapy that slowly increases touch or pressure over time).

A physical therapist gradually applies more pressure to sensitive areas to help retrain the body’s pain response.

Spinal Cord Stimulation

Spinal cord stimulation may help some people with chronic, treatment-resistant allodynia or neuropathic (nerve-related) pain.

This approach uses an implanted device to send mild electrical signals to the spinal cord. These signals may reduce pain and improve symptoms.

When To Talk to Your Doctor

Share all of your migraine symptoms, including allodynia, with your doctor. Allodynia has been linked to a higher risk of chronic migraine, so it’s important that your doctor understands what your attacks feel like.

Tracking your symptoms, triggers, and medications can help you and your doctor find the best treatment plan.

Allodynia has been linked to a higher risk of chronic migraine, so it’s important that your doctor understands what your attacks feel like.

Migraine-related allodynia often improves as the migraine attack ends. If your skin pain continues after the attack, talk with your doctor. They may check for other conditions that can cause allodynia, such as:

• Fibromyalgia (a condition that causes widespread pain and tenderness)
• Multiple sclerosis (a disease that affects the brain and spinal cord)
• Diabetes (a condition that affects blood sugar levels and nerves)
• Vitamin deficiencies (low levels of certain vitamins needed for nerve health)

If allodynia makes it difficult to rest, relax, or care for yourself, talk to your doctor about treatment options.

Because ongoing pain can also affect your emotional well-being, you may consider talking with a therapist about ways to cope with stress or discomfort.

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