If you’ve ever felt like your skin was burning or bruised during a migraine—like your hair hurts, or your shirt is suddenly too rough—you’re not imagining it. This is called cutaneous allodynia, and it’s a real, often overlooked part of migraine attacks.

Cutaneous allodynia is a form of painful skin sensitivity, where even light touch or temperature changes that wouldn’t normally hurt suddenly do. For people with migraines, it can be deeply frustrating, isolating, and misunderstood.

What Does Cutaneous Allodynia Feel Like?

Cutaneous allodynia doesn’t look like anything from the outside, but inside, it can feel like your entire body is screaming from the lightest touch.

Common sensations include:

• Pain or burning when brushing your hair

• Feeling bruised or sore when wearing glasses, earrings, hats, or clothing

• Sensitivity when touching your face, scalp, or neck

• Discomfort from water in the shower or changes in temperature

Sometimes, even lying your head on a pillow or pulling a blanket over yourself can feel like too much. This sensitivity can last for hours or days and is often hardest to describe to others, especially because it isn’t visible.

This type of pain affects up to 63% of people with migraine, especially those with frequent attacks.

Why Does It Happen?

Cutaneous allodynia is caused by a phenomenon known as central sensitization. Basically, it means the brain and nervous system become overly reactive to input. Things that shouldn’t hurt—like touch, warmth, or pressure—start sending pain signals to the brain.

This is common in people with chronic migraine, fibromyalgia, and other neurological conditions where the pain system goes haywire.

Here’s how it happens in migraines:

1. A migraine starts in the brain.

2. Pain pathways are activated, including the trigeminal nerve, which controls sensation in the face and head.

3. As the migraine progresses, the brain becomes more sensitive.

4. This leads to skin hypersensitivity, even far from the original migraine pain.

Once sensitization sets in, it can make future attacks more severe and harder to treat.

Is Cutaneous Allodynia a Warning Sign?

Yes—and that’s actually helpful.

Many people notice cutaneous allodynia as a prodrome (early warning symptom) before their migraine pain peaks. If you learn to recognize it, it can give you a head start on treatment.

You might notice:

• Your scalp suddenly feels tender

• Sunglasses or a hoodie feel uncomfortable

• Lying down makes your skin ache

• Showers or light wind feel sharp

When these signs show up, it may be time to reach for your acute migraine treatment—triptans, gepants, NSAIDs, or other tools in your migraine plan.

However, it’s important to know that some migraine meds, like triptans, work best before allodynia sets in.

How Is It Diagnosed?

There is no blood test or imaging scan that can detect cutaneous allodynia. It’s based on your experience and your description of symptoms.

Doctors may ask questions like:

• Does it hurt to wear a ponytail or hairband?

• Do clothes or jewelry feel painful during a migraine?

• Do you avoid touch or brushing your hair because it hurts?

There’s even a validated questionnaire, the Allodynia Symptom Checklist (ASC-12), that many headache specialists use to understand how allodynia is affecting your life.

What Can Help?

There’s no one-size-fits-all treatment, but many people find relief through a combination of prevention, early intervention, and gentle self-care.

Migraine prevention may include:

• Daily medications (e.g., topiramate, amitriptyline, propranolol)

• CGRP monoclonal antibodies (Aimovig, Emgality, etc.)

• Neuromodulation devices like Cefaly or Nerivio

• Lifestyle tools (sleep, hydration, regular meals, managing triggers)

During an attack

• Take treatment early—don’t wait for the pain to ramp up

• Use ice packs or cooling cloths gently, if tolerated

• Rest in a dark, quiet space with soft fabrics

• Avoid friction or tight-fitting clothes

Long-term support

• Work with a headache specialist if possible

• Consider physical therapy or mind-body approaches like biofeedback

• Use journaling or apps to track symptoms and early warning signs

• Practice self-compassion—you’re not weak or overreacting. Your body is trying to keep you safe.

You Are Not Imagining This

Cutaneous allodynia can feel invisible. It’s hard to explain to people who’ve never experienced it. You might hear “but nothing’s touching you” or “it doesn’t look like anything,” and still feel like your body is on fire.

If this is you, your pain is valid. Your experience is real. And there are treatments and communities that care.

Whether you’re still figuring out your migraine triggers, or you’ve had chronic migraine for years—recognizing cutaneous allodynia can be a key to finding relief. You deserve care that listens and works with your body, not against it.