Kids Health Info

Headaches

  • A headache is a symptom of pain in the area of the head or neck. Headaches are common in children and adolescents.

    Headaches can be caused by many things, including colds, stress, dehydration, lack of sleep or eye problems (e.g. straining to read). Most headaches in children are not due to a serious underlying problem, but they can be upsetting for the child and have an impact on schooling, sport and play activities.

    If your child's headaches are severe and persistent, and cause them to miss school or activities more often than once a month, they should be checked by their GP.

    Signs and symptoms of different headaches

    Children are affected by many different types of headaches, and they can range in severity from a mild ache to severe pain.

    Headaches can be thought of as primary headaches and secondary headaches.

    Some primary headaches and their symptoms are:

    • Tension headache – feels like a tight band around the head. A tension headache is usually a dull, steady ache felt on both sides of the head, but may be felt at the front and back of the head.
    • Migraine headaches – often described as a throbbing feeling, which may be on one side of the head. Migraines are sometimes accompanied by symptoms of dizziness, nausea, vomiting and visual disturbances. See our fact sheet Migraine headaches.

    Other primary headache disorders are less common, and can be associated with sudden, one sided, facial pain, and nasal congestion or lots of tears (tears without actually crying).

    Secondary headaches are due to an identifiable underlying cause, commonly a mild illness (e.g. a viral infection) or dehydration.

    What causes headaches?

    Children and adolescents who experience primary headaches often have other family members who get headaches. Common triggers for headaches in children with migraine or tension headaches are not getting enough sleep or being stressed. In rare cases, exercise can also trigger these types of headaches.

    Common causes of secondary headaches are viral infections such as colds, sinusitis, or ear infections. Rare causes of secondary headaches are tumours or intracranial (inside the skull) bleeding.

    Care at home

    Treating an occasional headache can be as simple as having something to eat and drink, and a lie down to rest and relax. A cool, wet cloth placed on the forehead may help relieve the headache, and massaging or stretching the head and neck muscles if they are tight or tender may also help.

    If these strategies don’t work, it may help to give your child some non-prescription pain medicine, such as paracetamol or ibuprofen (see our fact sheet Pain relief for children). Follow the instructions on the packet and do not use pain medication for more than two days in a week without advice from your GP. Overuse of pain medication can cause additional problems.

    To try to prevent headaches, make sure your child is getting enough sleep and rest, regular exercise and balanced nutrition. Balanced nutrition means your child should eat plenty of vegetables and fruit, lean meats and dairy products, and limit processed foods that are high in fats and sugars.

    Keeping a headache diary is a good way to try to identify what triggers (causes) your child's headaches. The diary will also be helpful for your child’s doctor in determining the best way to manage and treat your child’s headaches in the future. If you find there are any specific triggers that seem to cause your child’s headaches, you can work to avoid them.

    The headache diary should include:

    • when the headache started and what seemed to trigger it
    • how long it lasted
    • which part of the head hurt
    • how bad it was on a scale of 1 (mild) to 10 (severe)
    • if anything helped to soothe the headache
    • the time of going to bed the night before
    • if there were any other symptoms with the headache
    • if school was missed because of the headache.

    When to see a doctor

    Some headaches can be serious, so if you are concerned, see your GP. Your child should see the GP if:

    • the headaches are getting worse
    • they are having a headache more than once a week
    • the headache wakes your child from sleep or the headache is worse in the morning
    • the headache is associated with vision changes, vomiting or high fevers
    • the headaches begin to disrupt your child’s school, home or social life
    • you identify that stress is causing your child’s headaches but cannot manage it without further help. 

    For severe, recurrent headaches, your child may be prescribed medication that is stronger than over-the-counter paracetamol or ibuprofen. If the headaches happen a lot, the doctor may suggest a daily prophylactic (preventative) medicine to help prevent the headaches. In cases where psychological stress is identified as a trigger for headaches, a referral to a child psychologist may be helpful.

    Key points to remember

    • Headaches are common in children and generally not serious.
    • They can have an impact on schooling, sport and play activities.
    • Keeping a headache diary can help identify the things that trigger your child’s headaches, so you can try to avoid them.
    • Regular healthy meals, and enough sleep and exercise are important to help prevent headaches.
    • Some headaches can be serious, so see your GP if you are concerned.

    For more information

    Common questions our doctors are asked

    Will my child outgrow his headaches?

    This depends on the type of headache your child suffers. Learning what triggers cause your child's headaches allows you to avoid them in the future, and this usually leads to fewer headaches as your child gets older.

    My daughter has just started getting her period. Could her headaches be hormonal?

    Some adolescent girls have migraine headaches around the time of their monthly period. When this occurs, a preventative medicine (prophylaxis) can be used as the headaches have a predictable pattern.

    Does my child need a scan?

    A scan is necessary for headaches that get worse over a short period of time and do not go away, and are associated with other worrying symptoms, such as drowsiness, severe vomiting or problems with balance or speech. MRI is the preferred scan as there is no radiation risk; however, in children a general anaesthetic is often needed. A CT scan or head X-ray is not recommended due to the radiation. Typical migraines or tension headaches, where the child is well between the episodes, do not need imaging.   

    Does too much screen time lead to more headaches?

    Some children and adolescents may get headaches from looking at the bright screens of electronic devices, and some children remain in a poor posture for an extended time while they are on their device, which can lead to headaches. Encourage them to take regular breaks from the screen and turn the brightness down. Screen time should be limited.  


    Developed by The Royal Children's Hospital Neurology department. We acknowledge the input of RCH consumers and carers.

    Reviewed May 2018.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.

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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.