Headaches and migraine in children (Headache and migraine in children and young people)
Why children get headaches and migraines, how they are usually managed, and the red-flag warning signs that mean a child needs to be seen urgently.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Most childhood headaches are tension-type or migraine and are not caused by anything serious.
- Everyday triggers — too little fluid, missed meals, poor sleep, screens and stress — matter a lot, and a headache diary helps spot them.
- Simple painkillers used correctly help, but taking them too often can cause 'medication-overuse' headaches; preventer treatment is reserved for frequent migraines and takes weeks to work.
- Some signs are red flags — a headache that wakes a child from sleep, is worse lying down or with coughing, comes with vomiting, unsteadiness, vision or behaviour changes, or follows a head injury — and need urgent assessment; sudden 'worst-ever' headache or one with a non-fading rash, stiff neck or drowsiness is a 999 emergency.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Reassurance, for the majority of children whose headaches are not serious.
A routine, non-urgent appointment is the wrong setting for a child with red-flag features — these need urgent or emergency assessment.
You leave with a likely diagnosis, advice on triggers and treating attacks, and a plan for what to do and when to come back. Most children need no scan.
A clear diagnosis, a trigger-management plan, and correct, limited use of attack treatment.
You leave with a likely diagnosis, advice on triggers and treating attacks, and a plan for what to do and when to...
You work on the basics — regular meals and drinks, good sleep, sensible screen limits, and treating attacks early...
A follow-up looks at the headache diary to see whether triggers, frequency or severity are changing, and adjusts...
For frequent migraines, a daily preventer may be tried. These usually take several weeks to work, so patience is...
What causes headaches and migraine in children?
Headaches are common in children and most are not caused by anything serious. The two commonest types are tension-type headache, often a tight, pressing pain across the head, and migraine, which is usually more intense, may throb, can make a child feel sick or be put off by light and noise, and often makes them want to lie down in a dark, quiet room. Headaches frequently come with everyday illnesses such as colds and viruses.
Most childhood headaches are 'primary' — meaning the headache itself is the problem, not a sign of a disease in the brain. A smaller number are 'secondary', caused by something else, which is why a careful look for warning signs matters. Common everyday triggers include not drinking enough, missing meals, poor or irregular sleep, screen time, stress and worry, and, in older children, sometimes overusing painkillers.
The aim of care is to work out what kind of headache it is, rule out the rare serious causes, and help the child have fewer, milder headaches and miss less school. What this guide cannot do is diagnose your child or decide whether a scan is needed — that requires a clinician who can take a history and examine them. Crucially, it can help you recognise the red flags that mean a child should be seen urgently.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Tension-type headache
The commonest type: a tight, pressing or band-like pain across the head, usually mild to moderate, without nausea. Often linked to stress, tiredness, dehydration or screen...
Migraine
More intense, sometimes throbbing head pain, often with feeling sick, dislike of light and noise, and a wish to lie down. Some children get a warning 'aura' such as visual...
Headache with everyday illness
Headaches that come with colds, viral infections, sinus problems or a fever. These usually settle as the illness passes.
Medication-overuse headache
A headache that becomes frequent because painkillers are taken too often. It is more common in older children and teenagers and improves when the overused medicine is reduced...
Preparing for your treatment
- Keep a headache diary for a couple of weeks: when headaches happen, how long they last, how bad they are, what helps, and any triggers like missed meals, poor sleep or screens.
- Note any other symptoms with the headaches: feeling sick, vomiting, vision changes, dizziness or unsteadiness.
- Write down how much your child drinks and eats, their sleep pattern, and their screen time.
- List any medicines used for the headaches and how often, as overuse can itself cause headaches.
- Note how much school your child is missing and how the headaches affect daily life.
- Mention any family history of migraine, and reassure your child the appointment is to help them feel better.
What happens
A clinician — usually your GP first — will take a careful history of the headaches: how often, how long, how severe, what they feel like, what brings them on or eases them, and whether there are any other symptoms. They will ask about sleep, drinks, meals, screens, stress and school, and review any headache diary you have kept.
They will examine your child, including a basic check of the nervous system — such as eye movements, balance and coordination — and may look at the back of the eyes and check blood pressure. The main purpose is to identify the headache type and look for any red-flag features that need urgent attention.
Most children do not need a brain scan. Scans are arranged when the history or examination raises concern about a secondary cause, not simply for reassurance, because unnecessary scans carry their own downsides. If migraines are frequent or hard to manage, or if anything is worrying, your child may be referred to a paediatrician or paediatric neurology service.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- A routine, non-urgent appointment is the wrong setting for a child with red-flag features — these need urgent or emergency assessment.
- A brain scan is usually not appropriate purely for reassurance when the history and examination are normal.
- Long-term daily painkillers are not a suitable treatment and can cause medication-overuse headache.
- Preventer medicines are not needed for occasional headaches and are reserved for frequent migraine.
Delay or rearrange if…
- There is an acute illness, such as a feverish infection, that should be assessed and treated in its own right first.
- A recent head injury needs assessment for that, rather than routine headache management.
- Painkillers are being overused — reducing these first may itself improve the headaches.
- There is significant unaddressed stress, anxiety or sleep disruption that needs support alongside any headache plan.
Alternatives to discuss
- Trigger management — sleep, hydration, regular meals, screen breaks and stress reduction — as the first-line approach.
- Simple, correctly used attack treatment rather than daily medicines.
- Psychological support where stress or anxiety is contributing.
- Specialist paediatric or neurology assessment if headaches are frequent, worsening or worrying.
- Imaging only when clinically indicated by red-flag features.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Reassurance, for the majority of children whose headaches are not serious.
- A clear diagnosis of the headache type, guiding the right treatment.
- Identifying triggers so that simple changes can reduce how often headaches happen.
- A plan to treat attacks effectively and avoid medication-overuse headache.
- Prompt recognition of the rare serious causes that need urgent assessment.
Risks & complications
- Headaches taking time and trial-and-error to bring under control.
- Missed school and disrupted activities during bad spells.
- Frustration if the cause is everyday triggers rather than a single 'fixable' problem.
- Painkillers used too often making headaches worse (medication-overuse headache).
- Side effects from preventer medicines, if these are needed for frequent migraine.
- Anxiety about the cause, especially worry about a brain tumour, which is rare.
- Needing referral to a specialist or, occasionally, a scan.
- A serious underlying cause, such as raised pressure in the head, an infection like meningitis, or a brain tumour.
- A scan finding something unexpected (an incidental finding) that needs further assessment.
- Headache being part of another condition that needs specific treatment.
The biggest worry for most parents is a brain tumour, which is rare — but certain red flags do need urgent assessment: a headache that wakes a child from sleep or is there on waking, is made worse by coughing, sneezing or lying down, comes with persistent vomiting, unsteadiness, vision changes, squint, or a change in behaviour or alertness, or that follows a head injury. A sudden 'worst-ever' headache, or a headache with a non-fading rash, stiff neck, dislike of light, fever or drowsiness, is a 999 emergency. Overusing painkillers is a common, fixable cause of worsening headaches.
Published figures to discuss
Headache is very common in childhood and the great majority of cases are benign, but the small risk of a serious cause is why red flags are taken seriously. Serious secondary causes such as brain tumours are rare, and routine scanning of children with normal examinations finds little while exposing them to incidental findings and, with CT, radiation. Because the chance of a serious cause depends heavily on the specific features present, this guide describes risk qualitatively rather than quoting precise percentages.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Primary headache or migraine | Common | Most recurrent headaches in otherwise well children are not due to a brain tumour, but pattern and examination matter. | Guide sourcesClinical context |
| Medication-overuse headache | Recognised | Frequent use of painkillers can worsen headache frequency; families need clear limits. | Guide sourcesClinical context |
| Red-flag headache | Uncommon but urgent | Morning vomiting, progressive worsening, abnormal neurology, seizures, papilloedema, thunderclap onset or headache waking from sleep needs urgent assessment. | NHS — Migrainenhs.ukSource-linked context |
| School and lifestyle impact | Common in frequent migraine | Sleep, hydration, meals, stress, screen habits and school support should be part of treatment. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Headaches are a symptom rather than a procedure, so there is no physical recovery. 'Afterwards' means putting a management plan into action — sorting out triggers, treating attacks properly, and reviewing progress. Improvement is often gradual, and any preventer medicine takes several weeks to show its full effect.
- Gradual, rather than instant, improvement as triggers are tackled.
- Some ongoing headaches while the right plan is found.
- A few weeks' wait before a preventer medicine shows its effect.
- Headaches easing when sleep, hydration and routine improve.
- Occasional bad days even once things are generally better.
Aftercare
- Encourage regular meals, plenty of water and a consistent, good sleep routine.
- Set sensible limits on screen time and build in breaks and outdoor activity.
- Treat attacks early with the recommended painkiller at the right dose, and rest in a quiet, dark room for migraine.
- Do not give painkillers too often — overuse can cause more headaches; follow your clinician's limits.
- Never give aspirin to children under 16.
- Keep the headache diary to track patterns and triggers.
- Keep school informed so your child is supported during episodes.
- Watch for red-flag warning signs and know when to seek urgent help.
- A headache diary started before the appointment
- A plan for regular meals, drinks and sleep
- Agreed screen-time limits and breaks
- The right painkiller and dose for your child, with clear limits on how often
- A note of how much school is being missed
- A follow-up appointment booked
- A clear list of red flags and when to call 999 or go to A&E
⚠ Get urgent help if…
- Sudden, severe 'worst-ever' headache, or a headache with a non-fading rash, stiff neck, dislike of bright light, fever or drowsiness — call 999.
- A headache that regularly wakes your child from sleep, or is present on waking, especially with vomiting.
- Headache made worse by coughing, sneezing, bending or lying down.
- New unsteadiness, clumsiness, weakness, numbness, or problems with vision, eye movements or a new squint.
- A change in behaviour, personality, alertness or school performance alongside headaches.
- Headache after a head injury, or that is getting steadily worse over days to weeks.
- Headaches in a very young child (especially under about 5 or 6), or a first or rapidly worsening severe headache.
- Persistent vomiting without diarrhoea, or seizures.
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result is fewer, milder headaches, less missed school, and confidence that nothing serious is being missed. For most children, identifying and tackling everyday triggers — sleep, hydration, regular meals, screen breaks and stress — makes a real difference, and attacks can be treated effectively when they do happen.
A normal examination and reassuring history are genuinely reassuring, but they reflect the situation now; that is why parents are given clear red flags to watch for. Where migraines are frequent, a preventer may reduce them, though no treatment removes headaches entirely, and the aim is better control rather than a guaranteed cure.
Many children's headaches improve as they get older, and migraine in particular often changes over time. Tension-type headaches usually settle when triggers are managed. Because headaches can come and go and patterns change, the plan may need revisiting, and any new or different headache should be reassessed rather than assumed to be the same as before.
Related tests, treatments or support
Headache management often goes hand in hand with looking at sleep, mood, stress and school pressures, which frequently contribute. Where anxiety or low mood is part of the picture, addressing this can reduce headaches. For frequent migraine, attack treatment and a daily preventer may be combined under guidance.
Follow-up & long-term care
Follow-up usually involves reviewing the headache diary to see whether frequency, severity and triggers are improving, and adjusting the plan, including any preventer medicine. If headaches are frequent, not improving, or any red-flag features appear, your child may be referred to a paediatrician or paediatric neurology service, sometimes with imaging if clinically indicated.
- Keep up regular meals, good hydration and a consistent sleep routine.
- Maintain sensible screen limits and regular activity.
- Keep using attack treatment correctly and avoid overusing painkillers.
- Continue the headache diary if helpful, to catch changing patterns.
- Review with your clinician if headaches change, worsen, or stop responding to the plan.
Repeat, follow-on and what comes next
- The headache plan is often adjusted over several reviews as triggers, frequency and treatments are fine-tuned.
- A preventer may be changed or stopped if it does not help after an adequate trial of several weeks.
- A previously reassuring assessment should be revisited if the headache changes character, worsens, or develops red-flag features.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear diagnosis, a trigger-management plan, and correct, limited use of attack treatment.
- A written list of red flags and exactly when to seek urgent or emergency help.
- A follow-up plan that reviews the headache diary and a named contact for questions.
- A clear route to paediatric or neurology referral, and imaging, if features warrant it.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether care is through the NHS or a private GP, paediatrician or neurologist.
- The length and number of appointments and reviews.
- Whether imaging (such as an MRI scan) is arranged, and the reporting fee.
- Whether any blood tests or other investigations are needed.
- Any prescribed medicines, including preventers, and monitoring.
- Referral to a paediatric neurology service for complex cases.
- The consultation fee and how long the appointment lasts.
- Whether follow-up reviews are included or charged separately.
- Whether any scan or tests are included, and the imaging and reporting fees.
- The cost of any prescribed medicines and monitoring.
- What happens, and what it costs, if your child needs referral to a specialist.
- What you receive in writing, and the cancellation policy.
On the NHS? Assessment and management of childhood headache and migraine are available on the NHS through GPs and paediatric services; private review may be used for reassurance, convenience or a second opinion.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being told it is 'just headaches' without being given the specific red flags to watch for.
- Arranging or requesting a scan without explaining its limits and the downsides of unnecessary imaging.
- Starting daily painkillers without warning about medication-overuse headache.
- No clear plan for follow-up or for when to seek urgent help.
Marketing red flags
- Offering a brain scan as routine 'peace of mind' for ordinary childhood headaches.
- Promising to 'cure' migraine, which is managed rather than cured.
- Selling unproven supplements or devices as headache treatments for children.
- Downplaying or omitting the red-flag warning signs.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What type of headache do you think my child has?
- Are there any red-flag features here, and does my child need a scan or referral?
- Which triggers should we focus on first?
- How should we treat attacks, and how often is it safe to use painkillers?
- Would a preventer medicine help, and how long before we know if it works?
- When should we come back, and what signs mean we should seek urgent help?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
When is a child's headache an emergency?
Does my child need a brain scan?
What triggers headaches in children?
What painkillers can I give, and how often?
How is migraine in children treated?
Could my child's headaches mean a brain tumour?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Migraine Healthier Together — Migraine and tension headaches in children NICE QS198 — Headaches and red-flag symptoms in children NICE NG150 — Headaches in over 12s: diagnosis and management Great Ormond Street Hospital — Headache
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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