Migraine-related stigma is a pervasive issue impacting nearly half of chronic migraine patients, with significant consequences for their quality of life, disability and mental health. Despite its profound effects, migraine stigma remains under-recognised in both clinical practice and research. This narrative review explores the three primary types of stigmas affecting migraine patients: public, structural and internalised. Public stigma involves negative societal attitudes and stereotypes that trivialise the condition. Structural stigma is reflected in policies that restrict access to necessary care and resources. Internalised stigma occurs when patients absorb these negative views, leading to self-blame and diminished self-worth. Addressing these different types of stigmas is crucial for improving the understanding, diagnosis and treatment of migraine. Educational efforts, advocacy and policy reform are essential strategies in this context. A deep understanding of stigma is vital for developing effective interventions that enhance clinical management and patient quality of life. Ultimately, reducing stigma can lead to better health outcomes and a more comprehensive approach to migraine care.

Several factors contribute to stigma associated with migraine, such as the lack of objective diagnostic tests and biomarkers or traditional gender stereotypes. Patients with migraine can perceive the stigma from different sources: other people (public stigma), organisations (structural stigma) or themselves (internalised stigma), and even neurologists may harbour stigma towards patients with headache. At a social level, repeated migraine attacks lead to restricted participation in work and family life, inducing anxiety, depression and reduced self-esteem. Regarding the workplace, the impact of migraine on their proffesional lives is significant. Individuals who were acquainted with people with migraine at job tended to behave more negatively towards them, and over half of the managers did not consider headache as a valid reason for being absent from work. Effectiveness at work is reduced during a migraine attack, but also because of the interictal symptoms these patients go through. Regarding presenteeism, migraine was the second most expensive disease in the USA, with an annual cost of approximately $240 billion. For all these facts, destigmatisation should take place at the level of healthcare providers, patients and the general population. Implementing educational programmes, training more neurologists in a specialised headache approach, listening to the patients and taking their concerns seriously, or recognizing the disability that the disease causes are strategies that may help minimizing the stigma of migraine.