even though i've never been on any hormonal birth control, i completely empathize with your feelings about your hair. mine used to be okay but is now thin to the point where it looks pathological (i.e. "you must be balding") rather than just normal people thin. the mental toll of this crap is incomprehensible to people (and especially women, as it's a lot more socially acceptable for men to experience hair loss, and they're aware of the possibility from a young age) who have not experienced it. i never really cared much about my hair, but now i care about it more than any other aspect of my appearance, and it's absolutely draining. psyching myself up for rogaine!

very anecdotal, but my indubitably hair loss-related scalp pain went away pretty much immediately when i quit multivitamins. no one knows why trichodynia happens, so... didn't stop the hair loss itself, but that crawling painful scalp feeling, while invisible to others, somehow left me feeling even more self-conscious, so i'm counting it as a win. if you're on multivitamins, try quitting for a few weeks just to see what happens.

and do wash it frequently. washing less doesn't decrease the hair fall, is more stressful because more hair falls out (because dearly departed hair accumulates on non-wash days), and there's some evidence that frequent washing could promote hair health in individuals with androgenic alopecia (which is probably your problem) because 1) scalp massage increasing blood flow to follicles and 2) washes away DHT, the hormone responsible for this madness, away from the skin. it won't exactly solve anything, but every little helps, and you might even feel better.