What is Scalp Psoriasis?
It is very common for plaque psoriasis to occur on the scalp. At least 50% of the people who have psoriasis will have the scalp affected at some time during the course of the disease. Scalp psoriasis usually looks similar to plaque psoriasis on other areas of the body. New skin cells form in days rather than weeks, and the skin cells pile up on the surface of the skin, causing red, flaky areas. Scalp psoriasis may also be visible around the hairline, on the forehead, neck and behind the ears. It can make the scalp feel itchy and tight. Other symptoms of scalp psoriasis include dandruff-like flaking, burning sensation or soreness.
Does Scalp Psoriasis cause hair loss?
Scalp psoriasis itself doesn’t normally cause hair loss but scratching a lot or picking at the scaly spots, and harsh treatments can lead to temporary hair loss. People with severe scalp psoriasis can also experience a thinning of hair because of the build-up scale. Fortunately, the hair usually grows back after the skin clears with the appropriate treatment.
What are the treatment options?
Psoriasis is a chronic (long-lasting) disease that may wax and wane, usually involving periods with milder symptoms, followed by periods when symptoms are more severe. Whilst there is no cure yet, there are many treatments available to help manage scalp psoriasis. In most cases, the first treatment used will be an over-the-counter topical preparation, such as shampoos with coal tar, salicylic acid or coconut oil.
- Coal Tar: Tar has been used to treat various skin disorders since ancient times. It is still not completely understood how coal tar works to treat skin conditions. The theory is that the topical application of coal tar normalises keratin growth in the skin which reduces scaling. It appears to reduce itching as well. You can find our selection of coal tar shampoos here.
- Salicylic acid: Salicylic acid is an organic acid that has been used for many years in the topical treatment of psoriasis. It has the ability to disrupt the cellular structures that hold the upper cell layers of the skin together. This leads to the exfoliation which helps prevent the pores from clogging with dead skin cells and decreases plaque formation. Have a look at our shampoos containing salicylic acid here.
- Coconut Oil: A preparation with coconut oil like ArtNaturals Coconut & Lime Shampoo or Sorion Shampoo can be used to soften the scalp and make plaques easier to lift. Coconut oil hydrates skin by improving the barrier function of the skin and preventing water loss.
If these are not effective, a topical steroid or a combined product with a topical steroid and a topical vitamin D analogue (calcipotriol, calcitriol) can be prescribed by your doctor. In severe cases, where the topical treatments are ineffective, systemic treatments may be used. These are oral or injected medicines that work throughout the whole body.
What else can I do? Tips and tricks:
- Brush and comb hair gently and regularly to remove loose scales. Avoid scratching the scalp.
- Be patient and give your treatments several weeks to work.
- Inform your hairdresser about your scalp psoriasis and ask for a mild shampoo or bring your own shampoos if in doubt.
- Be careful with hair treatments like perms and dyes which touch the scalp, especially if there is broken skin. You can ask your hairdresser to do a patch test in advance to check for possible reactions.
- When applying scalp treatments, ensure that it is applied on the scalp rather than the hair. Try to part the hair in sections and apply the treatment on the exposed areas of your scalp.
As with other types of psoriasis, scalp psoriasis can have a significant impact on quality of life for those more severely affected. Speak to your GP or dermatologist if you have scalp psoriasis and you can not manage it satisfactorily with your current treatment. They can offer advice and further treatment if necessary.
You can find all our products for scalp psoriasis here.
Fitzpatrick's Dermatology In General Medicine 6th ed. 2003