What Is Scalp Psoriasis?
Scalp psoriasis is a common skin disorder marked by raised, reddish, thickened, scaly patches (plaques). These patches may appear as a single patch or multiple patches and can even affect the entire scalp. Sometimes it can also spread to the forehead, the back of the neck (most common), or behind and inside the ears. The condition is not contagious and does not transmit from one person to another. The mild forms of scalp psoriasis are usually unnoticeable, while severe forms last long and cause thick, crusted sores. Scalp psoriasis, in most cases, is a cause of social embarrassment due to the flaking of the scale. In addition, intense itching can affect sleep and everyday life, and severe scratching can lead to various skin infections and localized hair loss.
What Does Scalp Psoriasis Look Like?
Scalp psoriasis causes cell buildup on the skin, resulting in thick, scaly, itchy patches on the scalp and other body areas. In some cases, symptoms may mimic dandruff. However, mild scalp psoriasis usually includes only slight, fine scaling.
The symptoms of moderate to severe scalp psoriasis may include:
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Scaly, red, raised patches.
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Silvery-white scales.
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Dandruff-like flaking.
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Dry scalp.
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Severe itching.
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Burning or soreness.
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Temporary hair loss from intense scratching.
What Causes Scalp Psoriasis?
The exact cause is still not known. But researchers believe psoriasis is an immune-mediated inflammatory condition that causes skin cells to build up. The cells form within a few days, making it difficult for the body to eliminate excess cells. Genetics can also be a contributing factor. People may be more likely to get scalp psoriasis if they run in their families.
Who Is More Likely to Get Scalp Psoriasis?
Psoriasis may be more common in people with:
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Inflammatory factors that occur with obesity.
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Gluten sensitivity and nutritional deficiencies.
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Sedentary lifestyle.
Some factors that may trigger a flare-up of symptoms in people who are prone to scalp psoriasis include:
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Skin injury, like a burn, cut, or bruise.
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Skin infection, especially strep throat.
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Emotional stress.
What Are the Possible Complications of Scalp Psoriasis?
Scalp psoriasis can cause complications like:
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Bleeding may occur from scratching or removing scales.
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Severe itching and discomfort.
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Temporary hair loss.
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Certain scalp psoriasis treatments and stress may worsen hair loss.
Consult a healthcare professional about ways to avoid hair loss from scalp psoriasis. Avoiding hair treatments (like hair dying or perming) or changing the scalp psoriasis treatment may help hair grow back.
How Is Scalp Psoriasis Diagnosed?
During a visit, the doctor examines the affected area and asks about symptoms, medical conditions, and family health history. A doctor may diagnose scalp psoriasis simply by examining the rash. The doctor may recommend a skin biopsy to rule out other conditions in suspected cases.
How Is Scalp Psoriasis Treated?
Scalp psoriasis may flare up periodically, but appropriate treatment can manage the symptoms. The first line of treatment is topical medications, including medicated shampoos, creams, gels, lotions, foams, oils, ointments, and soaps. The treatment for scalp psoriasis usually consists of topical corticosteroid medications. Multiple treatments may be used together for severe psoriasis cases.
1) Topical Treatments:
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Topical corticosteroids.
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Vitamin D derivatives such as calcipotriene.
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Retinoids.
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Coal tar shampoo.
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Anthralin.
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Salicylates.
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Vitamin A, Tazarotene.
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Other topical steroids.
The healthcare professional may prescribe lotions, liquids, gels, foams, or sprays instead of thicker creams or ointments because the hair on the scalp may make topical medications for psoriasis challenging to use. It may take around eight weeks or more for scalp psoriasis to resolve completely. Once the scalp psoriasis has cleared, shampoo regularly or twice weekly with a product containing coal tar or other medications to prevent it from returning.
2) Systemic and Biologic Treatments:
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If topical treatment is ineffective, oral-systemic medications and biologic infusions or injections may help relieve the psoriasis symptoms.
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These treatments help slow down the growth of skin cells and alleviate inflammation.
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Biologic medications that help block proteins in the immune system related to psoriasis, including:
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Tumor necrosis factor-alpha (TNF-alpha).
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Interleukin 17-A.
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Interleukins 12 and 23.
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3) Phototherapy Treatments:
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Phototherapy treatments with a laser or non-laser light source may help, especially when other treatments fail to work.
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For example, the excimer laser uses high-intensity light on affected areas and avoids the surrounding healthy skin. Ultraviolet (UV) light delivered with a hand-held device called a UV comb is used to treat the entire scalp.
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For thin hair or a shaved head, the doctor may recommend going out in natural sunlight for brief periods.
How to Reduce Hair Loss in Scalp Psoriasis?
Certain ways can help prevent further psoriasis-associated hair loss like:
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Gently comb and brush away the scale to treat scalp psoriasis.
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Brush gently to avoid loosening the hair along with the scale.
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Avoid picking off the scale, as it can aggravate the skin, causing psoriasis to flare.
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Keep the fingernails short, and file the fingernails so that the tips are smooth. Short and smooth nails can prevent scratching hard and prevent loosening the hair.
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Try using a medicated shampoo one day and a non-medicated, gentle shampoo the next time to avoid overdrying the scalp and hair. Dry hair is more prone to breakage, leading to hair loss.
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Use a mild conditioner after every shampoo. Conditioners can help the scalp feel less dry.
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Let the hair air dry. Blow drying can dry the scalp even more.
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Test the hair care products. Hair colors or dyes, straightening products, and hair sprays can dry the hair and irritate the scalp. Before using a hair-care product, dab a small amount of product on the scalp and let it stay there for a while. If the scalp feels irritated in a few hours, swap that product for something milder.
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Consult a health care professional if the psoriasis treatment scalp seems too harsh. The health care professional may switch treatments.
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If facing difficulty clearing the scalp psoriasis, see a health care provider. When following an effective treatment plan, it is rare to have scalp psoriasis for a longer time.
Conclusion
Having scalp psoriasis can be a challenge sometimes. However, prompt treatment can help prevent scalp psoriasis from worsening. The available treatments are usually effective and help reduce the visibility of the symptoms, control flare-ups, and prevent it from returning. As a result, people following their treatment plan properly have severe scalp psoriasis. Besides seeking treatment, recognizing and avoiding psoriasis triggers can also help manage the condition.
