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Scalp psoriasis

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read
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Psoriasis is a long-term condition that causes thickened patches on the skin. It may only affect the scalp, or you might have other patches on your body. It can be intensely itchy and, in a mild form, may cause red patches, usually at the back of the head and extending to the neck or behind the ears. In a more severe form, thickened plaque may cause temporary hair loss, which requires stronger and more prolonged treatment.

Causes and risk factors

The exact cause of scalp psoriasis is not fully understood, but it is believed to result from a combination of genetic and environmental factors. A malfunction in the immune system prompts rapid skin cell turnover, leading to the characteristic symptoms. Genetics play a role, as individuals with a family history of psoriasis are more predisposed to develop the condition. Environmental triggers, such as stress, infections, or certain medications, can exacerbate or trigger flare-ups.

Types of Scalp Psoriasis

Several forms of psoriasis can affect the scalp, including plaque psoriasis, which is the most common. Other types include:

  • guttate psoriasis
  • pustular psoriasis
  • inverse psoriasis

Each subtype presents with distinct characteristics, influencing the choice of treatment.

Symptoms of scalp psoriasis

Scalp psoriasis presents with a variety of symptoms that can vary in severity from person to person. Common signs include red or silvery patches on the scalp, itching, burning sensations, and the presence of scales or plaques. These symptoms can extend beyond the hairline, affecting the forehead, neck, and ears. In severe cases, scalp psoriasis may lead to temporary hair loss.

Diagnosis and differential diagnosis

Diagnosing scalp psoriasis typically involves a visual examination by your doctor. Sometimes, a skin biopsy may be conducted to confirm the diagnosis. It is essential to differentiate scalp psoriasis from other scalp conditions, such as seborrheic dermatitis, eczema, or fungal infections, as the treatment approaches vary.

Impact on quality of life

Scalp psoriasis can affect the health of the hair and scalp, leading to issues like dandruff and hair loss. Proper care and gentle cleansing are essential to maintain scalp health. Avoiding trauma to the affected areas and choosing hair care products specifically designed for sensitive skin can contribute to overall hair and scalp well-being.

Psychological and social considerations

The psychosocial impact of scalp psoriasis should not be underestimated. Individuals may experience feelings of embarrassment, frustration, or depression due to the visible nature of the condition. Seeking support from your doctor, support groups, or mental health professionals is crucial to addressing the emotional challenges associated with scalp psoriasis.

Treatment options

The management of scalp psoriasis involves a combination of topical treatments, systemic medications, and lifestyle modifications. Steroid creams are commonly prescribed to reduce inflammation and itching. Medicated shampoos containing ingredients like coal tar, salicylic acid, or ketoconazole can help alleviate symptoms. In more severe cases, systemic treatments such as oral medications or biologics may be recommended. Phototherapy, involving exposure to ultraviolet light, can also be an effective treatment option.

Home remedies and lifestyle modifications

Several home remedies and lifestyle changes can complement medical treatments for scalp psoriasis.

Regular use of moisturizers can help soothe dry skin, while avoiding harsh hair products and minimizing stress may reduce flare-ups.

Some individuals find relief from natural remedies such as aloe vera, tea tree oil, or apple cider vinegar. We prefer more evidence-based approaches.

Preventive measures and long-term management

While scalp psoriasis may not have a definitive cure, preventive measures and long-term management strategies can help control symptoms and reduce the frequency of flare-ups. Consistent use of prescribed medications, adherence to treatment plans, stress management, and lifestyle modifications contribute to effective long-term control of scalp psoriasis.

When should I see my doctor?

If you think you have scalp psoriasis, you should book a routine appointment with your doctor, who will listen to your symptoms and examine you - they may ask about rash elsewhere and symptoms of associated conditions. They can suggest targeted scalp treatments to reduce itchiness, soften any plaque and help resolve the psoriasis.

Research and Advancements

Ongoing research in dermatology and immunology continues to explore new insights into the mechanisms of psoriasis. Advancements in treatment options, including targeted therapies and biologics, offer hope for improved outcomes and enhanced quality of life for individuals with scalp psoriasis. Clinical trials and innovative approaches contribute to expanding the toolkit for managing this chronic condition.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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