Of the approximately 7.5 million Americans that suffer from psoriasis, nearly half will experience scalp psoriasis, according to the National Psoriasis Foundation. A chronic conditions that’s characterized by intermittent flare-ups and alternating periods of remission, the effects of scalp psoriasis vary. For some, the condition can be mild, while others experience significant pain and discomfort.  

Symptoms of scalp psoriasis   

Psoriasis is a disorder that affects skin at the cellular level, rapidly accelerating the production of cells and causing them to build up on the surface of the skin. Before long, silver, scale-like patches form, and are often accompanied by dryness, itchiness, inflammation and pain. While psoriasis can occur anywhere on the body, scalp psoriasis characterizes this condition when it occurs on the scalp, along the hairline, on the forehead or face and behind the ears. Scalp psoriasis is a form of plaque psoriasis and often, as the result of the buildup of dry, dead skin, flaking will occur or the patches will thicken to form scale-like plaques.

The severity of scalp psoriasis varies from person to person. Some will experience one or a few small patches while others may develop patches across the entire surface of the scalp. Some lesions cause little discomfort and can go unnoticed, while others may become painful, swollen, itchy, dry and/or inflamed. In rare cases, temporary hair loss may occur as the result of excessive scratching or harsh treatments.

Causes and risk factors

Unfortunately, scientists haven’t determined a specific cause for psoriasis, but genes are likely to play a role. According to Mayo Clinic, one in three individuals affected with psoriasis has a close relative that also suffers from the disease. Other factors can increase the risk of developing psoriasis and/or scalp psoriasis, including:

• obesity
• HIV
• strep throat
• smoking
• stress

Many sufferers find that certain environmental factors can cause an outbreak or worsen an existing bout. Potential triggers include infection, minor skin irritations including scratches, scrapes or sunburn, cold temperatures, alcohol and certain medications. An important step in controlling scalp psoriasis is to identify the specific factors that may influence your condition and work to control or reduce them in your daily lifestyle.

Treatment options

Scalp psoriasis can easily be misdiagnosed as dandruff or seborrheic dermatitis, so it’s important to visit the doctor or dermatologist if you experience any unusual symptoms. He or she will likely do a small skin biopsy in order to properly diagnose the condition. Even though there isn’t a cure for scalp psoriasis, there are treatments and lifestyle remedies that can significantly improve symptoms. Treatment depends on the severity of the condition and most medications intended to treat scalp psoriasis contain similar ingredients as those that treat psoriasis on the body.

• Mild to moderate: For a mild case of psoriasis, using specially formulated shampoos or topical creams that contain coal tar and non-coal tar is an effective treatment that hydrates skin while relieving itchiness and inflammation.

• Product picks: Tarsum Shampoo/Gel from Summers is a therapeutic shampoo that features a special applicator cap to apply the product directly on psoriasis plaques.

For a moisturizing and healing cream, Mushatt's No. 9 Scalp Cream blends urea, sweet almond oil, sesame seed oil and salicylic acid to relieve itching, stop flaking and restore moisture for a healthier scalp.  

• Severe cases: For severe cases of scalp psoriasis, your doctor may prescribe a topical treatment. Prescription medications including Anthralin, Calcipotriene (Dovonex), Tazarotene (Tazorac) or corticosteroids. These treatments vary in strength and each has different potential side effects.

In addition, your doctor may recommend biologics, which are oral drugs that work to improve immune function and may relieve the symptoms of scalp psoriasis. Talk to your doctor about which medication is right for you.

Phototherapy, or the use of UV light, is also incorporated into the treatment of scalp psoriasis, and at-home devices with comb-light attachments are available. This method can be less effective on the scalp, however, as hair creates a barrier between the light and the lesions, and some doctors caution about the risk factor of skin cancer. Talk with your doctor about the lifestyle factors that may influence your condition. Certain changes like reducing alcohol consumption, reducing stress and quitting smoking can help improve existing cases while preventing new outbreaks.

All forms of psoriasis, including scalp psoriasis, are often accompanied by mental and emotional challenges that only make dealing with the physical symptoms more difficult. Many find the visible plaques, scales and flaking to be unattractive, uncomfortable and embarrassing, causing stress, social anxiety and depression. When treating the physical symptoms of psoriasis, be sure to talk with your doctor about coping mechanisms to help deal with the mental stigma as well. Although there is no cure, with a diligent treatment plan, you can control the symptoms and prevent future outbreaks of scalp psoriasis for skin that looks and feels better.

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See also:

Dry, Flaky Scalp (Dandruff)

Hair Loss and Women: A Common Scalp Condition

Fall Hair Care: 5 Tips For Transitioning Your Tresses

Products for Dandruff: Soothing Itchy Scalp