There is no cure for scalp psoriasis, and treatments are aimed at relieving symptoms. Scalp psoriasis can be difficult to treat.
Treatments to help get rid of psoriasis on the scalp include:
- Topical treatments, such as creams and ointments
- Over-the-counter (OTC) topical treatments: The National Psoriasis Foundation (NPF) has a Seal of Recognition program that recognizes over-the-counter products that are created for or intended to be non-irritating and safe for people with psoriasis
- Look for products such as shampoos that contain:
- Salicylic acid which helps soften plaques and scales and remove scales from the skin
- Coal tar or wood tar, which helps slow skin cell growth and reduce inflammation, itching, and scaling
- Scale lifters (keratolytics) with an active ingredient of salicylic acid, lactic acid, urea, or phenol help loosen and remove scale, allowing medications to reach the psoriasis plaques
- Anti-itch treatments such as calamine, hydrocortisone, camphor, diphenhydramine hydrochloride (HCl), benzocaine, and menthol (may increase irritation and dryness)
- Aloe vera, jojoba, zinc pyrithione, and capsaicin may help moisturize, soothe, remove scale, or relieve itching
- Castederm may be used for inverse psoriasis to help dry moist plaques in the folds of the body
- Bath solutions such as oil, oatmeal, Epsom salts or Dead Sea salts can help remove psoriasis scales and soothing itch
- Coverings such as cellophane, plastic wrap, waterproof dressing, cotton socks, or a nylon suit may be applied over topical treatments which can help increased the effectiveness of some topical medications or moisturizers
- Prescription topical treatments
- Phototherapy (light therapy)
- Ultraviolet light B (UVB): broad band and narrow band
- Psoralen + UVA (PUVA)
- Systemic treatments
- Biologics and biosimilars
- Tumor necrosis factor-alpha (TNF-alpha) inhibitors
- Interleukin 12 and 23 (IL-12, IL-23) inhibitors
- Interleukin 17 (IL-17) inhibitors
- T-cell inhibitors
- Interleukin 23 (IL-23) inhibitors
- Disease-modifying antirheumatic drugs (DMARDs)
- Traditional oral systemics
- Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen (Advil, Motrin) for inflammation
- Biologics and biosimilars
What Are Symptoms of Scalp Psoriasis?
Psoriasis commonly affects the skin of the scalp, elbows, and knees. Symptoms may worsen (flare) for weeks to months and then subside (go into remission).
Symptoms of scalp psoriasis may affect all or part of the scalp and include:
- Fine scaling that looks like dandruff
- Appears powdery with a silvery sheen
- Thick, crusted plaques that cover the entire scalp
- Dry, cracked skin that itches or bleeds
- Localized hair loss
- Scalp psoriasis can also cause emotional effects such as embarrassment, depression, and anxiety.
- Psoriatic arthritis may occur in some patients and cause stiff, swollen, painful joints.
What Causes Scalp Psoriasis?
Scalp psoriasis is caused by an overactive immune system, but the cause of the immune system overactivity is unknown.
Factors that can increase a person’s chances of developing scalp psoriasis include:
- Family history
- Certain types of infections, such as strep
- Use of certain medicines, including blood pressure medicines, lithium, and antimalarial drugs
Triggers for scalp psoriasis flares include:
- Weather, especially cold and dry weather
- Excess alcohol consumption
- Skin injury, including scratches, scrapes, cuts, bug bites, sunburns, and vaccinations
- Illness, such as ear infection, bronchitis, tonsillitis, or respiratory infection
- Exposure to secondhand smoke
- Certain foods
- Environmental factors
How Is Scalp Psoriasis Diagnosed?
Scalp psoriasis is diagnosed with a patient history and physical examination of the scalp.
A small sample of skin may be taken (a biopsy) to help confirm a diagnosis of psoriasis.
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