Psoriasis occurs when your immune system sends faulty signals to your skin cells and tells them to mature too quickly. New cells form within days instead of weeks. Your body can’t shed the excess skin cells, causing the skin cells to pile up on the surface of the skin, which leads to the formation of patches of psoriasis.
Psoriasis can appear anywhere on the skin, but your scalp is one of the most common spots. Scalp psoriasis can range from mild (small, red, rash-like bumps) to severe (thick, scaly plaques). Scalp psoriasis can cause uncomfortable burning and itching, as well as severe dandruff.
Psoriasis can extend beyond the scalp and appear on the forehead, back of the neck, and behind the ears. Factors that can cause a flare-up include:
- injury to skin
- certain medications
- cold or dry air
Psoriasis on the scalp can require different treatment than psoriasis found elsewhere, because the skin on the scalp is thicker and your hair can get in the way. Many consumer systemic and topical treatments can help treat symptoms. For example, special shampoos and conditioners can help in the daily preventive treatment of scalp psoriasis.
Psoriasis affects everyone differently, so it’s important to know your treatment options and be proactive in preventing flare-ups and outbreaks.
Different people experience different symptoms, but there are a few common symptoms of psoriasis. One of the most common symptoms is persistent itching. For some, the itch is mild. For others, intense itching can interfere with everyday life and cause sleepless nights. Scratching an itchy scalp can lead to bleeding and even temporary hair loss.
Other symptoms of scalp psoriasis include:
- reddish patches on the scalp
- dandruff-like flaking
- dry scalp
- a burning sensation or soreness
Symptoms can come and go. Some people have mild flare-ups on their scalps, but other symptoms can be much more serious.
Itching is often a big problem for people with psoriasis. Though it may be hard, you should try to avoid scratching your scalp. Scratching only further irritates your scalp and can cause bleeding, irritation, and even hair loss.
Some shampoos may help relieve the itch. Coal tar shampoos slow skin cell growth and can reduce itching and inflammation. Coal tar is a byproduct of coal production, and is one of the oldest treatments for psoriasis. The higher the concentration of coal tar in the shampoo, the stronger the treatment. The U.S. Food and Drug Administration allows up to 5 percent for psoriasis treatment.
Salicylic acid promotes the sloughing off of dead skin cells and reduces scaling. It’s sometimes combined with other medications, such as corticosteroids or coal tar to increase effectiveness. Salicylic acid is found in some medicated shampoos and scalp solutions, and can be used to treat scalp psoriasis.
Some popular consumer brands with products gentle enough for daily use include:
- Neutrogena T/Gel
Over-the-counter treatments are most effective for mild psoriasis. If the psoriasis is more severe or it has extended past your scalp, they may not work as well.
Some people can get relief from psoriasis using over-the-counter options or home remedies. Others may need to seek help from a dermatologist, especially when over-the-counter treatments aren’t effective or when psoriasis appears on other places on the body. A dermatologist can help you find the best treatment options for your scalp psoriasis. For moderate to severe psoriasis, prescription treatment is often necessary.
Some popular nonsteroidal prescription topical medications include:
These prescription topicals generally slow down the excessive skin cell growth associated with psoriasis. They can also help reduce inflammation. They’re most effective if the psoriasis plaques are removed, to help them penetrate the skin.
Though the chemical makeup of each of these treatments is different, their side effects are all relatively the same and include:
- worsening of the psoriasis
- reddening of skin
Topical creams and ointments can help with mild forms of psoriasis, but severe cases generally require a combination of creams and oral medications. This can help treat psoriasis everywhere on the body.
If you have severe scalp psoriasis or are resistant to other types of treatment, your doctor may prescribe oral or injected drugs, such as adalimumab (Humira). Some of these drugs can have severe side effects, so you should only use them for brief periods.
Lifestyle and Alternative Remedies
Aside from medical treatments, incorporating certain behaviors into your daily routine can keep outbreaks, flare-ups, and symptoms to a minimum.
Some people have found that keeping your scalp moist and hydrated helps fight outbreaks. Shampoo is also able to better penetrate the scalp if hair is kept clean, short, and well-groomed. The more hair you have, the harder it can be to treat scalp psoriasis.
Some people use natural alternative therapies to help ease their symptoms. Light therapy (phototherapy) is sometimes used to treat psoriasis. This method exposes the skin to controlled amounts of natural or artificial ultraviolet light.
Applying aloe vera, taken directly from the leaves of an aloe plant or from a cream, and coconut oil directly to the scalp may help reduce redness, scaling, itching, and inflammation.
Increasing your intake of fish oils can also help.
Talk to your doctor or a dermatologist before trying any treatments, including natural ones.
In Infants and Children
While most common in adults, infants and children can also be affected by scalp psoriasis. Fortunately, most infant scalp psoriasis is mild and can be easily cleared up with treatment. Treatments for mild infant and childhood psoriasis include topical steroids and tar shampoo.
Treating severe infant and childhood scalp psoriasis is more tricky. Though there aren’t other medications approved by the FDA for treating psoriasis of infants and young children, off-label medications can be used at a doctor’s discretion.
Some treatments used for more severe psoriasis in infants and children include:
- topical vitamin D analogues
- topical corticosteriod cream
When to See Your Doctor
If you are experiencing discomfort or pain from scalp psoriasis or any of its symptoms, make an appointment with your doctor. Even if you’re just concerned about the effects on your appearance, a doctor can help.
Scalp psoriasis can become infected. Symptoms of infection include tenderness and crusting of the scalp, and sometimes may include swollen lymph nodes. If you’re experiencing these symptoms, you should make an appointment with your doctor right away.
Treatment usually means a combined effort of medication and lifestyle methods. Diet, exercise, low stress levels, foods high in fiber, fruits, and topical and systemic measures can all help reduce flare-ups and ease discomfort.
Psoriasis can be very unpredictable, so what works for one person may not work for you. Your skin can also become resistant to certain medications over time.
To successfully treat scalp psoriasis and prevent dandruff and other symptoms:
- get the right information
- decide what treatments are right for you
- follow a generally healthy lifestyle
Talk to your doctor and work together to help control your symptoms.