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What is scalp psoriasis?

Psoriasis is a common skin condition. It features raised and scaly red patches, or plaques, on the skin. It’s a chronic condition with symptoms that may worsen at times and then improve. It’s also considered an autoimmune disease. This means your immune system causes harm to your body instead of protecting it.

There are different types of psoriasis. The most common type is chronic plaque psoriasis. This type can spread over the body, but it most often affects the:

  • elbows
  • knees
  • back
  • scalp

Other types of psoriasis may affect the whole body or specific areas like the legs and trunk, or areas where skin touches skin, like the fingers or in the armpits.

When psoriasis appears on the scalp, it’s called scalp psoriasis. Scalp psoriasis is common among people with chronic plaque psoriasis. The American Academy of Dermatology notes it affects the scalp in at least 50 percent of people with chronic plaque psoriasis.

Treatment can lessen symptoms and help prevent complications. Read on to learn more about scalp psoriasis.

Symptoms may vary from mild to severe and include:

  • dryness
  • flaking that resembles dandruff
  • itching, burning, or discomfort
  • raised reddish patches
  • silvery-like scales
  • bleeding or temporary hair loss from scratching or removing the plaques on the scalp

These symptoms usually appear evenly on both sides of the scalp, or they may affect most of the head. They may also extend to the:

  • neck
  • ears
  • forehead
  • other parts of the face

You may be referred to a dermatologist for diagnosis and treatment. The usual treatment for scalp psoriasis is topical corticosteroid medication.

Other topical medications include:

  • vitamin D
  • retinoids
  • coal tar shampoo
  • anthralin

The hair on the scalp may make usual topical medications for psoriasis difficult to use. So, you may be prescribed lotions, liquids, gels, foams, or sprays instead of thicker creams or ointments used on other parts of the body.

Treatment may also include a combination of more than one topical medication. Salicylates may also be used to help remove plaques.

If topical treatment isn’t effective, there are other treatments available, such as phototherapy, oral medications, and biologic infusions or injections.

Make sure you follow all instructions for using your medication. For example, you’ll need to know when to shampoo your hair so that the medication stays on for the desired amount of time. Once you start treatment, your doctor will check to see if your symptoms are improving.

You can find vitamin D cream, coal tar shampoo, or anthralin cream online.

Self-care tips

  • Dandruff. Scalp psoriasis dandruff is different than common dandruff. There may be large and silvery scales. The scales must be carefully removed. Don’t scratch or pick them.
  • Combing and brushing. Scalp psoriasis can also make combing or brushing difficult. Be careful combing or brushing your hair, because it can irritate your scalp. You can use a comb to gently remove scales. Clean the comb before each use to help prevent infection.

Scalp psoriasis can cause two complications:

  • Bleeding. Scalp psoriasis can cause itching and discomfort. Bleeding may occur from scratching or removing scales.
  • Hair loss. The effect on hair follicles, heavy scaling, and excessive scratching can cause noticeable hair loss. Entire clumps of hair may also come out when the scalp is damaged. Certain scalp psoriasis treatments and stress may make hair loss worse.

Talk with your doctor about ways to avoid hair loss if you have scalp psoriasis. You may need to avoid hair treatments (like dyes and perms) or change your scalp psoriasis treatment. But keep in mind, your hair will grow back.

Having scalp psoriasis may be challenging to cope with. Treatment is usually effective and helps reduce the visibility of this condition.

Ask your doctor about support groups in your area. The National Psoriasis Foundation can provide information about support groups, the condition, treatment, and current research.