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Psoriasis is a medical condition that commonly causes skin changes on the knees, elbows, hands, feet, and scalp. When it affects the scalp, raised, scaly patches appear, and hair loss may occur.
Psoriasis affects more than 8 million people in the United States. The condition affects the immune system and can lead to a range of skin symptoms. Psoriasis can occur anywhere on the body, including the scalp.
This article looks at scalp psoriasis and hair loss in more detail. It also covers prevention and treatment.
Psoriasis is an autoimmune condition that causes skin cells to grow too quickly, resulting in scaling, inflamed skin and other symptoms.
Skin cells typically take around 1 month to be replaced by new cells. However, psoriasis speeds up this process of skin regeneration. When a person has psoriasis, it takes only a few days for new cells to form and rise to the surface.
The speed at which this happens causes the skin to build up in patches, or plaques, on the surface. A person with these symptoms will often receive a diagnosis of plaque psoriasis. This is the most common form of psoriasis.
In scalp psoriasis, these plaques affect the top of the head, the forehead, the back of the neck, and the area behind the ears.
A person with scalp psoriasis may notice:
- discolored patches on the scalp
- flaking and scales that may, at first, resemble dandruff
- a dry scalp that may crack and bleed
- burning, soreness, or pain on the scalp
Scalp psoriasis can result in temporary hair loss, but it does not directly cause it.
Psoriasis plaques on the scalp can become very itchy and, in some cases, even painful. Itching the scalp or forcibly removing skin plaques can result in skin damage and hair loss.
To prevent hair loss, a person with scalp psoriasis should try to avoid scratching or rubbing their scalp. Medicated shampoos and topical ointments may help reduce itching.
When hair loss does occur, it normally grows back after psoriasis symptoms disappear.
Preventing a flare of scalp psoriasis before it starts is the best way to avoid hair loss.
Getting proper treatment is crucial to prevention. A dermatologist can provide medical treatment that can ease a flare quickly, before symptoms become severe or cause complications.
The following sections look at treatment options in more detail.
Depending on how severe the symptoms are, a doctor may suggest applying the following treatments to the affected area:
There are several over-the-counter (OTC) treatments that may help with the symptoms of scalp psoriasis.
The active ingredients that a person should look out for when choosing an OTC option are salicylic acid and coal or wood tar.
Products with tar as an ingredient can slow the growth of new skin cells and soothe itching. However, tar products can stain clothing.
Psoriasis is a condition that affects the whole body. If the symptoms are severe, a doctor
Some options include:
- biologics, which are drugs that target specific genes in the body
- methotrexate and apremilast, which are both disease-modifying antirheumatic drugs that affect the way the immune system works
- retinoids, which are a form of vitamin A
Sometimes, a doctor will prescribe a combination of drugs or treatment types.
Light treatment was once a mainstay of psoriasis treatment, but the introduction of new medications to treat this condition means that it is now becoming less common.
UVB light occurs naturally in sunlight and can be effective in slowing the growth of skin cells affected by psoriasis. It directly suppresses immune cells in the skin.
UVB therapy involves exposing the skin to an artificial light source for set periods of time on a regular basis. A dermatologist will typically carry out UVB therapy in a medical setting, though at-home UVB units are also available.
UVA light can also treat psoriasis plaques, though doctors typically only use this in combination with psoralen medications. These are drugs that make the skin more sensitive to light.
Other medications can also help treat scalp psoriasis and reduce the risk of hair loss. The sections below look at these in more detail.
Topical, oral, and injectable steroids can help reduce inflammation and the severity of psoriasis plaques.
Mild corticosteroid creams are available without a prescription and can be effective at treating small areas of psoriasis. A doctor or dermatologist
In more severe cases of scalp psoriasis, a dermatologist may prescribe oral medications.
Some oral medications for psoriasis include:
- apremilast, which is a newer, non-immunosuppressive treatment to reduce inflammation
- methotrexate, which can also help reduce inflammation
- acitretin, which can slow skin growth and reduce inflammation
- cyclosporine, which can inhibit a person’s immune response
Injectable or infusion drugs
Injectable treatments can also help reduce the symptoms of psoriasis. These include biologic treatments. Biologics are medications that target the immune system in order to reduce inflammatory responses.
Some injectable drugs for psoriasis include:
- anti-tumor necrosis factor agents, such as etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade)
- anti-interleukin-12/23 agents, such as guselkumab (Tremfya), risankizumab-rzaa (Skyrizi), and ustekinumab (Stelara)
- anti-interleukin-17 agents, such as secukinumab (Cosentyx)
Some home remedies and lifestyle changes can help people take control of their scalp psoriasis and prevent flares.
When symptoms occur, the American Academy of Dermatologists suggests the following:
- Seek medical advice as soon as possible.
- Avoid scratching or picking.
- Shampoo gently to prevent further irritation.
- Gently brush and comb out flakes and scales.
- Apply any treatment to the scalp, not just the hair.
- Let the hair dry without using a hairdryer.
- Alternate shampoos and use a conditioner to reduce the risk of dryness.
Some types of shampoo are also more suitable for people with scalp psoriasis.
Medicated and coal tar shampoos are available for purchase online, but a person must ask a doctor which one they should use.
Psoriasis is an inflammatory skin condition that can affect the whole body. It can cause raised, discolored patches of skin, or plaques, that may feel itchy or painful.
Scalp psoriasis can lead to hair loss if a person itches or picks at affected areas. However, this hair loss is usually only temporary. A person’s hair typically grows back after their psoriasis symptoms disappear.
There are a variety of treatment options available for psoriasis, including topical creams, oral medications, and biologic injections. A person with psoriasis should consult a doctor or dermatologist to decide the best course of treatment.