It can affect a person's entire scalp or just develop in small patches. The condition is more common in adults, but it can also develop in children.
About half of the people who have psoriasis develop the condition on the scalp, according to the American Academy of Dermatology.
Scalp psoriasis can affect the head, neck, forehead, and ears.
If scalp psoriasis is mild, the only symptom may be small scaly patches. But some people develop severe psoriasis, and symptoms may include itching, flaking, and red bumps on the scalp. Some people may even feel a burning sensation on their scalp. Scalp psoriasis may spread beyond the scalp to the ears, neck, and forehead.
Complications from scalp psoriasis may develop if the condition is severe. One possible complication is hair loss. When hair loss occurs, it is usually only temporary.
Hair loss does not stem not from the condition itself. Instead, it tends to occur as a result of picking at the dry patches or from vigorous scratching. If a person scratches excessively, bleeding and infection may result.
Other skin conditions can cause similar symptoms. For example, seborrheic dermatitis causes a patchy, red rash, and this can develop on the scalp.
The condition is common in babies and is referred to as cradle cap. The patches associated with seborrheic dermatitis tend to look greasy or moist, while with scalp psoriasis, the patches are scaly and dry.
Ringworm can also cause a crusty, red rash on the skin and scalp. The rash from ringworm tends to form in the shape of a ring or a circle.
Causes, risk factors, and triggers
Although it is a common condition, the cause of scalp psoriasis is not fully understood. According to the American Academy of Dermatology, scalp psoriasis appears to develop when the immune system sends the wrong signals to the body.
The body's immune system sends these messages to the skin cells, and this causes the cells to multiply too quickly. Normally, new cell formation on the scalp may take weeks.
But the faulty signals cause cells to form within days. This increase in cell production makes it difficult for the body to shed the excess cells. The skin cells build up on the surface of the scalp and they form scaly patches.
Although few risk factors have been identified for developing scalp psoriasis, there appears to be a genetic link. People who have a family member with the condition have an increased risk of developing scalp psoriasis.
Certain factors may trigger a flare-up of symptoms in people who are prone to scalp psoriasis. For example, an injury to the skin, such as a burn, cut, or bruise, can trigger psoriasis symptoms. An infection, especially strep throat, can also cause symptoms to flare up.
Stress may be another trigger for scalp psoriasis. Stress may make existing psoriasis more severe or it may trigger symptoms for the first time.
In some cases, certain medications may trigger scalp psoriasis. For example, Indomethacin, which is used to treat arthritis, may give rise to the symptoms of psoriasis in some users. Certain heart medications, such as Quinidine, can also cause symptoms to flare.
When to see a doctor
A dermatologist can diagnose psoriasis and recommend treatment.
The decision to see a doctor may depend on the severity of symptoms. However, anytime a rash develops anywhere on the body, including the scalp, it is helpful to see a doctor. Treatment may depend on the cause, and this is why an accurate diagnosis is needed, even if symptoms are mild.
In many cases, scalp psoriasis is diagnosed after a physical exam and medical history.
A dermatologist may be able to diagnose scalp psoriasis just by examining the rash. In some instances, a skin biopsy may be recommended to rule out other conditions.
Although scalp psoriasis may flare up periodically, it is usually not a serious medical condition. In many cases, symptoms can be controlled with treatment.
Currently, there is no known cure for scalp psoriasis, but over-the-counter and prescription treatments are available. The type of treatment recommended may depend on the extent or severity of the symptoms.
Topical treatments are usually suggested before systemic medications. Topical treatments are applied to a specific area of the scalp. They may include medicated shampoo or medications that contain coal tar or salicylic acid.
Salicylic acid works by promoting the shedding of the outer layer of the skin. It also softens the scales that develop with scalp psoriasis. The problem with shampoo and topical ointment that contains salicylic acid is it can be irritating to the skin and weaken the hair, which may lead to breakage.
Coal tar products are derived from coal. They treat scalp psoriasis by slowing the growth of skin cells to restore a normal appearance to the skin. Coal tar products may also decrease itching and inflammation.
Additional topical treatments include Taclonex, Tazorac, and Dovonex.
Systemic medication is another option. It may be used if topical treatment is not effective. Systemic medication refers to a drug that works throughout the body, instead of just in a localized area. Systemic medication for scalp psoriasis is taken orally.
New medications are available that target specific molecules within immune system cells. By targeting selective cells, the drugs correct the overactive immune response, which causes an increase in cell production.
Medications containing steroids may also be prescribed to decrease inflammation and itching. These drugs carry a risk, however, in that they slow down the immune system. This can leave people at a higher risk of infection.
Light therapy may be recommended to treat scalp psoriasis. Light therapy involves exposing the scalp to ultraviolet light on a regular basis using a special lamp that emits UVB light.
The therapy is done under medication supervision to avoid burns or over exposure.
People with psoriasis should not use tanning beds because they emit significant amounts of UVA light, which can be dangerous.
Prevention and outlook
Scratching the scalp can lead to hair loss.
Since researchers are not sure why some people develop an immune system reaction that leads to scalp psoriasis, it may be difficult to prevent the condition. But treating the condition as soon as symptoms appear may prevent it from becoming worse.
Although it is more common in adults, children can also develop scalp psoriasis. When the condition develops in children, symptoms are the same as for an adult.
It may be difficult to keep children from scratching, so topical medication to treat itching may be recommended.
Regardless of age, scalp psoriasis affects people differently. Some people have an occasional flare-up while others deal with the condition frequently.
Tips for managing scalp psoriasis
People who have scalp psoriasis can manage the condition in part with home remedies and the following tips:
- Seek treatment: Topical ointment or oral medication can be effective in decreasing symptoms and itchiness
- Treat the scalp gently: Avoid vigorously washing and combing the hair, as this can lead to breakage, especially if the hair is fragile due to treatment
- Avoid scratching: Scratching can lead to bleeding and possibly an infection
- Moisturize: Keeping the scalp moist will not cure psoriasis, but it may help improve the appearance of the skin
- Avoid triggers: If possible, identify triggers for scalp psoriasis and consider things you can do to limit them
It is important to seek treatment as this can reduce the risk of further complications such as hair loss or cracked and bleeding skin on the scalp.