What can I do about scalp psoriasis?
A variety of home remedies and shampoos can reduce pain and itching associated with scalp psoriasis, accelerate the healing process, and prevent hair loss.
However, treating scalp psoriasis can be complicated. A person might need to try numerous combinations and treatments before they find one that works for them.
In this article, we look at how to recognize scalp psoriasis, what causes it, and how best to manage it.
Shampoos for scalp psoriasis
Shampoos are available to treat scalp psoriasis.
Treating scalp psoriasis can be difficult due to the sensitivity of the skin and the presence of hair. Treatment aims to remove plaques and soothe itching.
It is possible to make a psoriasis-relieving shampoo at home. People can try mixing psoriasis-friendly ingredients, such as apple cider vinegar or tea tree oil, with their usual shampoo.
This can serve as a gentle, homemade psoriasis remedy. However, this is usually only an effective measure in very mild presentations of scalp psoriasis.
Shampoos that contain salicylic acid or coal tar are available over the counter. These can help people manage mild scalp psoriasis. These might also be available in the form of creams, lotions, and ointments.
Use warm water to make the plaques softer before applying shampoos or ointments. Comb the hair afterward in a gentle circular motion. This can help remove plaques from the scalp.
Whether homemade or shop-bought, any psoriasis shampoo should contain one of the following ingredients (but not in combination) to be effective:
Salicylic acid is a medication that helps the skin peel. It may also remove psoriasis scales and help the patches of skin heal faster.
Stronger treatments contain more salicylic acid. However, this might irritate the skin. People may wish to try starting with a product that has relatively low salicylic acid content and gradually increasing the strength based on how their skin reacts to it.
Shampoos containing salicylic acid also support other scalp psoriasis treatments, such as topical corticosteroids.
Some other acids, including glycolic acid and lactic acid, can also help the skin peel. However, much like salicylic acid, they can irritate the skin at higher concentrations.
Ketoconazole is an antifungal agent that can also help people with the dry, scaly skin associated with psoriasis. Shampoos that contain ketoconazole can help remove both dandruff and psoriatic plaques.
Some people with scalp psoriasis have a higher risk of fungal infections than people who do not have the condition. Ketoconazole is an especially beneficial ingredient that can protect the scalp from painful yeast infections.
This is a preparation that people use to treat many conditions that affect the skin, including hyperkeratosis and seborrheic dermatitis.
Some people use coal tar to treat psoriasis, including scalp psoriasis. Although researchers have carried out more studies into coal tar and psoriasis, pine tar soaps and shampoos may also work.
It is also possible to wash the scalp with tar soap. However, the soap has a strong, distinct smell and can be irritating to the skin. One 2016 review concluded that the evidence for using coal tar is not yet strong enough to confirm its benefits.
People should start with a low concentration and work up to more potent formulas. However, it is important for people to check with a doctor about the maximum strength they should use.
A doctor might prescribe topical treatments for scalp psoriasis.
If shampoos and milder treatments are not effective, a doctor might consider prescribing a more intensive topical treatment, including:
- calcipotriene (Dovonex), which is a synthetic form of vitamin D-3 that helps by slowing cell growth in the skin, shedding scales, and reducing the size of lesions
- calcipotriene and betamethasone dipropionate (Taclonex), which can help make lesions flatter, reduce skin cell production, get rid of scales, and soothe itching
- anthralin (Zithranol-RR), which helps slow skin cell production
- tazarotene (Tazorac), which is a topical retinoid that helps reduce the speed of skin cell growth
A doctor might also consider systemic therapies. These are medications that affect many systems in the body and target the autoimmune activity at the root of psoriasis.
However, they will only recommend these in very severe cases of scalp psoriasis that do not respond to other treatments.
Treatment might become less effective if a person uses the same medication for a long period of time. A doctor may need to change their treatment regimen if this is the case. People can rotate a combination of treatments for the best long-term results.
No home remedy can resolve scalp psoriasis on its own. However, certain natural and alternative treatments can help improve the appearance of psoriasis lesions, moisturize the skin, and soothe itching when a person uses them alongside more traditional treatments.
The National Psoriasis Foundation recommend the following herbal remedies for psoriasis:
Some research in rats has suggested that turmeric can reduce the inflammation associated with psoriasis.
A 2018 randomized controlled trial suggested that turmeric tonic has anti-inflammatory effects in those who have scalp psoriasis. The study authors reported satisfactory results supporting its use as a treatment.
Apple cider vinegar
Apple cider vinegar can help relieve itching. People can buy a bottle from the store and apply it to the scalp a few times per week.
If apple cider vinegar causes a burning sensation, rinse it after it dries or dilute it 1:1 with water. People whose skin is cracked and bleeding should not try this remedy.
Dead Sea salts or Epsom salts
People can try mixing either of these with warm bathwater and soaking in the solution for around 15 minutes.
The salts might help a person remove scales and relieve itching. People who try this remedy should remember to moisturize the area afterward.
Aloe vera is a plant-sourced gel that can help soothe red skin and reduce scaling in people with psoriasis.
Avoid taking oral aloe supplements, however, as they provide no benefit and may carry health risks.
Oats or colloidal oatmeal
Oats can soothe irritated skin and may help with extremely dry plaques on the scalp.
Stress is a possible trigger for scalp psoriasis flares.
For most people, an environmental factor triggers a flare in the immune system, causing patches of psoriatic plaque to develop.
Triggers vary between people, but common triggers include:
Some people also notice that their psoriasis symptoms get worse after eating certain foods or as a result of allergies. Research has not yet conclusively proven that these factors can trigger psoriasis, however.
It is worth noting that environmental triggers alone do not cause psoriasis. People without a genetic predisposition for psoriasis will not develop it, even when they experience these triggers.
In the following sections, we will cover the different types of shampoo and home remedies that people with scalp psoriasis can try.
What is scalp psoriasis?
Psoriasis is a group of autoimmune conditions that affect the skin. Autoimmune conditions cause the immune system to target the wrong cells or overreact to harmless triggers.
In the case of psoriasis, the autoimmune activity causes skin cells to grow more quickly than usual, creating scales and lesions on the skin. The appearance of the lesions depends on the type of psoriasis.
The only type of psoriasis that affects the scalp, however, is plaque psoriasis.
The most common symptoms of scalp psoriasis include:
- Scales on the scalp: These may be light and fine or thick and crusty. The patches of scales might be small, or they could cover the entire scalp.
- Psoriasis plaques on other areas of the body: Scales may spread from the scalp, extending to the face or neck. They may also develop on distant parts of the body.
- Hair changes: In more severe cases, hair loss, changes in hair texture, or patchy hair can develop.
Scalp psoriasis is not a distinct type of psoriasis. Around half of all people who have psoriasis develop plaques on their scalp.
Although shampoos and home remedies can improve the appearance of scalp psoriasis, they will not cure the underlying condition. The patches will keep returning and may get worse with each flare-up.
Living with psoriasis can affect a person's self-esteem and may give rise to depression or anxiety. For this reason, people with psoriasis may wish to try out some positive coping strategies to boost their well-being.
People who experience symptoms of psoriasis on the scalp should seek medical attention. A range of systemic and topical treatments can slow the progress of the condition.
Where else can plaques develop?
Scalp psoriasis is a form of plaque psoriasis. Plaque psoriasis can occur on any part of the body but most often appears on the elbows, knees, and lower back. Plaques could also develop on the face, especially the hairline, eyebrows, and sides of the nose.
Doctors classify severity and decide on treatments based on how much of the body the plaques cover.Debra Sullivan, PhD, MSN, RN, CNE, COI Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.