How to identify and treat scalp psoriasis
The causes of scalp psoriasis are similar to those of psoriasis on other parts of the body, but it can be more challenging to treat.
This article provides an overview of scalp psoriasis, including its symptoms, treatment, and possible complications. It also includes pictures to help people identify the condition.
Symptoms of scalp psoriasis
Scalp psoriasis causes red, itchy, sore skin and silvery scales of dry skin on the scalp. It can extend to a person's forehead, neck, and ears.
The severity of scalp psoriasis usually varies over time. People often experience flare-ups, when their symptoms become worse, and periods of remission.
Some people may confuse this dry, scaly skin with dandruff, which is a different condition. Unlike dandruff, scalp psoriasis causes a general "silvery sheen" in the hair, and people can usually detect silvery scales on the scalp.
Other symptoms of scalp psoriasis include:
- reddish patches on the scalp
- a dry scalp
- hair loss
Scalp psoriasis pictures
Image credit: Dermnet New Zealand
While scalp psoriasis shares many of the same symptoms as psoriasis on other parts of the body, the presence of head hair can make it more challenging to treat.
For example, it is more difficult to apply topical medications directly to the skin on the scalp.
Historically, lotions could make a person's hair feel greasy and unpleasant. However, modern treatment products use different methods of application, as people are more likely to adhere to medications that do not have unpleasant side effects. These products include sprays, gels, and foams.
The best way to manage scalp psoriasis is to apply medication according to the instructions of a healthcare professional.
According to the National Psoriasis Foundation, the initial treatment of scalp psoriasis will typically involve shampoos and other topical treatments.
If a person's psoriasis does not respond to these treatments or they have moderate-to-severe psoriasis elsewhere on their body, the doctor may also prescribe systemic or biologic medications. These drugs target the underlying cause of a person's psoriasis rather than just providing symptom relief.
Many people use coal-tar shampoo to treat scalp psoriasis. However, researchers do not know how effective this is because they have not yet conducted any double-blind studies. One article reported that coal-tar treatments for psoriasis were not significantly more effective than a placebo.
According to research, the most effective treatment options for scalp psoriasis include topical corticosteroids, clobetasol propionate shampoo, and vitamin-D derivatives.
Applying corticosteroids directly to the scalp is the treatment that doctors most commonly prescribe for scalp psoriasis. It is usually highly effective.
The medication is available in many different forms, including creams, ointments, gels, foams, sprays, and shampoos.
Clobetasol propionate shampoo
Shampoo medications are more convenient than other topical medications. However, research has only shown some psoriasis shampoos to be effective.
The active drug in clobetasol propionate is a corticosteroid, which is highly effective in the management of psoriasis symptoms.
Shampoo with a 0.05-percent concentration of clobetasol propionate is an effective treatment for many people. In a small-scale randomized control trial, 85 percent of people with moderate-to-severe plaque psoriasis of the scalp found that they were free or almost free of symptoms after 4 weeks of using a clobetasol propionate spray twice a day. In comparison, only 13 percent of people in the control group had these results.
Clobetasol propionate shampoo may also reduce the likelihood of scalp psoriasis relapsing, and it is suitable to use in combination with some other medications.
Lotions containing vitamin-D derivatives may also be effective as a treatment for scalp psoriasis.
Some people may achieve the best results from using a combination treatment of corticosteroids and vitamin-D medications. It is best to speak with a healthcare professional to determine the best course of treatment.
As with psoriasis on other body parts, a person with scalp psoriasis has a higher risk of other illnesses and complications.
A person with psoriasis may have a higher risk of:
- psoriatic arthritis
- Crohn's disease
- heart disease
- heart attack
- metabolic syndrome, including diabetes and obesity
People who know the risk factors and complications associated with psoriasis can visit a doctor as soon as they notice any warning signs.
While there is no cure for scalp psoriasis, most people can control their symptoms using prescription shampoos or topical medications.
There are many different ways to apply these medications, making it easier than ever before to manage the condition effectively.
If scalp psoriasis does not respond to these treatments, people may wish to try systemic medications or light therapy to minimize the symptoms and their effect on quality of life.