Scalp psoriasis is a chronic skin condition that causes the rapid buildup of skin cells on the scalp, leading to thick, scaly patches. These patches may appear red, inflamed, and can sometimes cause itching, soreness, or even hair loss in severe cases. It's a form of psoriasis, a condition that can affect other parts of the body as well.
Common symptoms include:
- Red, inflamed patches: These can be covered with silvery-white scales.
- Itching or soreness: The patches may itch or become painful.
- Dryness and flaking: Like dandruff, but often thicker and more persistent.
- Hair thinning or loss: Scalp psoriasis can sometimes lead to temporary hair loss, particularly if the scalp becomes inflamed or irritated.
Treatment options:
- Topical treatments:
- Shampoos with coal tar or salicylic acid can help reduce scaling.
- Corticosteroids: Topical steroids may reduce inflammation and itching.
- Vitamin D analogs (e.g., calcipotriene) help slow skin cell turnover.
- Light therapy (UV therapy): Targeted ultraviolet light can reduce symptoms for some people.
- Systemic treatments: In severe cases, oral medications or biologics (immune system-suppressing drugs) may be prescribed.
- Lifestyle changes: Avoiding triggers such as stress, smoking, and alcohol can also help manage flare-ups. Gentle hair care and avoiding excessive scratching can minimize irritation.
Treatment
Treating scalp psoriasis effectively typically involves a combination of topical treatments, lifestyle adjustments, and sometimes systemic therapies. The best approach depends on the severity of the condition. Here are some of the most effective treatments:
1. Topical Treatments:
- Coal Tar Shampoos: These are often recommended to help reduce scaling and inflammation. Coal tar can slow skin cell turnover and reduce itching. Shampoos containing coal tar, like Neutrogena T/Gel, are common.
- Salicylic Acid: Found in many medicated shampoos and scalp treatments, salicylic acid softens and removes scales, making it easier to treat underlying psoriasis. It may be used in conjunction with other treatments.
- Topical Steroids: Corticosteroid creams or lotions are often prescribed to reduce inflammation and itching. These are especially effective for flare-ups but should be used cautiously to avoid side effects from prolonged use.
- Vitamin D Analogues (e.g., Calcipotriene): These help regulate skin cell production and reduce scaling. It’s often used when topical steroids are not enough.
- Topical Retinoids: These can help decrease the rapid turnover of skin cells and reduce scaling. They may cause some irritation, so it's important to start slowly.
2. Light Therapy (Phototherapy):
- UVB Light Therapy: This involves exposing the affected skin to ultraviolet light under controlled conditions. It helps slow down the overproduction of skin cells. Phototherapy can be effective for people with more extensive psoriasis or who don't respond to topical treatments.
3. Systemic Treatments (for severe cases):
- Oral Medications: If topical treatments don’t work, or the psoriasis is extensive, oral medications like methotrexate, acitretin, or cyclosporine may be used to suppress the immune system.
- Biologic Drugs: Biologics like adalimumab (Humira), etanercept (Enbrel), or ustekinumab (Stelera) target specific parts of the immune system that cause psoriasis. These are typically reserved for moderate-to-severe cases and are administered via injections.
4. Scalp Care Tips:
- Use gentle shampoos: Avoid harsh shampoos or hair products that can irritate the scalp. Opt for mild, fragrance-free shampoos.
- Avoid scratching: Scratching can worsen inflammation and may lead to hair loss. Use treatments that reduce itching to prevent this.
- Moisturize: Keeping your scalp moisturized can help reduce dryness and scaling. Use oils like coconut oil, tea tree oil, or specialized scalp moisturizers to soothe the skin.
- Gentle washing: Wash your hair with lukewarm water instead of hot water to avoid irritation, and be gentle when towel-drying to prevent aggravating the scalp.
5. Lifestyle Adjustments:
- Reduce stress: Stress is a major trigger for psoriasis flare-ups, so practicing stress management techniques like meditation, yoga, or deep breathing may help.
- Dietary changes: Some people find that certain foods can exacerbate their psoriasis. Anti-inflammatory diets rich in omega-3 fatty acids (found in fish, flaxseed, and walnuts) and antioxidants (from fruits and vegetables) may help, although more research is needed.
- Avoid triggers: Common psoriasis triggers include smoking, excessive alcohol, infections, and certain medications. Identifying and avoiding your specific triggers can prevent flare-ups.
- Regular exercise: Staying active can help reduce stress, improve circulation, and promote overall skin health.
6. Natural Remedies (as complementary treatments):
- Aloe Vera Gel: Can help soothe the skin and reduce redness.
- Apple Cider Vinegar: Diluted apple cider vinegar (ACV) may help relieve itching and flaking. Be cautious, though, as it may irritate broken skin.
- Oatmeal Baths: Soaking in an oatmeal bath can relieve itching and inflammation.
When to See a Doctor:
If over-the-counter treatments are not working or the psoriasis is affecting a large area of your scalp, it’s important to consult a dermatologist or Dr Young to check the best treatment options.
Scalp psoriasis can be managed effectively with the right treatment plan, and working with a healthcare provider to tailor your treatment is key to long-term relief.