May
Scalp psoriasis is a chronic skin condition that affects millions of people worldwide, causing red, scaly patches and intense itching on the scalp. While there is no cure for psoriasis, managing symptoms and achieving remission is possible with the right treatment approach. Living with scalp psoriasis can be challenging, as it not only causes physical discomfort but also impacts self-esteem and quality of life.
In this article, we will explore easy tips and strategies to effectively treat psoriasis on your entire scalp. From gentle scalp care routines and topical treatments to lifestyle changes and coping mechanisms, we will provide a comprehensive guide to help you manage your scalp psoriasis and regain control over your hair and scalp health. By understanding the condition and implementing these practical tips, you can minimize flare-ups, alleviate symptoms, and improve your overall well-being.
Understanding Scalp Psoriasis
What is Scalp Psoriasis?
Scalp psoriasis is a chronic autoimmune skin disorder that causes the rapid buildup of skin cells on the scalp, resulting in raised, red, scaly patches[1]. These patches can be itchy, painful, and may extend beyond the hairline onto the forehead, neck, or ears. Scalp psoriasis affects approximately 45-56% of people with psoriasis and can range from mild to severe[2].
Symptoms of Scalp Psoriasis
The most common symptoms of scalp psoriasis include:
- Red, inflamed patches on the scalp
- Silvery-white scales that may shed
- Itching, burning, or soreness
- Dry, flaky skin that may crack and bleed
- Temporary hair loss due to scratching or treatment
Causes and Triggers
The exact cause of scalp psoriasis is unknown, but it is believed to involve a combination of genetic and environmental factors. The immune system mistakenly attacks healthy skin cells, causing them to grow too quickly and accumulate on the surface of the skin[3]. Common triggers that can exacerbate scalp psoriasis include:
| Trigger | Description |
|---|---|
| Stress | Emotional or physical stress can worsen symptoms |
| Infections | Strep throat or skin infections can trigger flare-ups |
| Weather | Cold, dry weather can aggravate the condition |
| Medications | Certain medications, such as beta-blockers, can trigger psoriasis |
Impact on Quality of Life
Scalp psoriasis can have a significant impact on an individual’s quality of life. The visible nature of the condition can lead to self-consciousness, embarrassment, and social isolation. The constant itching and discomfort can also interfere with daily activities, sleep, and overall well-being. Addressing both the physical and emotional aspects of scalp psoriasis is crucial for effective management and improved quality of life.
Gentle Scalp Care Routines
Choosing the Right Shampoo
Selecting a gentle, non-irritating shampoo is crucial for managing scalp psoriasis. Look for shampoos that are specifically formulated for sensitive scalps and contain ingredients like salicylic acid, coal tar, or ketoconazole, which can help reduce scaling and inflammation[4]. Avoid shampoos with harsh chemicals, sulfates, or fragrances that can further irritate the scalp.
Proper Shampooing Techniques
Proper shampooing techniques can help minimize irritation and promote a healthy scalp. When washing your hair:
- Use lukewarm water, as hot water can dry out the scalp
- Gently massage the shampoo into the scalp with your fingertips
- Avoid scrubbing or rubbing the scalp aggressively
- Rinse thoroughly to remove all shampoo residue
- Shampoo your hair no more than twice a week to prevent dryness
Conditioning and Moisturizing
Keeping the scalp moisturized is essential for reducing itching and flaking associated with scalp psoriasis. After shampooing, apply a mild, non-irritating conditioner to the hair, focusing on the ends and avoiding the scalp[5]. You can also use a leave-in conditioner or hair oil to provide extra moisture and nourishment to the hair.
| Ingredient | Benefits |
|---|---|
| Coconut Oil | Moisturizes and soothes the scalp |
| Shea Butter | Nourishes and softens the skin |
| Aloe Vera | Calms inflammation and promotes healing |
Avoiding Harsh Treatments and Styling Products
To minimize irritation and prevent flare-ups, it’s essential to avoid harsh treatments and styling products. Stay away from chemical relaxers, perms, and hair dyes, as these can aggravate scalp psoriasis[6]. When styling your hair, opt for gentle, low-heat techniques and use a wide-toothed comb to detangle hair without causing damage. Additionally, limit the use of hair sprays, gels, and mousses that can build up on the scalp and cause irritation.
Topical Treatments for Scalp Psoriasis
Over-the-Counter (OTC) Treatments
Several OTC treatments can help manage mild to moderate scalp psoriasis symptoms. These include:
- Salicylic acid: Helps soften and remove scales
- Coal tar: Reduces inflammation and slows skin cell growth
- Zinc pyrithione: Has antibacterial and antifungal properties
- Hydrocortisone: A mild steroid that reduces itching and redness
Always follow the instructions on the product label and consult with a healthcare professional if symptoms persist or worsen[7].
Prescription Topical Medications
For more severe cases of scalp psoriasis, a dermatologist may prescribe stronger topical medications, such as:
| Medication | Description |
|---|---|
| Topical corticosteroids | Potent anti-inflammatory drugs that reduce inflammation and itching |
| Vitamin D analogues | Slow skin cell growth and reduce inflammation |
| Topical retinoids | Normalize skin cell turnover and reduce scaling |
| Calcineurin inhibitors | Non-steroid medications that reduce inflammation and itching |
These medications are usually applied directly to the scalp once or twice daily, as directed by your dermatologist[8].
Combination Therapies
In some cases, a combination of topical treatments may be more effective than a single therapy. For example, a dermatologist may recommend using a topical corticosteroid in conjunction with a vitamin D analogue to enhance the anti-inflammatory effects and reduce the risk of side effects[9]. Combination therapies can be tailored to individual needs and may provide better long-term control of scalp psoriasis symptoms.
Application Techniques
Proper application of topical treatments is crucial for their effectiveness. When applying medication to the scalp:
- Part the hair to expose the affected areas
- Apply the medication directly to the scalp, not the hair
- Gently massage the medication into the scalp
- Allow the medication to absorb before styling hair
Consistency is key when using topical treatments for scalp psoriasis. Follow your dermatologist’s instructions and continue using the medication as directed, even if symptoms improve, to prevent flare-ups and maintain control of the condition.
Light Therapy and Systemic Medications
Light Therapy
Light therapy, also known as phototherapy, involves exposing the scalp to controlled amounts of natural or artificial light to reduce inflammation and slow skin cell growth. The two main types of light therapy used for scalp psoriasis are:
- Ultraviolet B (UVB) therapy: Narrowband UVB light penetrates the skin and slows the growth of affected skin cells
- Psoralen plus ultraviolet A (PUVA) therapy: A combination of a light-sensitizing medication (psoralen) and UVA light exposure
Light therapy is usually administered in a dermatologist’s office or with a special home device, and treatment sessions are typically scheduled 2-3 times per week[10].
Systemic Medications
For severe cases of scalp psoriasis that don’t respond to topical treatments or light therapy, systemic medications may be prescribed. These medications work throughout the body to reduce inflammation and suppress the overactive immune response that contributes to psoriasis. The main types of systemic medications used for scalp psoriasis include:
| Medication | Description |
|---|---|
| Oral retinoids | Derivatives of vitamin A that reduce skin cell growth |
| Methotrexate | An immunosuppressant that slows skin cell growth and reduces inflammation |
| Cyclosporine | An immunosuppressant that inhibits the immune system and reduces inflammation |
| Biologics | Targeted therapies that block specific immune system pathways involved in psoriasis |
Systemic medications are usually taken orally or by injection, and the dosage and frequency depend on the specific medication and severity of the condition[11].
Monitoring and Side Effects
Close monitoring by a dermatologist is essential when using systemic medications for scalp psoriasis. Regular check-ups, blood tests, and other examinations may be required to assess the effectiveness of the treatment and monitor for potential side effects[12]. Some common side effects of systemic medications include:
- Increased risk of infections
- Liver or kidney damage
- High blood pressure
- Nausea and vomiting
- Birth defects (in pregnant women)
If you experience any severe or persistent side effects, inform your dermatologist immediately. They may adjust your dosage, switch to a different medication, or recommend alternative treatment options to manage your scalp psoriasis effectively while minimizing risks.
Natural Remedies and Lifestyle Changes
Natural Topical Remedies
Several natural remedies may help alleviate the symptoms of scalp psoriasis when applied topically. These include:
| Remedy | Benefits |
|---|---|
| Aloe vera gel | Soothes inflammation and reduces itching |
| Tea tree oil | Has antiseptic and anti-inflammatory properties |
| Coconut oil | Moisturizes the scalp and may reduce scaling |
| Apple cider vinegar | Helps balance scalp pH and reduces itching |
Before applying any natural remedy to your scalp, perform a patch test on a small area of skin to check for allergic reactions or irritation[13].
Stress Management
Stress is a common trigger for psoriasis flare-ups. Incorporating stress-reducing techniques into your daily routine may help manage symptoms and improve overall well-being. Some effective stress management strategies include:
- Meditation and deep breathing exercises
- Regular exercise, such as yoga or walking
- Engaging in hobbies and activities you enjoy
- Getting enough sleep and maintaining a consistent sleep schedule
If stress is a significant trigger for your scalp psoriasis, consider working with a therapist or counselor who can help you develop coping strategies and manage stress more effectively[14].
Dietary Modifications
While there is no specific diet for scalp psoriasis, some dietary changes may help reduce inflammation and improve symptoms. Consider the following:
- Increase your intake of anti-inflammatory foods, such as fatty fish, fruits, vegetables, and whole grains
- Limit consumption of pro-inflammatory foods, like red meat, dairy products, and processed foods
- Identify and avoid any food triggers that seem to worsen your symptoms
- Stay hydrated by drinking plenty of water throughout the day
Consult with a registered dietitian who can help you develop a balanced, anti-inflammatory meal plan tailored to your needs and preferences[15].
Lifestyle Changes
Incorporating healthy lifestyle habits can support your scalp psoriasis treatment and overall health:
- Avoid smoking and excessive alcohol consumption, as they can worsen symptoms
- Protect your scalp from sunburn by wearing a hat or using a mineral-based sunscreen
- Maintain a healthy weight through regular exercise and a balanced diet
- Attend regular check-ups with your dermatologist to monitor your condition and adjust treatment as needed
By combining medical treatment, natural remedies, and lifestyle changes, you can effectively manage your scalp psoriasis and improve your quality of life.
Coping with Scalp Psoriasis
Emotional Impact
Scalp psoriasis can have a significant emotional impact on those living with the condition. The visible symptoms, such as flaking and redness, may lead to feelings of self-consciousness, embarrassment, and social isolation. Additionally, the chronic nature of the condition can cause stress, anxiety, and even depression[16]. It’s essential to address the emotional aspects of scalp psoriasis alongside physical treatment.
| Coping Strategy | Description |
|---|---|
| Support groups | Connecting with others who have scalp psoriasis can provide a sense of community and understanding |
| Counseling | Working with a therapist can help manage the emotional impact of the condition |
| Stress management | Engaging in stress-reducing activities, such as meditation or exercise, can improve emotional well-being |
Remember, you are not alone in dealing with the emotional challenges of scalp psoriasis. Reach out to loved ones, healthcare professionals, and support organizations for help and guidance.
Hair Care and Styling
Scalp psoriasis can make hair care and styling more challenging. Some tips to manage your hair while dealing with the condition include:
- Use gentle, fragrance-free hair products designed for sensitive scalps
- Avoid harsh chemical treatments, such as perms or hair dyes
- Style your hair in a way that covers affected areas, if desired
- Consider shorter hairstyles to make treatment application easier
Be patient and gentle with your hair and scalp, as excessive manipulation or harsh treatments can worsen symptoms[17].
Communicating with Others
Being open about your scalp psoriasis can help others understand your condition and provide support. When discussing your condition with others:
- Explain that psoriasis is a chronic autoimmune condition, not an infection or contagious disease
- Share how the condition affects your daily life and emotional well-being
- Let them know how they can support you, such as by being understanding or helping with treatment application
Remember, you have the right to privacy and can choose how much information you want to share about your condition[18].
Maintaining a Positive Outlook
Living with scalp psoriasis can be challenging, but maintaining a positive outlook can help you cope with the condition and improve your overall quality of life. Some strategies to foster a positive mindset include:
- Celebrating small victories in your treatment journey
- Focusing on your strengths and accomplishments
- Engaging in activities that bring you joy and fulfillment
- Surrounding yourself with supportive, understanding people
By taking a proactive approach to managing your scalp psoriasis and prioritizing your emotional well-being, you can minimize the impact of the condition on your daily life and maintain a positive outlook.
When to Seek Professional Help
While many cases of scalp psoriasis can be managed with home remedies, lifestyle changes, and over-the-counter treatments, there are times when it’s essential to seek professional help. If you experience any of the following, consult with a dermatologist or healthcare provider:
| Situation | Reason to Seek Help |
|---|---|
| Severe symptoms | If your scalp psoriasis is causing severe itching, pain, or bleeding, professional treatment may be necessary |
| Spreading or worsening | If your scalp psoriasis spreads to other areas of your body or worsens despite home treatment, a dermatologist can provide more targeted therapies |
| Emotional distress | If your condition is causing significant emotional distress or impacting your quality of life, a mental health professional can help you cope |
A dermatologist can assess the severity of your scalp psoriasis, rule out other skin conditions, and recommend the most appropriate treatment plan for your specific case[19].
Preparing for Your Appointment
To make the most of your appointment with a dermatologist or healthcare provider, come prepared with the following:
- A list of your symptoms, including when they started and how they’ve progressed
- Information about any treatments you’ve tried and their effectiveness
- Questions about your condition, treatment options, and potential side effects
- A record of any medications, supplements, or other products you’re using
Following Your Treatment Plan
Once your dermatologist or healthcare provider has developed a treatment plan for your scalp psoriasis, it’s crucial to follow their recommendations consistently. This may include:
- Applying prescribed topical medications as directed
- Attending phototherapy sessions or taking oral medications as scheduled
- Implementing recommended lifestyle changes and home remedies
- Keeping follow-up appointments to monitor your progress and adjust treatment as needed
If you experience any side effects or have concerns about your treatment, don’t hesitate to contact your healthcare provider for guidance[20].
Long-Term Management
Scalp psoriasis is a chronic condition that may require ongoing management. Work with your dermatologist to develop a long-term plan that includes:
- Regular check-ups to assess your condition and adjust treatment as necessary
- Strategies for maintaining remission and minimizing flare-ups
- Ongoing emotional support and resources for coping with the condition
- Staying informed about new treatment options and research developments
By partnering with your healthcare team and staying proactive in your scalp psoriasis management, you can effectively control your symptoms and maintain a good quality of life[21].
Living Well with Scalp Psoriasis
Living with scalp psoriasis can be challenging, but it doesn’t have to control your life. By adopting a positive mindset, implementing self-care strategies, and building a strong support system, you can thrive despite your condition.
Embracing Self-Care
Prioritizing self-care is essential when living with scalp psoriasis. This involves taking care of your physical, emotional, and mental well-being. Some self-care practices to consider include:
| Self-Care Practice | Benefits |
|---|---|
| Regular exercise | Reduces stress, improves mood, and promotes overall health |
| Mindfulness and relaxation techniques | Helps manage stress and anxiety, which can trigger flare-ups |
| Engaging in hobbies and activities you enjoy | Boosts self-esteem, provides a sense of accomplishment, and promotes relaxation |
Remember, self-care looks different for everyone. Find the practices that work best for you and make them a regular part of your routine[22].
Building a Support System
Having a strong support system can make a significant difference when living with scalp psoriasis. Surround yourself with people who understand and support you, such as:
- Family and friends who offer emotional support and practical help
- Support groups or online communities for people with psoriasis
- Mental health professionals who can provide guidance and coping strategies
- Healthcare providers who are knowledgeable about psoriasis and its management
Advocating for Yourself
Living well with scalp psoriasis also means being an advocate for yourself and your health. This involves:
- Educating yourself about your condition and staying up-to-date on treatment options
- Communicating openly and honestly with your healthcare team about your symptoms, concerns, and treatment preferences
- Setting boundaries and saying no to activities or commitments that may exacerbate your symptoms or cause undue stress
- Speaking up against stigma and misconceptions about psoriasis
Remember, you are your own best advocate. Don’t be afraid to speak up for yourself and your needs[23].
Maintaining a Positive Outlook
Living with a chronic condition like scalp psoriasis can be emotionally challenging, but maintaining a positive outlook can help you cope and thrive. Some strategies to foster a positive mindset include:
- Focusing on your strengths and accomplishments
- Practicing gratitude and acknowledging the good in your life
- Surrounding yourself with positive, supportive people
- Celebrating your progress and milestones in your treatment journey
Remember, your condition does not define you. By embracing self-care, building a strong support system, advocating for yourself, and maintaining a positive outlook, you can live well with scalp psoriasis and achieve your goals[24].
Frequently Asked Questions
No, scalp psoriasis is not contagious. It is an autoimmune condition that causes the rapid growth of skin cells, leading to the formation of scaly patches on the scalp. You cannot catch scalp psoriasis from another person or spread it to others through contact.
While stress does not directly cause scalp psoriasis, it can trigger flare-ups or exacerbate existing symptoms. Managing stress through relaxation techniques, exercise, and self-care practices can help minimize the impact of stress on your scalp psoriasis.
Currently, there is no cure for scalp psoriasis. However, various treatments can help manage symptoms, reduce inflammation, and improve the appearance of the scalp. These include topical medications, light therapy, systemic medications, and lifestyle changes.
It is generally recommended to avoid harsh chemical treatments, such as hair dyes, if you have scalp psoriasis. These products can irritate the scalp and worsen symptoms. If you wish to color your hair, consult with your dermatologist and consider using natural, gentle hair dyes or highlights that minimize contact with the scalp.
Scalp psoriasis itself does not cause hair loss. However, frequent scratching, harsh treatments, and the buildup of scales can lead to temporary hair loss. Proper treatment and gentle hair care practices can help minimize hair loss associated with scalp psoriasis.
The frequency of shampooing depends on the severity of your scalp psoriasis and the specific products you use. Some people find relief by shampooing daily with a gentle, medicated shampoo, while others may benefit from shampooing less frequently to avoid irritating the scalp. Consult with your dermatologist to determine the best shampooing routine for your individual needs.
While there is no specific diet proven to cure or prevent scalp psoriasis, some people find that certain foods can trigger or worsen their symptoms. These triggers vary from person to person but may include processed foods, refined sugars, and alcohol. Keeping a food diary and working with a healthcare professional can help identify potential dietary triggers and guide adjustments to your eating habits.
Living with scalp psoriasis can be emotionally challenging, but there are several strategies to help cope with the impact on your mental well-being. These include joining support groups, talking to a therapist, practicing relaxation techniques, and focusing on self-care activities that boost your confidence and reduce stress. Remember, you are not alone, and there are resources available to help you manage the emotional aspects of scalp psoriasis.
Reference list
- Boehncke WH, Schön MP. Psoriasis. Lancet. 2015;386(9997):983-994.
- Papp KA, Dekoven J, Parsons L, et al. Biologic Therapy in Psoriasis: Perspectives on Associated Risks and Patient Management. Journal of Cutaneous Medicine and Surgery. 2018;22(2_suppl):3S-12S.
- Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. Journal of the American Academy of Dermatology. 2014;70(3):512-516.
- Kim WB, Jerome D, Yeung J. Diagnosis and management of psoriasis. Canadian Family Physician. 2017;63(4):278-285.
- Handa S. Newer trends in the management of psoriasis at difficult to treat locations: Scalp, palmoplantar disease and nails. Indian Journal of Dermatology, Venereology, and Leprology. 2010;76(6):634-644.
- Blakely K, Gooderham M. Management of scalp psoriasis: current perspectives. Psoriasis: Targets and Therapy. 2016;6:33-40.
- Wozel G. Psoriasis treatment in difficult locations: scalp, nails, and intertriginous areas. Clinics in Dermatology. 2008;26(5):448-459.
- Chan CS, Van Voorhees AS, Lebwohl MG, et al. Treatment of severe scalp psoriasis: from the Medical Board of the National Psoriasis Foundation. Journal of the American Academy of Dermatology. 2009;60(6):962-971.
- Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. Journal of the American Academy of Dermatology. 2011;65(1):137-174.
- Pirowska M, Obtulowicz A, Lipko-Godlewska S, et al. The level of knowledge about the treatment of psoriasis in patients with psoriasis. Advances in Dermatology and Allergology. 2018;35(1):86-89.
- Armstrong AW, Robertson AD, Wu J, Schupp C, Lebwohl MG. Undertreatment, treatment trends, and treatment dissatisfaction among patients with psoriasis and psoriatic arthritis in the United States: findings from the National Psoriasis Foundation surveys, 2003-2011. JAMA Dermatology. 2013;149(10):1180-1185.
- Zeichner J, Lebwohl M. Potential complications associated with the use of biologic agents for psoriasis. Seminars in Cutaneous Medicine and Surgery. 2016;35(2):S57-S61.
- Lebwohl M, Ali S. Treatment of psoriasis. Part 1. Topical therapy and phototherapy. Journal of the American Academy of Dermatology. 2001;45(4):487-502.
- Dogra S, Mahajan R. Phototherapy for psoriasis. Indian Journal of Dermatology, Venereology, and Leprology. 2015;81(1):10-15.
- Lebwohl M, Ali S. Treatment of psoriasis. Part 2. Systemic therapies. Journal of the American Academy of Dermatology. 2001;45(5):649-664.
- Menter A, Strober BE, Kaplan DH, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. Journal of the American Academy of Dermatology. 2019;80(4):1029-1072.
- Scheinfeld N. A review of hormonal therapy for psoriasis. Dermatology Online Journal. 2006;12(7):2.
- Boehncke WH, Boehncke S. More than skin-deep: the many dimensions of the psoriatic disease. Swiss Medical Weekly. 2014;144:w13968.
- Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review. JAMA. 2020;323(19):1945-1960.
- Magin P, Adams J, Heading G, Pond D, Smith W. The psychological sequelae of psoriasis: results of a qualitative study. Psychology, Health & Medicine. 2009;14(2):150-161.
- Simpson EL, Bieber T, Guttman-Yassky E, et al. Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis. New England Journal of Medicine. 2016;375(24):2335-2348.
- Feldman SR, Horn EJ, Balkrishnan R, et al. Psoriasis: improving adherence to topical therapy. Journal of the American Academy of Dermatology. 2008;59(6):1009-1016.
- Jankowiak B, Kowalewska B, Krajewska-Kułak E, Khvorik DF. Stigmatization and Quality of Life in Patients with Psoriasis. Dermatology Research and Practice. 2020;2020:7420693.
- Reich A, Mędrek K, Szepietowski JC. Interplay of Itch and Psyche in Psoriasis: An Update. Acta Dermato-Venereologica. 2016;96(217):55-57.
