While it mainly affects the skin, psoriasis is a serious disorder that can have serious effects on your overall health and well-being, on top of your general self-esteem. This is made worse by how unpredictable psoriasis can be, and the way it can show up just about anywhere. Even though it’s not clear what causes scalp psoriasis, it is particularly common, affecting about 50 percent of all people with psoriasis. Let’s take a closer look at scalp psoriasis and the signs and symptoms you should keep an eye out for.
What is Psoriasis?
Psoriasis is an autoimmune disorder that primarily affects the skin cells, causing their natural lifecycle to speed up. The result is scaly patches with a silvery sheen. These patches are often dry, inflamed and sometimes itchy and painful. For some, psoriasis may also be accompanied by pitted or ridged nails or a form of arthritis known as psoriatic arthritis, which causes joints to become stiff, swollen, and achy.
Scalp Psoriasis Symptoms and Signs
Psoriasis can appear anywhere on your skin, but it is most prone to show up on your elbows, knees, and your scalp. About half of all people with psoriasis will experience at least one flare-up in the scalp area.
Symptoms of scalp psoriasis can vary in severity. More mild forms are noted by slight scaling, while more severe forms are characterized by thicker, more crusted plaques that cover the entire scalp, potentially extending to the forehead, the back of the neck, and around the ears. Other common symptoms of scalp psoriasis include:
- Red patches on the scalp
- Flaking that appears like dandruff (scalp psoriasis has more of a silvery sheen than regular dandruff)
- A generally dry scalp that may crack and bleed
- Itching that may be mild or so intense that it can interfere with everyday activities or sleep
- Bleeding from excessive scratching
- Soreness or burning sensation
Although scalp psoriasis cannot actually cause hair loss, scratching or attempting to remove the scales can result in temporary hair loss. Hair should grow back once the psoriasis has cleared and your scalp has healed.
As with all forms of psoriasis, these symptoms come and go in cycles of flare-ups lasting weeks or months and then subsiding or even going into remission. What scalp psoriasis looks like also varies from person to person.
Treatments for Scalp Psoriasis
There is currently no cure for any form of psoriasis. Thankfully, there are treatments for scalp psoriasis that aim to control the dryness, itchiness, and inflammation in the scalp. These treatments are often rotated as psoriasis can actually grow accustomed to medications and become less responsive. The treatment methods are determined by the severity of the symptoms.
For mild scalp psoriasis, most doctors will simply recommend topical treatments containing coal tar or salicylic acid. Both work by helping to shed dead skin cells. These are often available as medicated shampoos, but keep in mind that these shampoos are for treating the scalp, not your hair. Other treatments may involve antifungal medications such as prescription Ketoconazole shampoo or OTC products containing zinc pyrithione or selenium. For some cases of scalp psoriasis, your doctor may also inject steroid medications.
Severe forms of scalp psoriasis may involve a combination of topical treatments on top of more intensive treatments. Systemic treatments, which refer to prescription drugs taken orally, are often only prescribed for moderate to severe cases, though these may only be administered for short periods of time as they often come with side effects. Your doctor may also prescribe antimicrobial drugs if you are experiencing crusting in your scalp or enlarged lymph nodes in your neck, which often points to a yeast infection.
For severe scalp psoriasis, your doctor may also prescribe ultraviolet light treatments. However, hair naturally blocks UV rays, which can make it hard for UV treatments to reach your scalp. If you don’t naturally have thin hair, you may need to part your hair into rows or shave your head to allow for optimal exposure to the UV light.
The good news is that there are so many treatments for scalp psoriasis, which means finding a treatment that works the best for your needs is only a matter of time. Consult your doctor if you believe you have scalp psoriasis to get a thorough diagnosis and begin looking into treatment options.