As an autoimmune skin condition, psoriasis can appear virtually anywhere on your skin, but a flare-up of scalp psoriasis and its symptoms can be a challenge to deal with.
Due to its sensitive location, scalp psoriasis can cause additional discomfort and embarrassment, according to the American Academy of Dermatology. It also notes that nearly 50 percent of those with psoriasis will experience at least one flare-up on the scalp during their lifetimes.
According to the National Psoriasis Foundation, the severity of scalp psoriasis can vary from mild symptoms, such as fine scaling, to more severe, including thick, crusted plaques. Other common symptoms include red bumps, itching, scalp cracking and/or bleeding, a burning sensation and hair loss, which is generally temporary and limited to the affected flare-up area. As a localized skin condition, scalp psoriasis may be limited to areas on the scalp or extend beyond the hairline to the forehead, neck or around the ears.
Like psoriasis that appears elsewhere on the body, according to UCLA Health, scalp psoriasis has the same cause: it is an autoimmune disorder that causes skin cells to grow too quickly, with new skin cells forming in days rather than weeks. Because the body does not shed skin cells that quickly, they pile up on the surface of the skin and cause the physical and visual symptoms.
It’s important to seek medical care in determining whether or not the symptoms are that of scalp psoriasis or other skin conditions that can cause symptoms. For example, babies can develop seborrheic dermatitis, commonly known as cradle cap, which appears as a patchy, red rash that can look greasy or moist. Ringworm can affect anyone of any age as it is a fungal infection, and it’s commonly identified by the appearance of scaly dry patches that typically form a ring on the skin. It is also possible that skin irritation could be an allergic reaction to a variety of things, from environmental factors to hair care products.
Your dermatologist may diagnose scalp psoriasis through a visual inspection, in combination with reviewing your medical history to see if you have already been diagnosed or treated for psoriasis. In some instances, the American Academy of Dermatology notes that it may be necessary for your dermatologist to take a skin sample. This sample will be sent to a lab and the doctor will receive a report confirming whether or not you have scalp psoriasis.
Treating Scalp Psoriasis
Though it is uncomfortable and can be distressing, the good news is that there are a number of treatment approaches that specifically target scalp psoriasis. Some cases can be stubborn to treat, but your dermatologist or doctor will examine your symptoms as well as their severity, and prescribe a treatment approach that is best for you. According to UCLA Health, it may include:
- The use of medicated coal tar shampoo, which has been proven effective in reducing scalp inflammation and cell growth on the scalp
- Scale softeners to treat existing plaque build-up areas. Shampoos and conditioners that are specifically formulated and often contain salicylic-acid for use during scalp psoriasis flare-ups
- Prescription topical medications that are directly applied to the scalp
- Prescription oral medications
- Biologics, which can be injected or introduced into the body through an IV drip
- Light treatments
The National Psoriasis Foundation reports that more severe or stubborn cases of scalp psoriasis may require your dermatologist to use a combination of treatments or cycle certain approaches to find the most effective treatment plan. This can include over-the-counter products as well as medical treatments.
Additionally, it’s important to avoid activities and life situations that can lead to or make a scalp psoriasis flare-up worse. Some people find that their psoriasis will flare up after periods of stress or illness. Vigorously scrubbing or scratching the scalp while shampooing, either at home or during a visit to the hair salon, can also aggravate a flare-up.
Scalp psoriasis is notoriously itchy for many people, and while it is tempting to itch or rub the scalp, this can prolong the outbreak or lead to permanent damage to hair follicles. The National Psoriasis Foundation notes that when this damage occurs, it’s not usually due to the psoriasis flare-up, but rather from the manual itching and scratching or prolonged use of products with certain ingredients.
Finally, it is important to seek medical help, rather than rely on a self-diagnosis of scalp psoriasis. Your dermatologist or doctor can make you aware of the most effective treatments, discuss any potential side effects and monitor your flare-up until your scalp returns to its normal, healthy state.