Psoriasis is a chronic skin condition that often causes scaly, red rashes or plaques. Coping with psoriasis can be frustrating, especially if you have scalp psoriasis. Some psoriasis rashes are mostly hidden from view under clothing, but scalp psoriasis is more visible and can have a direct impact your appearance.
Symptoms of scalp psoriasis
Scalp psoriasis can actually cause skin problems not just on the scalp, but also in adjacent areas of the body. For instance, the red, scaly rashes may also appear on your forehead. Other times, you might notice the rash on the back of your neck or behind your ears. Just like psoriasis in other areas of your body, scalp psoriasis rashes can itch, bleed and cause a burning sensation. They can also lead to dry skin that flakes off, creating the appearance of dandruff.
In some cases, the rashes can even lead to temporary hair loss in the affected area. The National Psoriasis Foundation notes that this hair loss is often from damage to the hair shaft or follicles as a result of exposure to the psoriasis rashes. Your hair typically grows back as soon as you find the right scalp psoriasis treatment and have the condition under control.
Strategies to treat scalp psoriasis
Scalp psoriasis can be a stubborn and sometimes embarrassing condition, but the news isn’t all bad. For one thing, scalp psoriasis is not contagious, so there’s no risk of passing it to others.
Also, most people can usually manage the condition successfully once they find the treatment plan that works best for them. Here are some treatment strategies for scalp psoriasis that are worth a try:
1. Home remedies and over-the-counter scalp psoriasis treatments
For mild cases of scalp psoriasis, you may be able to manage the condition without medication. The National Psoriasis Foundation recommends soaking your scalp in warm water (like in the shower) before applying lotions, creams or oils. This can soften the rashes and make it easier for your skin to absorb topical remedies. Products containing salicylic acid are especially useful for helping to loosen scales. You can also hold a comb almost flat against your scalp and gently move it in a circular motion to remove the softened plaque.
2. Medicated shampoo
The Mayo Clinic notes that medicated shampoos, such as tar shampoos, are another possible treatment option for managing scalp psoriasis. These can relieve the itching caused by psoriasis and also improve the appearance of the rashes.
Check with your doctor before trying a medicated shampoo. Although many are available over-the-counter, your doctor may be able to suggest the option that would work best for you.
Also, keep in mind that some medicated shampoos for scalp psoriasis are intended for treating the scalp, rather than washing the hair.
3. Steroid injections
If you have mild scalp psoriasis, with only a few small areas with plaques, your doctor may recommend trying steroid injections. These can provide direct relief to the areas with psoriasis and clear up the rash. However, the National Psoriasis Foundation notes that this treatment should be used only sparingly because steroids can have unintended side effects on areas of the body other than your scalp.
4. Prescription topical medication
If you have scalp psoriasis that is moderate to severe, treatment might require more than just shampoos or home remedies. The American Academy of Dermatology notes that you may need prescription medication that you apply directly to your scalp. A number of options are available, including calcipotriene (Calcitrene, Dovonex, Sorilux), calcipotriene-betamethasone (Enstilar, Taclonex Scalp, Dovobet), tazarotene (Tazorac) and anthralin (Dritho-Scalp), among others.
Finding the solution that's right for you might take some trial and error.
5. Other scalp psoriasis therapies
Treatments for psoriasis in general can also help with scalp psoriasis. For example, light treatments, called phototherapy, may help with overall scaling and inflammation and slow down the turnover of skin cells.
If you have moderate to severe psoriasis or psoriatic arthritis, and if other treatments have not helped, newer drugs that alter the immune system (known as biologics) may be an option. However, the side effects of some of these medications can be severe, so these drugs need to be used with caution.
Work closely with a dermatologist to find the right combination of medications for you.
- Scalp Psoriasis, American Academy of Dermatology, 2018, https://www.aad.org/public/diseases/hair-and-scalp-problems/scalp-psoriasis#treatment
- Scalp Psoriasis, National Psoriasis Foundation, 2019, https://www.psoriasis.org/about-psoriasis/specific-locations/scalp
- Slide Show: Type of Psoriasis, Mayo Clinic, 2019, https://www.mayoclinic.org/diseases-conditions/psoriasis/multimedia/psoriasis-pictures/sls-20076486?s=3
- Psoriasis, Mayo Clinic, 2019, https://www.mayoclinic.org/diseases-conditions/psoriasis/diagnosis-treatment/drc-20355845