What If Those Psoriasis Treatments Dont Work
If psoriasis doesnt improve, your healthcare provider may recommend these treatments:
- Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
- PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
- Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
- Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
- Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
- Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.
Signs And Symptoms Of Scalp Psoriasis
The most common complaint is a dry, flaky, red scalp with occasional itchiness. Many people find that it worsens with stress and after some infections. Other common symptoms include:
- Reddish patches on the scalp, sometimes thick and inflamed
- Dandruff-like flaking and silvery-white scale that looks like dandruff
- Dry scalp that may crack and bleed
- Mild to intense itching
- Temporary hair loss
Cut The Itch With Apple Cider Vinegar
Some people say to use this on your scalp a few times a week. Itâs long been used as a disinfectant, so it may burn a bit when you put it on. You can mix it with equal parts water to cut the sting. Some people like to use it full-strength and then rinse once it dries. But donât try this one if you have cracks or open skin. Itâll really hurt! It may take a few weeks to notice a difference in itchiness. In general, check with your doctor before you try natural remedies.
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Things To Avoid If You Have Scalp Psoriasis
Scalp psoriasis can be very uncomfortable, but find the right treatment and avoid these 6 pitfalls, and you can keep your scalp inthe best condition possible.
1. Dry skinKeep your scalp hydrated by using a moisturizing shampoo every time you wash your hair.
2. Itching and scratchingNever pick at scales or sore patches of skin Ââ this will make the condition worse!
3. Dry, cold weatherThe weather can have a big effect on psoriasis. Cold, dry weather can make the symptoms appear worse, so make sure to wrap up warm in winter and consider getting a humidifier to take the edge off the dry air.
4. Certain medicationTell your doctor about any medication you take and ask whether it might affect your psoriasis.
5. StressStress is often linked with flare-ups, so try to reduce stress and anxiety. Meditation and yoga are a good place to start.
6. AlcoholItâs thought that excessive alcohol consumption may worsen psoriasis symptoms, so drink in moderation. If youâre taking psoriasis medication, check whether itâs okay to drink alcohol while taking them.
How should you treat scalp psoriasis?Scalp psoriasis is a somewhat rare skin disorder, affecting about 3% of the population. If you havenât yet been diagnosed with the condition, itâs worthwhile to check to see if your symptoms are the result of a more common scalp flaking disorder like seborrheic dermatitis.
Try using Clinical Strength Shampoo for seborrheic dermatitis.
Shampoo For A Dry And Flaky Scalp
Several kinds, both over the counter and prescription, can help. Try selenium sulfide , zinc pyrithione, ketoconazole , or tar-basedones for thin plaques.
For thicker scales, salicylic acid shampoos can work well. Not all of these work for every person. You may have to try one for a few weeks and switch to another if it doesnât work.
Use the medicated shampoo first when youâd normally lather up. Itâs OK to use your regular shampoo and conditioner afterward. Know that tar-based options can be a bit smelly.
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What Are The Most Common Scalp Psoriasis Symptoms
Youre probably wondering, What does scalp psoriasis looks like? Generally, you might notice flaking or scaly patches of raised skin on your scalp first, Dr. Bhutani says. These patches can also be inflamed, thick, and swollen6, and sometimes extend to the forehead, the back of the neck, or behind the ears. On light skin tones, psoriasis plaques on the scalp typically appear pink or red with silvery scales. For people with dark skin, these lesions may range in color and appear salmon-y pink, silvery white, violet, or brown, depending on your specific skin tone7.
But the signs of scalp psoriasis go far beyond the physical effects. Scalp psoriasis, honestly, causes some of the largest impact on quality of life, Dr. Bhutani says. Thats because severe symptoms can interrupt sleep, create feelings of anxiety, and hurt a persons self-esteem, especially if the scalp psoriasis plaques are clearly visible.
In addition to plaques, other scalp psoriasis symptoms include6:
- An extremely itchy scalp that can be distracting
- A burning sensation or soreness on your scalp
- Cracked and/or bleeding skin from scratching too much or from having a dry scalp
- Temporary hair loss if you excessively touch your scalp or attempt to pick off your scales, which can forcibly remove hair follicles
Let Your Colorist Know About Your Scalp Psoriasis
If you are going to have your hair colored by a professional, its a good idea to let them know about your scalp psoriasis, even if it isnt active or flaring at the time.
If you feel uncomfortable or embarrassed, keep in mind that experienced hair colorists have likely seen it all, including scalp psoriasis. You may also want to mention any issues youve experienced in the past, such as allergies, rashes, or sensitivity to hair coloring products.
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Coconut Or Avocado Oil
Coconuts and avocadoes are filled with healthy fats that boost skin health. Massage a few drops of either type of oil, cool or lightly heated, onto your scalp and put on a shower cap. Wait 20 minutes, remove the cap, then wash your hair as usual. This can reduce and remove some of the scaling associated with the condition.
Shop for avocado and coconut oil.
Symptom: Red And White Patches
The most common form of the disease is plaque psoriasis. It looks like areas of thick, swollen, red patches with well-defined edges. On top of these areas are the silvery-white scales. It’s easy to knock them off and cause bleeding, so be gentle with yourself when you comb your hair, shampoo, or put on and take off hats.
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I First Started Getting Psoriasis Around The Age Of 26
It was when I worked at a steakhouse as a cook. I was eating a lot of beef and white bread because it was free. Somebody would mess up a steak or burger at least twice a day, and boom, I had a free meal. I ate beef and white bread almost everyday for two years. Not a good choice.
Red spots starts showing up around my eyelashes and above my lip. Then they started flaking and getting gross, then it started in my hair, little crusty bumps. I didnt know what to do, I didnt have health care, so I couldnt go to the doctor. And it wasnt that bad.
During the next summer I played a lot of basketball outside with no shirt on and it went away. Getting a tan apparently makes psoriasis disappear. But I was also thinking, oh it goes away in the summer, who cares.
I went back to college and started drinking black coffee twice a morning and feeling stressed out. I think the black coffee and stress made the psoriasis return. During that winter it got really bad. The red dots became huge and dry, it felt like my skin was made of rocks. I kept putting lotions on it recommended by some of my female friends, all of which contained alcohol and fragrance, which actually made it worse. When I would reach up to grab things, the dots would crack and bleed.
I was really scared to eat differently like actually scared. How could I ever live without disgusting food and Pepsi on a daily basis?
Treatment: Where To Start
The most common treatments for mild cases are medications that you put directly on your scalp. If you have a more severe case or have psoriasis elsewhere on your body, you may need a medication that treats your whole body. You can take these medications by mouth or injection.
If your psoriasis doesn’t respond well after repeated use of one medication, your doctor may replace or combine it with another type of treatment.
One of the first steps is to soften and remove scales. This makes it easier for medications to do their job.
- Apply over-the-counter products to your scalp to help soften scales and make them easier to peel off. Look for products with the active ingredients salicylic acid, lactic acid, urea, zinc pyrithione, or selenium sulfide.
- Gently loosen the scales with a brush or fine-toothed comb.
- Shampoo your scalp to remove the scales, using a salicylic acid shampoo or soap.
- Apply thick creams to your scalp while it’s still damp to hold in the moisture.
To apply medication:
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What You Can Do
Salicylic shampoos and other solutions can help with scales. Doctors can also prescribe high-potency steroids in the form of creams, gels, solutions, and foams. Creams can be greasy, so you may want to try the others on your scalp. It might help to put clobetasol foam, a corticosteroid, directly on damp skin. This is available in a prescription spray, too.
What Causes Psoriasis Of The Scalp
You cant catch scalp psoriasis from another person. As with other types, we dont know what causes it. Doctors believe it comes from something wrong with your immune system that causes skin cells to grow too quickly and build up into patches. You may be more likely to get scalp psoriasis if it runs in your family.
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Scalp Psoriasis Vs Dermatitis
Dermatitis is a term used to describe various types of skin inflammation. This includes contact dermatitis as well as seborrheic dermatitis .
Like psoriasis, dermatitis can also affect the scalp. While some of the treatments for these conditions may overlap, the conditions themselves have different causes.
Scalp psoriasis is likely caused by immune dysfunction. Dermatitis is caused by various skin irritants, such as allergens.
With scalp psoriasis, youll notice silvery-red scales that may extend beyond the hairline. Theyll cause itching, flaking, and redness. In dermatitis, scales are white or yellowish and accompanied by dandruff.
A doctor can usually tell the difference between scalp psoriasis and dermatitis by taking a look at the affected area. In other cases, it might be trickier to tell the difference.
They might perform a skin scrape or take a biopsy. An overgrowth of skin cells will be present in cases of scalp psoriasis. In dermatitis cases, there will be irritated skin and sometimes bacteria or fungi.
Dermatitis can cause dandruff. Scalp psoriasis and dandruff share many of the same symptoms, such as:
- white or yellow skin flakes on the scalp
- mild redness
It Can Affect The Scalp Hairline Forehead Back Of The Neck And Skin Around The Ears
Did You Know?
Symptoms may include fine scaling that looks like dandruff, or appear as thick, crusted plaques that cover the entire scalp. Other skin disorders, such as seborrheic dermatitis, may resemble psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis looks yellowish and greasy. Scalp psoriasis is common in patients of color, but treating it can be particularly tough due to the hair type.
Scalp psoriasis may be an indicator of psoriatic arthritis , as many people have both. If you think you have scalp psoriasis, see a dermatologist to diagnose scalp psoriasis and visit a rheumatologist to screen for psoriatic arthritis.
No matter how severe your scalp psoriasis is, there are options for treating the itching and flakes â from over-the-counter shampoos and topicals to light therapy, oral treatments and biologics.
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Tips For Managing Scalp Psoriasis
The following tips can help people to manage scalp psoriasis:
Seek treatment: A health professional can provide a topical ointment or oral medication that will help manage symptoms and itchiness.
Treat the scalp gently: People with this condition should avoid washing and combing the hair vigorously, as this can lead to breakage, especially if the hair is fragile due to treatment.
Avoid scratching: Scratching can lead to bleeding and possibly an infection.
Moisturize: Keeping the scalp moist will not cure psoriasis, but it may help improve the appearance of the skin.
Avoid triggers: If possible, individuals should identify their triggers for scalp psoriasis and consider things ways to limit them.
It is important to seek treatment, as this can reduce the risk of further complications, such as hair loss or cracked and bleeding skin on the scalp.
It is difficult to prevent scalp psoriasis, because the exact cause remains unclear.
However, treating the condition as soon as symptoms appear may prevent it from becoming worse.
Scalp psoriasis affects individuals differently. Some people have an occasional flare-up while others deal with the condition frequently.
If a person knows what triggers symptoms for them, they can try to avoid these factors.
What Causes Scalp Psoriasis Anyways
One study showed that researchers dont know the exact cause of scalp psoriasis. But, it appears to develop when your immune system sends particular signals to your skin cells. This makes your cells multiply too fast, leading to those scaly patches.
According to a research review, other factors that lead to psoriasis include:
- genetics
- nutrition
- body weight
Some folks also claim that allergies are to blame, but theres not enough proof to back this up.
Scalp psoriasis symptoms can range from mild to severe. Common side effects include:
- dryness
Psoriasis can indirectly cause hair loss. Giving in to scratch attacks on the reg or harsh treatments can make you lose some of your luscious locks. Thankfully, your hair should grow back after your skin clears up.
The AADA suggests trying these techniques to prevent hair loss:
- Avoid blow dryers or other hot tools.
- Use hair products that have menthol.
- Dont use products that contain irritants.
- Keep your scalp moisturized with a top-notch conditioner.
- Press an ice pack or cool towel on the inflamed parts of your scalp.
While theres currently no cure for psoriasis, there are a ton of over-the-counter treatments, medications, or home remedies that can help. The exact type of treatment depends on the severity of your symptoms.
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Treatment For Scalp Psoriasis
Your dermatologist can treat mild scalp psoriasis with topical medications. For more stubborn cases, oral or injectable treatments are also effective but may have side effects including increased infections.
At UCLA Dermatology, our specialists may recommend one or more of the following:
- Topical medications applied to the scalp, such as tar shampoos and steroid sprays, creams and solutions
- Medicated shampoos
Dont Dye During A Scalp Psoriasis Flare
If your scalp is highly inflamed, its a good idea to wait until your psoriasis calms down before playing with color. Thats because the dyes could cause further irritation, inflammation, and discomfort. I advise my patients to get their psoriasis under control before using chemicals of any kind on the scalp, says Pariser. If you get dermatitis on top of psoriasis, you can get weeping , crusting, and hair sticking together.
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Are There Complications Of Psoriasis
In some people, psoriasis causes more than itchiness and red skin. It can lead to swollen joints and arthritis. If you have psoriasis, you may be at higher risk of:
- Use medicated shampoo for scales on your scalp.
Other steps you should take to stay as healthy as possible:
- Talk to your healthcare provider about lowering your risk for related conditions, such as heart disease, depression and diabetes.
- Lower your stress with meditation, exercise or seeing a mental health professional.
Scalp Psoriasis Can Cause Temporary Hair Loss
Fortunately, hair loss from psoriasis isnt all that common, but it does occur, says Dr. Bagel. Some people may lose clumps of hair, but this hair does grow back in about a month with adequate scalp psoriasis treatment, he says. The hair loss may be from scratching and the inflammation of the disease. Looking for relief? Try these 10 psoriasis remedies that can ease symptoms.
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Systemic And Biologic Treatments
If topical treatment isnt effective, oral systemic medications and biologic infusions or injections are available.
These treatments work to slow down the growth of skin cells or to reduce inflammation.
Biologic medications block proteins in the immune system that are related to psoriasis, such as:
- tumor necrosis factor-alpha
is continually being done to see how these biologics can help reduce symptoms, and to develop newer medications.
Scalp Psoriasis Vs Seborrheic Dermatitis
Occasionally, seborrheic dermatitis of the scalp can be confused with scalp psoriasis since both can produce excess scale and can itch. Pathological examination of the skin biopsy material occasionally may be helpful in distinguishing the two entities. As a practical matter, this is rarely necessary because most patients with psoriasis have typical psoriatic lesions present in other areas, such as the elbows, knees, or torso. In addition, both conditions generally respond to similar topical medications.
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