Medications For Severe Scalp Psoriasis
If you have moderate to severe scalp psoriasis, your doctor may prescribe a drug you take by mouth or one that’s injected or pumped through a needle into a vein. Oral medications include:
- A strong form of vitamin A called a derivative
- , a small molecule inhibitor taken twice daily
Since these medications can cause serious side effects, including liver damage, they require a doctorâs close eye. It’s also important to know that oral vitamin derivatives are different from — and more powerful than — vitamin supplements bought over the counter. Ordinary vitamin A and D supplements do not help.
The latest class of FDA-approved medications are called biologics. These drugs, which you get by injection or IV, may keep your skin from making too many cells. According to the American Academy of Dermatology, 11 biologics may work:
How The Two Conditions Are Similar And Different
The similarities. Seborrheic dermatitis and psoriasis tend to be lifelong conditions. They can take an emotional toll too, especially when the patches are very noticeable. Both can often be managed. Psoriasis usually needs stronger medicines than seborrheic dermatitis.
Both can also flare. This happens when youâre exposed to certain triggers that are unique to you, like the weather or stress.
Neither condition is contagious. You canât pass it to someone or get it from someone. But both conditions can run in families. So having one can be in your genes.
Psoriasis plaques are itchy like seborrheic dermatitis, but they can also be painful. About one-third of people with psoriasis get a form of arthritis as the disease gets worse.
The scales on psoriasis plaques are thicker than those of seborrheic dermatitis, with more defined edges. Their color is closer to silver than the white or yellow of seborrheic dermatitis scales.
Who Gets Seborrheic Dermatitis
About 11% of the population has seborrheic dermatitis. It occurs most often in infants younger than three months old and in adults ages 30 to 60. It is more common in men than in women, and in Caucasians more than African Americans.
If you are born with naturally oily skin, you are more likely to get this type of dermatitis. A history of psoriasis in your family makes you vulnerable as well. If you live in a dry, cold region, the weather doesnt cause the seborrheic dermatitis, but it does make it worse.
If you have these health issues, youre more prone to seborrheic dermatitis:
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How Are Scalp Psoriasis Vs Dandruff Diagnosed
Both scalp psoriasis and dandruff are usually diagnosed with a physical examination of the scalp.
If the diagnosis is uncertain, a small sample of skin may be taken may be taken to help confirm a diagnosis or to help rule out other conditions.
What To Do About Dandruff
Most cases of dandruff can be easily banished using an over-the-counter medicated shampoo, conditioner, lotion or foam, Mayo Clinic and AAD point out. There are several different ingredients that target the flakes, and you may need to experiment a bit to find which one works best for you.
“I like tar shampoos, which are good for decreasing inflammation,” says Dr. Rokhsar, adding a caution that the tar may discolor blond or light hair. Another ingredient he likes is salicylic acid, “which is good for decreasing flakiness.”
Dr. Sodha recommends zinc or selenium-based products, both antifungal. Ketaconozole is another antifungal ingredient in some over-the-counter anti-dandruff shampoos. “Use the product two to four times a week for a few weeks, and then if you see improvement or resolution, switch to once or twice a week for maintenance.”
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What Is The Treatment For Scalp Psoriasis Vs Dandruff
It is important to get a diagnosis for scalp psoriasis versus dandruff, because in some cases, scalp psoriasis may require prescription medications.
Scalp psoriasis can be difficult to treat. The goal of treatment for scalp psoriasis is to relieve symptoms.
Treatments to help get rid of psoriasis on the scalp include:
- Topical treatments, such as creams and ointments
- Over-the-counter topical treatments: The National Psoriasis Foundation has a Seal of Recognition program that recognizes over-the-counter products intended to be non-irritating and safe for people with psoriasis
- Look for products such as shampoos that contain:
- Salicylic acid to help soften plaques and scales and remove scales from the skin
- Coal tar or wood tar, to help slow skin cell growth and reduce inflammation, itching, and scaling
- Scale lifters with active ingredients such as salicylic acid, urea, lactic acid, or phenol to help loosen and remove scale, and allow medications to reach the psoriasis plaques
- Aloe vera, jojoba, zinc pyrithione, and capsaicin to soothe, moisturize, remove scale, or relieve itching
- Anti-itch treatments such as calamine, hydrocortisone, camphor, benzocaine, diphenhydramine hydrochloride, and menthol
- Coverings such as plastic wrap, cellophane, waterproof dressing, cotton socks, or a nylon suit may be applied over topical treatments to help increase effectiveness
Treatment For Dandruff And Itching Scalp
- zinc pyrithione or zinc omadine
- selenium sulphide
- piroctone olamine this is the most recent addition to the medicated shampoos. It is known as a ‘second generation’ anti-dandruff agent. It is less toxic than zinc pyrithione and is therefore safer for family use
- antifungal agents
- tar shampoos containing tar have been used for years, usually for more severe scalp conditions. In the past, the scent of the tar-based shampoos made them less acceptable. However, newer preparations are well tolerated and simple to use.
If the dandruff is severe, or refractory to shampoo treatments then, topical corticosteroid lotions can provide symptomatic relief.
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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
The Top Medications For Treating Eczema On Your Scalp
There is no cure for scalp eczema or seborrheic dermatitis, but medications can help reduce and prevent symptoms.
For example, you can usually treat irritation and an itchy scalp with a medicated, over-the-counter dandruff shampoo.
The chemical ingredients in these shampoos can help ease the inflammation and get rid of flaky, scaly skin when used two or three times a week. Look for these items:
Topical creams, ointments, or sprays made from these ingredients can also be applied to help calm the irritation and stop the flaking.
If you have severe scalp eczema, your doctor may prescribe products containing stronger doses of the aforementioned medicines or medicines containing other ingredients, such as corticosteroids, ciclopirox, sulfacetamide sodium, Protopic , or Elidel .
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How Is Seborrheic Dermatitis Diagnosed
Seborrheic dermatitis is an easy condition to diagnosis because of its appearance on the affected skin and where it appears on your body. No blood, urine or allergy tests are needed. Your dermatologist may perform a skin biopsy to rule out other diseases if your condition does not respond to treatment.
Seborrheic Dermatitis: Treatment And Remedies
The treatment for seborrheic dermatitis includes dandruff shampoos, over-the-counter antifungal creams, avoidance of harsh soaps and detergents, and anti-itching creams applied topically to the affected area. Foods high in biotin, or vitamin B7, might also help alleviate symptoms, at least in infants: one study reported that nursing infants with cradle cap improved when foods rich in biotin, such as liver and egg yolk, were added to the mother’s diet. However, further studies are warranted before any recommendations can be made with regard to the use of biotin as a remedy for seborrheic dermatitis.
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What Treatment Options Are Available
Treatments for seborrheic dermatitis and other types of scalp conditions will vary based on the type you have. If you know what triggers your condition, you can make certain lifestyle changes to reduce your risk.
But if lifestyle changes and over-the-counter medications arent enough, contact your healthcare provider. Also contact them if youre experiencing severe pain, swelling, or other unusual symptoms.
What Medications Are Used To Treat Psoriasis And Eczema
There are many ways to treat psoriasis and eczema. In fact, some of the same treatments are used for both conditions.
Topical treatments are ones that you apply directly to the skin, like creams, gels, and ointments. Some topical treatments are available over the counter, while others need a prescription.
Corticosteroids are the most common topical treatments for both psoriasis and eczema. They reduce inflammation, which helps with redness and itching. They come in different strengths, ranging from weaker to very strong .
Other topical medication options for psoriasis include:
Calcitriol: helps to slow down skin cell growth and is also related to vitamin D
Tazarotene: helps to slow down skin cell growth and is chemically similar to vitamin A
Zithranol: helps to slow down skin cell growth and is available as a cream or shampoo
These are other topical medication options for eczema:
Eucrisa: blocks a specific protein that causes inflammation in atopic dermatitis
People with more severe eczema and psoriasis may need stronger treatments that work throughout the body. These are usually given as an oral pill or shot.
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What Are Scalp Psoriasis Symptoms And Signs Can Scalp Psoriasis Cause Hair Loss
Psoriasis appears as a small bump, a papule, surmounted by scale. When these papules coalesce, a plaque is formed that is often covered by thick layers of horny scale. When this scale is shed, it appears as dandruff, which can be quite unsightly. Scratching these plaques, either because of itching or because of the impulse to remove it, is a very poor idea because of what is called the Koebner phenomenon . This may cause psoriasis to develop in areas of inflammation and trauma. Scratching off the scale will only make things worse. Although most patients do not note hair loss, there can be extensive alopeciahair loss in severe cases.
Seborrheic Dermatitis Vs Scalp Psoriasis: Symptoms And Signs
Luckily, the two disease also differ in many aspects, and with a simple visual examination of the scalp, your doctor should be able to make a diagnosis. While you should leave the ultimate diagnosis to your doctor, you can get an idea of the differences between scalp psoriasis or seborrheic dermatitis by studying the table below.
|Seborrheic Dermatitis||Scalp Psoriasis|
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Does Scalp Psoriasis Come And Go
Dandruff or an itching or peeling scalp may cause embarrassment and discomfort.
eczema, which causes increased shedding of normal scalp skin cells.
Scalp psoriasisa type of psoriasis that causes thick, scaly plaques on the scalp, hairline, or neckcan certainly take a toll on self-esteem.
Psoriasis tends to come and go over time.
The patches usually appear on the knees, elbow, lower back and scalp, but they can appear anywhere on the body.
Scalp psoriasis is an inflammatory disease caused by the scalp skin that affects the adult population aged 15 to 25. But scalp psoriasis can be found in children too, and it is seen that this skin disease touches the peak around 5 8 years old in children.
Keep your scalp hydrated by using a moisturizing shampoo every time you wash your hair. 2. Itching and scratching. Never pick at scales or sore patches of skin.
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Common symptoms of scalp psoriasis include flaky, scaly skin that looks similar to dandruff, as well as thick, crusted plaques that can develop.
Psoriasis can appear anywhere on the skin. Scalp psoriasis can extend beyond the scalp. It can appear on the forehead as shown in the picture on this page. Sometimes, it extends to the back of the neck or appears behind the ears. On the scalp, psoriasis may need different treatment. The skin on the scalp is thicker.
Feeling the cold may also be related to anaemia, when the blood does not carry enough red blood.
What Are The Causes Of Seborrheic Dermatitis What Aggravates It
Researchers arent sure of the exact cause of seborrheic dermatitis. They think there may be many causes. Factors that are thought to play a role include:
- A type of yeast called Malassezia, which is present on everyones skin, but overgrow in some people.
- An increased level of androgens .
- An increased level of skin lipids.
- An inflammatory reaction.
- Family history .
Other factors that trigger or worsen seborrheic dermatitis include:
- History of other skin disorders, including rosacea, psoriasis and acne.
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One Last Thing About Scalp Eczema Treatment
Scalp eczema can be uncomfortable, but there are several over-the-counter solutions that can help relieve your symptoms.
But as always, consulting a professional can help you manage this skin condition. In particular, you may want to see a dermatologist to help identify the triggers for scalp eczema and get a prescription treatment if the remedies youve tried arent effective.
Importantly, see your dermatologist as soon as possible if your eczema-related skin patches drain fluid or pus, form crusts, or become very red or painful.
Additional reporting by Diana Rodriguez.
When Do Psoriasis And Eczema Usually Appear
Psoriasis usually appears between the ages of 16 and 22, but it can happen at any age.
Eczema usually begins younger, appearing as early as 6 months of age. Although some people grow out of eczema, many people continue to have it throughout their life. Even if you have eczema for a long time, there may be periods when it gets better or worse.
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What Are The Symptoms Of Seborrheic Dermatitis
- Itchy white flakes of skin on your scalp . When scratched, the flakes come loose, mix in with your hair, or fall onto your neck and shoulders.
- Red scales on your skin.
- Crusty yellow scales on infants heads . Cradle cap shouldnt itch, but scratching may cause additional inflammation in the area and break the skin, leading to bleeding or mild infections.
- Blepharitis .
- Pinkish plaques of scales on both sides of your face.
- Flaky patches on your chest and at your hairline that are shaped like a flower petal or a ring.
- Redness in the folds and creases of your genitals, armpits and beneath your breasts.
- Inflamed hair follicles on your cheeks and the upper half of your trunk.
How To Tell Seborrheic Dermatitis From Psoriasis
To tell the two apart, youâll need to take a close look at the differences in those patches, or plaques. Psoriasis starts as rough, red, scaly skin and grows into thick, usually silver-colored scales on top of those areas. These patches often show up on the scalp. You can also get them on your torso, limbs, hands, and feet.
Seborrheic dermatitis patches are more likely to vary in color. They may look whitish-yellow, red, or brown. They also tend to feel greasy or oily . This form of dermatitis, or inflammation of the skin, strikes most often on the scalp, on oily parts of the face , and on the upper chest and back. Think of it as dandruff 2.0. Simple dandruff causes only flakes, no inflammation, and itâs only on the scalp.
Itâs tricky to figure out which condition is which when the flaky red patches are only on the scalp, with no other clues. Itâs also possible to have both conditions at the same time. Thatâs called sebopsoriasis, and it can leave you with white and silver flakes.
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Who Develops These Conditions
Anyone can get psoriasis of the scalp. Theres no way to prevent it. Its more likely to occur in adults who have psoriasis elsewhere on their body.
The exact cause of psoriasis isnt known, but it involves an overreaction of the immune system. It tends to run in families, so its likely theres a genetic link.
Anyone can get seborrheic dermatitis, too. However, males develop it more often than females. Some things that may play a role in developing seborrheic dermatitis include:
- a family history of seborrheic dermatitis
- oily skin