What Are The Symptoms
Scalp psoriasis causes redness and scaliness, which may also involve the hairline, the forehead, behind the ears and the back of the neck. It can range from very mild with slight fine scaling to very severe, crusted thick scaling covering the entire scalp. Hair loss during the flare-up can occur in some cases, but the hair will normally grow back. Psoriasis can be itchy, make the scalp feel tight and occasionally cause soreness, especially if there are cracks in the skin.
Scalp Psoriasis Is Actually Pretty Common Among Those With Psoriasis
Overall, more than eight million Americans have psoriasis, according to the National Psoriasis Foundation and nearly 80 percent of patients with psoriasis will also have scalp psoriasis.
Conversely, some patients will only have scalp psoriasis, says Jessica Kaffenberger, MD, a dermatologist and psoriasis expert at The Ohio State University Wexner Medical Center. It can manifest as mild or severe , according to the NPF. Scalp psoriasis can also extend onto the forehead, the back of the neck, and around the ears.
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What Are Treatments For Dandruff
There are specific over-the-counter shampoos that are designed to treat dandruff, according to the AAD. They contain different ingredients, including salicylic acid , zinc pyrithione , coal tar , and selenium sulfide . And theres also an OTC anti-yeast shampoo thats used to treat dandruff, says Dr. Gohara. Prescription options are also available through your dermatologist.
Dr. Gohara adds that anti-yeast medications are sometimes used to treat dandruff, as well as anti-inflammatory topical steroids .
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How Do You Stop Guttate Psoriasis From Spreading
Still, you can do a lot on your own to help control and prevent flare-ups.
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What Is Scalp Psoriasis The Causes And Symptoms
Scalp psoriasis is a completely different animal from dandruff, says Dr. Gohara. Psoriasis can appear anywhere on the body, she points out, and according to the National Psoriasis Foundation , 45 to 56% of people who have psoriasis have it on their scalp. It can feel very itchy, and at times burning or painful. Here, more information on the cause of scalp psoriasis:
Psoriasis is the result of an over-proliferation of epidermis, the top layer of our skin, resulting in thick, scaly plaques, says Dr. Gohara.
The cause of that over-proliferation is an immune dysregulation around skin cells, Dr. Gohara explains. According to the Journal of Psoriasis and Psoriatic Arthritis, psoriasis is what is called an immune-mediated disease meaning that an unknown cause brings about a dysregulation of the immune system that causes inflammation. The overactive immune system revs up the growth of skin cells, which pile up rather than shedding, creating the plaques.
Generally, in scalp psoriasis, the plaques are usually very dry, not oily or greasy. And theres redness or pinkness or with dark skin, a dark red or purplish color,” says Dr. Gohara.
Scalp psoriasis can be very disruptive to ones lifestyle, says Dr. Gohara. Its very obvious everyone knows if you have it. If you have, say, a heart issue, people dont see it, but they see the flaking from scalp psoriasis.
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Visit Your Trusted Dermatologist
If youre struggling with scalp psoriasis or youre just ready for an annual skin exam, the U.S. Dermatology Partners team is here to help. You can get started planning your visit right away by completing our online scheduling request form. After we receive your appointment request, a team member will be in touch to finalize appointment details.
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Is Scalp Psoriasis Curable
Dr. Wofford says, Unfortunately, there is no cure for any form of psoriasis, including scalp psoriasis. However, advancing research has enabled your dermatologist to provide effective treatments to prevent flare-ups and manage symptoms when they do arise. That means most people have mild symptoms that do not last long.
There is a range of treatments available for scalp psoriasis. In most cases, youll begin with medicated shampoos, creams, or other topical treatments that you apply directly to the affected areas. Some of these products are available over the counter and in prescription-strength formulas. Prescription topical treatments may also include ingredients like anthralin, antimicrobials, vitamin D , corticosteroids, and/or vitamin A derivatives.
For severe symptoms that dont improve with topical treatment, a combination of in-office and at-home dermatology treatments may be recommended in addition to continuing topical treatments. Some commonly recommended solutions include:
- Laser therapy using low-heat lasers to address itch and redness and improve scalp psoriasis symptoms
- Oral medications corticosteroids, cyclosporine, methotrexate, retinoids , apremilast
- Biologics adalimumab, brodalumab, certolizumab, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab, ustekinumab
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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.
Main Symptoms Of Psoriasis
Psoriasis typically causes patches of skin that are dry, red and covered in silver scales. Some people find their psoriasis causes itching or soreness.
There are several different types of psoriasis. Many people have only 1 form at a time, although 2 different types can occur together. One form may change into another or become more severe.
Most cases of psoriasis go through cycles, causing problems for a few weeks or months before easing or stopping.
You should see a GP if you think you may have psoriasis.
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What Does Plaque Psoriasis Look Like
About 80 to 90 percent of people with psoriasis have plaque psoriasis, according to the National Psoriasis Foundation. This makes it the most common type of psoriasis.
A plaque psoriasis rash looks like raised patches of thick, inflamed skin. On light skin, it looks red and scaly, often with a layer of silver on top. On skin with more pigment, the plaques look purple, gray, or darker brown and tend to be thicker.
Plaques can develop anywhere but are most likely to appear on your:
- scalp
- knees
- lower back
Plaques also tend to be symmetrical. For example, youre more likely to have plaques on both knees or elbows than on just one side. Other symptoms include:
- itching
2009 study of 1,593 people with psoriasis found that guttate psoriasis affects about 8 percent of people with psoriasis.
You can spot this type of psoriasis rash by small, raised round spots called papules. They sometimes have a scaly appearance. The spots might look red on light skin and purple or brown on skin with more pigment.
Guttate psoriasis can start at any age. For most people, though, it starts in childhood or adolescence. It can develop after an infection, such as strep throat or tonsillitis.
Its most likely to develop on the limbs and torso, though some people get it on the scalp, face, or ears.
Psoriasis can appear anywhere on the body. It can develop in just one area, or it can show up in several. For example, theres:
Plaque, inverse, and guttate are the most common types. Others include:
What Is The Treatment For Guttate Psoriasis
Usually, this type of psoriasis goes away in a few weeks without treatment. Simple reassurance and moisturizers to soften the skin may be sufficient care. The choice of treatment depends on the severity of the outbreak and the individuals preferences. For example, applying topical steroids, although effective, could be bothersome because the outbreak occurs over a large portion of the body in most cases of guttate psoriasis.
- Antibiotics: If someone has a history of psoriasis, the doctor will most likely take a throat culture when that individual has a sore throat. If the culture results are positive , then starting immediately on antibiotics for the infection is very helpful.
The doctor may prescribe a short course of artificial light therapy . Broadband ultraviolet B or narrowband ultraviolet B light may be used.
It is probably advisable to avoid the ultraviolet lights provided in tanning salons.
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What Does Scalp Psoriasis Feel Like
Scalp psoriasis appears as raised, red or purple, itchy patches with silvery white scales that often start in one spot behind the ear, for example and spread through the hair. Symptoms include mild to severe itching, burning, cracking or bleeding skin. Members of MyPsoriasisTeam described how it feels in their own words:
- Feels like chicken pox in my scalp during a flare-up.
- My scalp feels like sandpaper.
- Looks like it’s constantly snowing from my head.
- My scalp is so itchy I feel like pulling out my hair.
- The plaque gets so thick, it feels like super glue in my hair and hard to get out.
- My scalp gets so bad it bleeds and is sometimes painful, especially behind the ears.
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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What Else Is There To Know About Scalp Psoriasis
Scalp psoriasis can really disrupt someone’s life and overall well-being. While you might think it’s solely a condition that affects the skin, in some cases, psoriatic arthritis can occur especially if the psoriasis is left untreated. According to the National Psoriasis Foundation, out of the 8 million people with psoriasis, approximately one-third of them will develop psoriatic arthritis, affecting the joints and the tendons. Having psoriasis doesn’t guarantee a psoriatic arthritis diagnosis, but, unfortunately, the risk is higher. If you’re concerned, visit a rheumatologist to screen for the condition and catch it early if you can.
Keeping the scalp soothed and calm is integral to a healthy head of hair. Whether you’re dealing with scalp psoriasis or not, steering clear of astringent chemicals and highly perfumed products is the way forward. Invest in a hair wellness system that takes a gentle, natural and effective approach to maintain your mane and keep your crowning glory glossy and happy.
How Does Psoriasis Lead To Hair Loss
As well as being visibly noticeable, psoriasis can be unbearably itchy. The itching can get so bad it can interfere with sleep and your everyday interactions. And that’s not all. Too much scratching can cause temporary hair loss over time as the hair follicles become damaged. The aim is to avoid scratching even though it’s really difficult. “When the scale is shed, it tends to pull the hair out with it,” said Bard. “While the inflammation doesn’t specifically affect the hair follicle, inflammation of the scalp can have a detrimental effect on hair growth and can lead to shedding.”
Though psoriasis scales are upsetting to live with, you might also suffer from hair loss if you try to forcibly remove scales. The American Academy of Dermatology Association suggests avoiding scratching and picking at the scales to lessen the chance of aggravating the skin. They also recommended keeping fingernails short and filed down to reduce hair loss and limit the damage caused when scratching is the only option.
It’s important to note that psoriatic alopecia also known as hair loss due to psoriasis can affect the entire scalp, and some data suggests that those living with psoriasis are also potentially at risk of developing alopecia areata over time. This is why, if you’re living with severe psoriasis, you must check in with a dermatologist or health care professional to arrange an educated treatment plan.
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What Are The Types Of Psoriasis
In children, common types of psoriasis include:
Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
Guttate psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a woman’s breasts.
What Procedures And Tests Diagnose Guttate Psoriasis
Guttate psoriasis is a medical condition that is typically diagnosed after a doctor or health care professional performs a physical exam of the skin. The dermatologist generally can tell if it is psoriasis just by clinical judgment based on the appearance of the skin lesions.
Skin biopsies are occasionally necessary to confirm diagnosis of psoriatic lesions.
Blood tests to rule out other treatable diseases may be necessary. In young children, certain drug eruptions and occasionally viral rashes can be confused with guttate psoriasis.
Findings from blood tests may confirm that the patient had a streptococcal infection recently. Increased levels of antibodies to the streptolysin-O are present in more than one-half of patients.
This type of psoriasis may be treated at home in most mild to moderate cases. Keeping the skin moist will prevent extra irritation. Thick moisturizers applied after a bath to keep in moisture and soften the skin are helpful.
If it is summertime or the patient is in a part of the country where there is plenty of sunlight, careful graded increases in sun exposure may be quite helpful in diminishing the eruption. One must take special care to avoid a sunburn because this can occasionally result in an exacerbation of the eruption.
Over-the-counter topical steroids like 1% hydrocortisone cream may help to reduce inflammation and itching.
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Whats The Difference Between Scalp Psoriasis And Dandruff
Dr. Bhutani says it can be really tough to tell scalp psoriasis and dandruff aparteven for doctors! Although both conditions can cause those annoying flakes, which may be the only visible symptom at first for some people, they tend to pop up for different reasons. Unlike scalp psoriasis, dandruff isnt an autoimmune issue and can be spurred by various factors, like having very dry or oily skin, which can lead to an overgrowth of a yeast-like fungus that thrives on a moist scalp10.
But you may be able to pick up on subtle differences if you look a bit closer. Dandruff flakes can be white or yellow, which is not common in scalp psoriasis. With scalp psoriasis, plaques have a dry scale with more clearly defined edges, and the scales themselves are often thicker with a silvery sheen.
If your scalp is extremely itchy or you have any other scalp psoriasis symptoms, then you may want to schedule an appointment with a dermatologist, who can thoroughly assess whats going on. If youre only noticing some flaking and have tried an over-the-counter dandruff shampoo but havent noticed improvement, then you may want to see a dermatologist anyway theyll be able to take a closer look and prescribe something a bit stronger if you need it.
Related Conditions And Causes Of Ringworm
Ringworm often resembles other conditions, including eczema . Eczema is a condition that makes your skin red and itchy. Like ringworm, itâs common in children, but anyone can get eczema. Symptoms include itching, and red to brownish-gray patches on the skin.
HIV is a virus that attacks the immune system, making you more vulnerable to other infections and diseases . It is spread by contact with certain bodily fluids of a person with HIV. Without treatment, HIV can lead to AIDS .
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How To Treat Scalp Psoriasis
While scalp psoriasis is a chronic condition, you can help ease uncomfortable symptoms with the right plan. Its important to see a dermatologist as soon as you suspect you may have the condition, though, as scalp psoriasis treatment is highly individualized and requires some persistence.
It depends on things like hair type, what treatments people have tried in the past, whether people have open sores, their stress level, even how long their hair is, Dr. Bhutani says. Please see your dermatologist. Even if what youre dealing with turns out to be just really bad dandruff, you shouldnt have to live with it.
The most common scalp psoriasis treatments include11:
I usually recommend treating scalp psoriasis from the outside first, Dr. Bhutani says, explaining that she often prescribes topical corticosteroids first. Although topical treatments are very effective for short-term management of scalp psoriasis flare-ups, if the symptoms are severe or if the plaques spread to other areas of the body, additional treatment may be needed.