Plaque Psoriasis Vs Seborrheic Dermatitis

What Does Scalp Psoriasis Look Like

Itchy, flaky scalp? It could be dandruff or scalp psoriasis, a form of plaque psoriasis, caused by an overactive immune system that makes skin cells grow too quickly.

Much like plaque psoriasis elsewhere on the body, psoriasis on the scalp typically appears in the form of reddened plaques covered with silvery scales, though the scales are often thickened and even itchier.

Scalp psoriasis is usually very scaly, and there can be caking of the hair and even some hair loss, said Dr. John Minni, a board-certified dermatologist at Waters Edge Dermatology who is also board certified in family practice.

About half of people with psoriasis will have psoriasis on their scalp at some point. Still, because scalp psoriasis can look like other scalp conditions and sometimes exist at the same time it can be hard to diagnose.

What Does Psoriasis Look Like

Red or silvery scales on the skin are typical features that distinguish psoriasis from atopic dermatitis. The most common type, plaque psoriasis, begins as small red round bumps that grow larger and form a scale. Scratching can pull the scales off the skin and result in bleeding.

Psoriatic rash or patches can erupt anywhere on the skin, sometimes all over the body . However, the common areas are as follows:

Psoriasis Vs Eczema: Complications

Any condition that impacts the skin barrier increases the chance of infection. This can happen with either psoriasis or eczema but tends to be more common in eczema. In eczema, people are scratching more, so its common to see the skin superficially infected, says Khetarpal.

Psoriasis can also lead to more serious complications. About 30 percent of people with psoriasis will develop psoriatic arthritis, a chronic, inflammatory disease of the joints, according to the National Psoriasis Foundation .

People with psoriasis are also 1.5 to 2 times more likely to develop heart disease than people without the skin condition, says the NPF. Psoriasis is not just inflammation of the skin it causes systemic inflammation and can put you at higher risk for cardiovascular conditions, such as heart attack and stroke, explains Khetarpal.

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What Are Causes And Risk Factors Of Scalp Psoriasis

It is generally accepted that scalp psoriasis, like all psoriasis, is related to genetic defects that affect certain parts of the immune system. There are undoubtedly environmental risk factors that trigger its initial development in genetically predisposed individuals. The notion that âemotional stressâ plays a causal role or at least exacerbates psoriasis has been difficult to prove. There is no question, however, that psoriasis of the scalp can be an extremely stressful experience.

Psoriasis Vs Eczema: Whats The Difference

If you have patches of itchy, inflamed, or red skin, youre not alone.

Chronic skin conditions like eczema and psoriasis can be uncomfortable but are very common.

Eczema affects up to 15 million Americans, many of whom are infants and young children.

Psoriasis is also widespread, impacting 3% of adults in the United States.

Although eczema and psoriasis are different conditions that require specific treatment plans, it can be difficult to distinguish between them.

Even general practitioners can misdiagnose patients with psoriasis.

So if you have patches of symptomatic skin and are unsure what is going on, its important to make an appointment with a dermatologist to get an accurate diagnosis.

In the meantime, this article will help you learn more about psoriasis and eczema, including the symptoms, causes, diagnosis, treatment, and risk factors for each.

Ill also explain the triggers for psoriasis and eczema, as well as how to prevent flare-ups and when to see a doctor about a skin condition.

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How To Treat Scalp Psoriasis

Topical treatments like medicated shampoos are the first course of action for scalp psoriasis, too, and sometimes products with the same ingredientssuch as salicylic acid and tarare recommended, according to the National Psoriasis Foundation. “But scalp psoriasis may also be treated with topical steroids and vitamin D analogs, both available by prescription,” says Dr. Feldman.

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

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Scalp Psoriasis Vs Seborrheic Dermatitis: What’s The Difference

Medically reviewed by Drugs.com. Last updated on Oct 2, 2020.

Your doctor can usually tell whether you have scalp psoriasis, seborrheic dermatitis or both based on an examination of your skin, scalp and nails.

Scalp psoriasis and seborrheic dermatitis are common conditions that affect the scalp. In addition, they share some similar signs and symptoms, such as red, scaly skin.

Most often, the scales of psoriasis are thicker and somewhat drier in appearance than are the scales of seborrheic dermatitis. Psoriasis has more of a tendency to extend beyond the hairline. In addition, psoriasis usually affects more than one area of the body. If you have scalp psoriasis, you may also have mild psoriasis on your elbows, knees, hands or feet or may notice subtle nail changes, such as pitting.

What Are Symptoms Of Scalp Psoriasis Vs Dandruff

Symptoms of scalp psoriasis and dandruff their similarities and differences are outlined in the table below.

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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.

What Causes Dandruff Vs Psoriasis Of The Scalp

There’s disagreement among dermatologists about what causes dandruff. Some believe it’s simply a buildup of the stratum corneumthe top layer of skinthat can occur if people don’t wash their hair very frequently. “Seborrheic dermatitis might be a bigger issue for African Americans because of some hair care practices,” explains Steve Feldman, MD, professor of dermatology at Wake Forest School of Medicine in North Carolina. “Because their hair would get dry if they shampooed very frequently, many African Americans use oils on their scalp and may only shampoo once a week or even less.”

Another possible cause of dandruff may be overgrowth of a fungusa type of yeast called Malassezia. “We all have various types of yeast on our scalp. It may be that some people’s bodies have a reaction to that,” says Dr. Feldman, who sits on the medical board of the National Psoriasis Foundation.

Or maybe you’re having a reaction to a hair care product. “An itchy, dry, and flaky scalp could be telling you that you need to do a better job of rinsing the shampoo from your hair,” says the American Academy of Dermatology . Leaving styling products on your scalp for too long without washing can also be irritating and lead to itching and flakes. AAD adds that some people may have an allergy to a shampoo, conditioner, or other product that touches the scalp.

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Where Does Dermatitis Form On The Body

The location of your dermatitis depends on the type. For example, atopic dermatitis can appear anywhere on your skin. But, in teens and adults, its typically on the hands, inner elbows, neck, knees, ankles, feet and around the eyes. Seborrheic dermatitis and cradle cap are typically on your scalp, face and ears. Periorificial dermatitis is found around your eyes, mouth, nostrils and sometimes the genitals.

How Do You Get Rid Of Seborrheic Dermatitis On The Scalp Naturally

Its best to work with your dermatologist to treat seborrheic dermatitis since this condition can be chronic and recur in some people. To help manage the itching on your own, you can try home remedies like a gentle moisturizer, unscented skin products, lukewarm baths or showers, coconut oil, tea tree oil, and stress management techniques.

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Different Forms Of Psoriasis

Guttate Psoriasis

This usually occurs in adolescents within few weeks after a hemolytic streptococcal infection. The lesions disappear spontaneously.

Pustular Psoriasis

Can occur as chronic deep seated lesions or generalized pustular psoriasis.

Flexural Psoriasis

This is the form of psoriasis that occurs in places such as submammary, axillary and anogenital folds. Scales are rare but there is a characteristic glistening nature.

Napkin Psoriasis

This appears in the area covered by the diapers. Babies who get napkin psoriasis are more likely to get psoriasis in the adult life.

Erythrodermic Psoriasis

Erythrodermic psoriasis is a rare form of psoriasis which is triggered by the irritant effect of chemicals such as tar.

Scalp Psoriasis Vs Seborrheic Dermatitis: Causes

Another thing psoriasis and seborrheic dermatitis have in common is that their causes are unknown. For many years, scientists have been trying to figure out what causes these conditions in order to find the right preventive treatment. Unfortunately, they havent come up with anything so far.

There are theories that seborrheic dermatitis is caused by the yeast called Malassezia and/or an irregular response of the immune system.

When it comes to psoriasis, the only theory is currently an irregular immune system response. Scientists believe that T-cells, which normally defend the body against viruses and bacteria, start attacking healthy skin cells, thus causing the body to think it needs to heal a wound or fight an infection. Researchers cant figure out what misleads the T cells. Among the possible causes are genetics or environmental factors.

Overall, both psoriasis and seborrheic dermatitis could be caused by the immune system overreaction.

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Severe And Pervasive Psoriasis

Like most skin conditions, psoriasis can become widespread and very irritating. For instance, plaque psoriasis may cover almost the entire surface of the body.

In extreme cases, inflammation can become so severe that it appears and feels like burns.

Extensive, highly painful, burn-like psoriasis can be life-threatening. This requires immediate attention from a health professional.

Other widespread psoriasis may simply require standard treatment to partially heal or resolve.

Eczema Up And Down The Legs

Eczema on the legs may often occur in body creases, such as the back of the knee or the front of the ankle. These areas may trap sweat or irritants from clothing and the air.

Close contact of irritants with skin and areas of skin rubbing together create a perfect environment for atopic dermatitis to thrive.

If eczema on the backs of the knees isnt quickly or effectively treated, it can become very irritating and painful. Constant contact from clothing can cause significant bleeding, oozing, and infection.

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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.

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Dermatologic Scalp Psoriasis Treatments

In addition to the available at-home treatments, a dermatologist may recommend patients with scalp psoriasis receive more advanced dermatologic treatments. According to Dr. Monjazeb, Long-term management of psoriasis on any part of the body typically requires a combination of both in-office and at-home treatments. Specifically, biologics are often recommended for individuals with scalp psoriasis due to the common link between scalp psoriasis and psoriatic arthritis. Biologics can help address the symptoms of both forms of psoriasis.

Additionally, patients may visit their dermatologist to receive treatments like phototherapy. This in-office procedure uses UV rays to treat the scalp, reducing itching and inflammation related to psoriasis flare-ups. Similarly, laser therapy may be recommended to decrease redness and itching and reduce the length of the scalp psoriasis flare-up.

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Interested In Learning More

If youre not sure whether youre dealing with dandruff or scalp psoriasis, a visit to the dermatologists office is the easiest way to find out. When youre ready to get started working with one of the knowledgeable dermatologists at U.S. Dermatology Partners, simply take a few minutes to complete our online scheduling request form.

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How Is Seborrheic Dermatitis Treated

Treatment may depend on the severity of your condition. Everyone responds differently to medication, so it may take a few tries to find the right solution for you.

For some people, dandruff clears up on its own. Over-the-counter shampoos and medication are usually enough to improve flaking and soothe itching. If not, ask your doctor about prescription-strength products.

In babies, cradle cap doesnt always require treatment. It generally resolves well before the first birthday. In the meantime, use a mild baby shampoo. Massage the scalp gently using a very soft brush. Be gentle breaking the skin can lead to infection. If youre concerned about your babys scalp, see their pediatrician.

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How Is Psoriasis Treated

Psoriasis of the scalp may be harder to treat. Topical corticosteroids may help reduce inflammation and slow the growth of skin cells.

Psoriasis can also be treated with light therapy. Systemic treatment may be beneficial for stubborn psoriasis. This may involve injectable medications. It may take a combination of treatments to get psoriasis under control.

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3. To help safeguard the skin, the immune system release chemicals that can cause nerves to itch and blood vessels to dilate to prepare the skin for a sudden rush of immune cells

4. When the immune cells arrive at the scene, most work to kill off the pathogens causing the distress, but a few capture some of the invaders and take them back to the heart of the immune system, where other soldier cells are produced in a way to recognize and attack the invading cells on contact

5. Inflammation is the bodys way of opening blood vessels to allow more soldier cells to rush to the battlefield.

While this entire process is completely normal, people with psoriasis tend to overproduce these soldier cells when the body feels threatened. This overabundance of killer immune cells can actually be dangerous to the skin since they begin to attack good cells along with the bad ones.

While it is great to finally understand the impact an improperly working immune system can have on your skin and cause psoriasis more research is needed to pinpoint the exact cause for the over-firing of the cell messages. Seborrheic Dermatitis Vs Plaque Psoriasis

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Seborrheic Dermatitis Vs Psoriasis Vs Eczema

When they see red patches with flakes, some people believe that they have eczema. If they are diagnosed with seborrheic dermatitis, its true. Seborrheic dermatitis is nothing more than one of the eczema types.

Most of the eczema types involve such symptoms as flaking, patching, itching, and burning. Each one of them requires a certain treatment approach.

Scalp Psoriasis Vs Seborrheic Dermatitis: Triggers

They seem to look very similar. They itch, flake, and burn. Perhaps they are triggered by different things?

• Some medications
• Skin injuries

Again, we can see that some of the triggers for these two diseases are the same. Thats why tracking the triggers may not always give you a definite answer which condition you are suffering from.

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Severe And Pervasive Eczema

Eczema can also become very serious and cover much of the skins surface. The amount of skin affected by eczema will depend on:

• the sensitivity of the persons skin
• the skins exposure to irritants
• the type and effectiveness of treatments

Severe cracking, oozing, and bleeding in cases of severe eczema can become dangerous. Widespread eczema also makes infection more likely because of the increased chance of broken skin.

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What Questions Should I Ask My Healthcare Provider

• Do my symptoms indicate seborrheic dermatitis, eczema, atopic dermatitis or psoriasis?
• What over-the-counter treatment or combination of treatments would work best for me?
• Is there a specific brand of dandruff shampoo, cream or lotion that you recommend?
• Is there a prescription shampoo, cream or lotion you can prescribe?
• How often should I see a dermatologist regarding this condition?
• What should I do if I have an allergic reaction to a shampoo/cream/lotion?
• Is my acne treatment covered by my insurance?

Although seborrheic dermatitis is itchy and uncomfortable, it does not harm your health. The condition can be managed with treatment. Itchy skin and white flakes on your black shirts shouldnt be a normal part of your day!

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