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.
Unwind With Lavender And Calendula
Not many antimicrobial and anti-inflammatory agents are known for helping you relax, but thats the magic of lavender essential oil. You can also add calendula oil to the mix , along with a carrier oil, and apply directly to the scalp.
Just remember to only add a few drops of essential oil to each tablespoon of carrier oil you use, and do a patch test first to make sure you dont have a sensitivity to those particular oils.
Some potential carrier oils:
- avocado oil
- jojoba oil
Sadly the science here is still a little lacking, so make sure to do your homework and chat with a derm before oiling up.
Another option that doesnt involve topical application: Since stress makes psoriasis flares worse, you can sit in a quiet room with dim lighting, some lavender oil in the diffuser, and just chilllll. This may not affect your psoriasis in the short term, but it could help the flare go away faster. And, bonus points for caring for your mental health.
Oats Or Colloidal Oatmeal
Some people also notice that their psoriasis symptoms get worse after eating certain foods or as a result of allergies. Research has not yet conclusively proven that these factors can trigger psoriasis, however.
It is worth noting that environmental triggers alone do not cause psoriasis. People without a genetic predisposition for psoriasis will not develop it, even when they experience these triggers.
In the following sections, we will cover the different types of shampoo and home remedies that people with scalp psoriasis can try.
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When To See A Doctor
If you suspect you have scalp psoriasis, you should schedule an appointment with a doctor. They may examine your scalp to rule out other conditions before sending you to a dermatologist for further evaluation and treatment.
If you dont already have a dermatologist, the Healthline FindCare tool can help you find a physician in your area.
Dovonex Scalp Solution Description
Dovonex® Scalp Solution, 0.005% is a colorless topical solution containing calcipotriene monohydrate, a synthetic vitamin D3 derivative, for topical dermatologic use.
Chemically, calcipotriene monohydrate is -24-cyclopropyl-9,10-secochola-5,7,10,22-tetraene-1,3,24-triol monohydrate, with the empirical formula C27H40O3H2O, a molecular weight of 430.6, and the following structural formula:
Calcipotriene monohydrate is a white or off-white crystalline substance. Dovonex® Scalp Solution contains calcipotriene monohydrate equivalent to 50 g/g anhydrous calcipotriene in a vehicle of isopropanol , propylene glycol, hydroxypropyl cellulose, sodium citrate, menthol and water.
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How To Use Salicylic Acid Topical
Follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.
Before using this product for the first time, check if you are allergic to it. To check, put a small amount on one or two small areas of acne for three days. If you have an allergic reaction, stop using this product and get medical help right away . If you don’t have an allergic reaction, you can use the product.
This medication is for use on the skin only. To avoid irritation, do not let this medication come into contact with your eyes, nose, mouth, groin, or any broken skin . If you do get the medication in those areas, flush the area with cool water for 15 minutes.
If you are using a cream, lotion, solution, or gel, apply a thin film of the medication to the areas of your skin affected by acne, usually 1 to 2 times a day or as directed by your doctor. Before applying each dose, gently wash the affected area with a mild cleanser, then pat dry. Apply a small amount of medicine to the affected area and rub in gently. If using the pads, wash the affected skin with a mild cleanser, then pat dry. Wipe the pad gently onto the skin to apply the medication, usually 1 to 3 times a day or as directed by your doctor. Wash hands after use.
If your condition persists or worsens, or if you think you may have a serious medical problem, seek immediate medical attention.
Medicine You Apply To The Scalp
This is the most commonly prescribed treatment. Your plan may include one or more of the following medicines.
Corticosteroids: This is the #1-prescribed treatment for scalp psoriasis in children and adults. Corticosteroids work quickly to reduce redness, swelling, itch, and scale. This makes it more effective than any other treatment that you apply to the scalp.
When used as directed, this medicine is safe. Because side effects can occur with long-term use, your dermatologist may recommend another treatment to use with the corticosteroid. This reduces possible side effects.
Medicated shampoos: This is often part of a treatment plan.
If you have stubborn scalp psoriasis, your dermatologist may prescribe a shampoo that contains clobetasol propionate. This can be quite effective when used in a shampoo. Studies show that patients can safely use this shampoo every day for up to four weeks. Its also safe to use it once or twice a week to maintain results.
Gently shampoo
Rubbing, scrubbing, and scratching your scalp can worsen existing psoriasis.
Scale softeners: If the psoriasis on your scalp is thick, it can be hard for the treatment you apply to work. A product that contains salicylic acid can soften thick, stubborn patches. Other ingredients can also help.
Tip for applying medicine
Lift your hair up and away when applying medicine to your scalp.
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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.
Dovonex Scalp Solution Dosage And Administration
Comb the hair to remove scaly debris and after suitably parting, apply Dovonex® Scalp Solution, 0.005%, twice daily, only to the lesions, and rub in gently and completely, taking care to prevent the solution spreading onto the forehead. The safety and efficacy of Dovonex® Scalp Solution, 0.005%, have been demonstrated in patients treated for eight weeks.
Keep Dovonex®Scalp Solution, 0.005%, well away from the eyes. Avoid application of the solution to uninvolved scalp margins. Always wash hands thoroughly after use.
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Best Natural: Wild Naturals Eczema & Psoriasis Cream
Looking for a lotion that provides itchiness relief, repairs damaged skin cells, and smooths the skin, all while not using any harmful additives, fragrances, or chemicals? Then Wild Naturals Eczema & Psoriasis Cream could be the lotion for you.
The formula boasts all-natural ingredients, including organic aloe veraan anti-inflammatory that penetrates deep to soothe cracked skinand manuka honey, which provides healing properties. In all, the moisturizer combines vitamins, minerals, and amino acids to help seal in moisture so the skin stays hydrated for hours on end. Customers say the product brightens and smoothes their skin while minimizing psoriasis patches.
How To Use Clobetasol Propionate Solution Non
Apply this medication to the affected area of the scalp as directed by your doctor, usually twice daily .
Use this medication only on the skin. However, do not use it on the face, groin or underarms unless directed to do so by your doctor.
Wash and dry your hands before applying. Apply the prescribed amount of medication to the affected area and gently rub in. Do not bandage, wrap or cover the area.
After applying the medication, wash your hands, unless you are using this medication to treat the hands. If applying this medication near the eyes, avoid getting it in the eyes because this may worsen or cause glaucoma. Also, avoid getting the medication in your nose or mouth. If you get the medication in your eyes, nose, or mouth, rinse with plenty of water.
Use this medication exactly as prescribed. Do not increase your dose, take it more frequently, or use it for longer than 2 weeks in a row. Do not apply more than 50 milliliters of medication in a given week unless directed by your doctor. Doing so could increase your risk of side effects.
Tell your doctor if your condition lasts or gets worse after 2 weeks.
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Updates To This Nice Pathway
Treatment You Receive At A Dermatologists Office Or Clinic
If the psoriasis fails to clear with treatment applied to the scalp or you have thick psoriasis on your scalp, your dermatologist may recommend the following.
Injections of corticosteroids: Your dermatologist can inject a corticosteroid directly into the scalp psoriasis. While this can be effective, its use is limited to a few times.
Excimer laser and other light treatments: This laser can treat psoriasis in difficult-to-treat areas like the scalp, feet, and hands. When used to treat the scalp, your dermatologist may use a device that looks like a blow dryer. A benefit of using this to treat scalp psoriasis is that this laser treats only the areas that need it.
The drawback to this treatment is that you will need to travel to your dermatologists office or a psoriasis clinic two or three times per week. Each treatment session takes about 10 minutes. Most patients need to continue these visits for several weeks. If your schedule wont permit this, be sure to tell your dermatologist.
While getting these treatments, you may also need to use another treatment at home.
Excimer laser treatment is usually painless, but possible side effects include redness and sunburn-like pain.
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Counseling Of Patients With Scalp Psoriasis
- Patients consider scalp psoriasis to be the most difficult aspect of their disease, which can lead to loss of self-esteem, social stigmatization, and even depression.
- A study showed that 1 in 3 patients are self-conscious of their scalp psoriasis, and 1 in 5 report depressive symptoms.8
- As part of routine clinic assessments, evaluate psychosocial aspects and quality of life.
Assessing For Psoriatic Arthritis
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Following Your Treatment Plan Is Key To Getting Results
When working with a dermatologist, it is important to use the treatment exactly as prescribed and for as long as recommended. Many patients fail to see clearing because they stop following their treatment plan.
ImagesBefore and after treating scalp psoriasis: Photographs used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol 2008 58:614.
ReferencesAl-Mutairi N, Al-Haddad A. Targeted phototherapy using 308 nm Xecl monochromatic excimer laser for psoriasis at difficult to treat sites. Lasers Med Sci. 2013 28:1119-24.
Bagel J, Lynde C, et al. Moderate to severe plaque psoriasis with scalp involvement: A randomized, double-blind, placebo-controlled study of etanercept. J Am Acad Dermatol 2012 67:86-92.
Chan CS, Van Voorhees AS, et al. Treatment of severe scalp psoriasis: from the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol. 2009 60:962-71.
Guenther L. Current management of scalp psoriasis. Skin Therapy Lett. 2015 20:5-7.
Paghdal KV, Schwartz RA. Topical tar: Back to the future. J Am Acad Dermatol. 2009 Aug 61:294-302.
Renton C. Diagnosis and treatment of adults with scalp psoriasis. Nurs Stand. 2014 Feb 26-Mar 4 28:35-9.
Wong, JW, Kamangar F, et al. Excimer Laser Therapy for Hairline Psoriasis: A Useful Addition to the Scalp Psoriasis Treatment Algorithm. Skin Therapy Letter. 2012 176-9.
Calcipotriol + Corticosteroids: A Powerful Combination
Simultaneous use of calcipotriol and corticosteroids has been found to be more effective than either therapy alone, and the combination appears to minimize the side effects of both. The combination works as quickly as the faster acting corticosteroid component, producing good results in about four weeks.
Combination products are available in a variety of formulations, though they can be far more expensive than some of the generic steroids that are available.
One option when cost is a factor is to be prescribed the two products separately and use them, for example, on alternating days. Some doctors, noting that the combination products are only modestly more effective, and recognizing that complexity in a treatment regimen reduces compliance, simply start off with a topical corticosteroid for scalp psoriasis.
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Tips For Improving Treatment Adherence
- Nonadherence to treatment occurs in up to 40% of patients with psoriasis.9 Fears about treatment side-effects, the nuisance of using prescribed therapies, and dissatisfaction with the clinic consultation can discourage adherence.
- Devote time to patient education. When patients are given accurate information about their psoriasis and the selected treatment, their understanding of the therapeutic objectives and the negative impacts of nonadherence improves.
- Clinical strategies that can promote adherence include individualizing the treatment approach, encouraging patient input when making therapeutic decisions, choosing fast-acting topical agents, selecting treatments that facilitate ease of use , and regular monitoring of progress while undergoing therapy.
How To Use Calcipotriene Cream
Use this medication on the skin only. Apply a thin layer of the medication as directed by your doctor to the affected area and gently rub in, usually once or twice daily for the ointment or twice daily for the cream or the foam. Wash your hands after using, unless you are using this medication to treat the hands. Do not apply the medication on the face, in the eyes, nose, or mouth, or inside the vagina. If you do get the medication in those areas, flush with plenty of water.
Do not apply more often or use longer than prescribed. This may increase the risk of side effects.
Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.
Inform your doctor if your condition does not improve or if it worsens. You should usually begin to see an improvement in your skin condition after 2 weeks of treatment.
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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:
- Corticosteroids
- 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:
Ingredients To Look For
The following ingredients can help reduce itchiness and flakes, as well as gently soften and remove thick scale.
- Hydrocortisone is a mild corticosteroid that can decrease itching and inflammation.
- Coal tar decreases skin cell growth and helps the scalp shed dead skin cells.
- Salicylic acid is a âkeratolytic,â or peeling agent, that helps soften and remove thick scale. Once scale is removed, other medications will be able to penetrate the skin more easily, potentially increasing effectiveness.
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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.