Why Do I Have Flakey Scales On My Scalp
Psoriasis is actually a chronic inflammatory disorder caused when the immune system doesnt work quite right. Doctors arent sure why, but some people have an immune system that churns out too many skin cells. Since the body cant get rid of these excess cells fast enough, they pile on top of each other, forming flakey, silvery scales.
What Is The Treatment
There are many treatment options that can help scalp psoriasis and often a combination approach using a number of different treatments may be required until the symptoms have settled. It is important to remember to continue to treat the scalp even if hair falls out. Hair usually grows back once the inflammation and scale has cleared.
Treatments can be time-consuming and you may find them easier if you ask someone to help you. It is important to choose one that suits your lifestyle carrying out intensive treatments over the weekend, for example, when you have more free time. Psoriasis is not curable, but the signs and symptoms can be well controlled.
It can take at least eight weeks until you gain adequate control of the plaques, whichever treatment you use. Remember to try to treat psoriasis daily when it is active.
If, however, you have seen no improvement after 4 weeks continuous treatment, you should return to your doctor or nurse for further assessment.
Once you have achieved clearance, it is important to maintain the improvement. This can usually be done with regular use of a tar shampoo and or by moisturising the scalp occasionally with an oil or emollient. Some people find daily treatment of the scalp an advantage in keeping the scales from returning, but this would be a personal reference depending on your circumstances. If you have no success in controlling your scalp psoriasis, ask your GP to refer you to a specialist.
Topical steroids
Vitamin D analogues
Risks
How To Check For Scalp Psoriasis
Psoriasis can attack your confidence, your self-esteem and your peace of mind. This is especially true if you have scalp psoriasis, which affects one of the most prominent and public areas of your body. Here are some tips to help you check for scalp psoriasis so that you can seek proper treatment to regain a happy and healthy scalp.
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Topical Treatments For Moderate To Severe Scalp Psoriasis
If your symptoms are more severe and the plaques on your scalp are thick, you will probably need prescription treatment. Your GP can recommend a topical treatment containing corticosteroids, vitamin D analogues, or dithranol. Prescription products containing these ingredients include dermovate scalp application, locoid scalp lotion, dithrocream and dovobet gel.
You should use these treatment exactly as directed by your doctor. Make sure that you apply the medicated product directly to the scalp, and not to the hair.
In addition to these medicated treatments, you might also try using emollients on your scalp, as these can help to soften thick plaques. An emollient is a rich moisturiser which can prevent itching and inflammation, and create a protective barrier on the skin, sealing in moisture. One to consider using is grahams natural psoriasis cream, which is made from manuka honey and calendula. Formulated with natural ingredients, this moisturising treatment offers effective relief will helping to normalise the skins structure.
If you are going to use an emollient on your scalp, you should try the following method:
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
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Scalp Psoriasis: Tips For Managing
To help their patients get maximum benefit from treatment for scalp psoriasis, dermatologists often share the following tips with their patients:
What Solution There Is For More Severe Cases Of Scalp Psoriasis
For these cases, the next best options are left in the scalp applications. In the first instance, you can try a prescription gel such as Daivobet.
This is both a topical steroid and a vitamin D analog that reduces the skins itching and redness.
You apply the gel to your scalp at night and then wash it off in the morning.
Typically you should use these up to two or three times per week, otherwise youll notice your scalp psoriasis getting worse.
There is also an ointment called Coco-Scalp which you can get over the counter, it contains a combination of coal tar, salicylic acid, and sulfur which is particularly effective.
It is applied by using a small amount into your scalp and massaging it gently.
Leave on at least for one hour and then shampoo it off later.
It is important to mention that this product stains a little bit, so if you have any jewelry or clothing that you dont want to stain, please remember to take it off.
Youll want to use this daily until your skin and scalp start to improve, and then you can reduce it down to once weekly.
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How Can I Prevent Scalp Psoriasis
The key to preventing scalp psoriasis is to reduce your levels of skin inflammation and inflammation-generating chemicals in your body.
The best way to do this is by avoiding artificial sun exposure, maintaining low levels of sugar, fat, sodium, and alcohol in your diet, eating more vegetables and a high-quality protein source like wild salmon at least twice a week.
Take care of vitamin D deficiency with regular supplementation or ultraviolet light therapy.
Can Scalp Psoriasis Be Related To Surrounding Factors
Undoubtedly, some risk factors trigger this problems initial development in genetically defected individuals.
But the thing that we hear the most about scalp psoriasis is emotional stress.
However, no scientifically proven studies show that stress even plays a causal or at least is the reason to exacerbate psoriasis.
Risk factors that contribute to Scalp Psoriasis
A lot of reasons are there that might be the ones to increase further and intensify the disease but they are not the real causes.
These might include:
- deep injury on the skin, such as a burn, cut, or bruises
- infection, or strep throat
- Being stressed may worsen the symptoms or trigger them for the first time.
- the use of some medications that might trigger the disease for the first time, such as Indomethacin, which is primarily used for treating arthritis, or Quinidine, a cardio-related medication
- Allergies that attack the skin
- Extremely dry or cold weather conditions
The factors that are proven or are connected somehow to affect the immune system are:
- Family history
Family history is the main and a proven risk factor as this condition runs in genetics that is family.
Having one parent or grandparent with psoriasis clearly increases your risk of inheriting the disease, while having both of the parents with psoriasis makes you the one with even more risk.
- Smoking
Smoking may also be a huge contributor in triggering the initial development of the disease.
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Salicylic Acid Works As A Peeling Agent
Best for: Mild psoriasis
Why it works: Salicylic acid is a key ingredient in over-the-counter anti-dandruff shampoos, acne medicines, and callus and wart removers. Because its a keratolytic, or peeling agent, its often used to treat scalp psoriasis. Salicylic acid also helps with the itching by managing the abnormal turnover of cells in the skin, causing those excess skin cells to soften and come off.
Dr. Daveluy says that shampoos containing salicylic acid can be effective in combination with topical steroids. The salicylic acid dissolves and removes the flakes so the topical steroid can penetrate the skin instead of being absorbed into the flakes, he explains.
Be aware that strong salicylic preparations can cause irritation if left on the skin for too long.
What Are The Symptoms Of Scalp Psoriasis
For many patients this is an embarrassing condition, and many of them feel ashamed.
This happens because of the flaking scales and severe dandruff that goes with it.
Some people are susceptible to lose hair with it, the main symptom is the dry and itchy scalp but others report to have no symptoms at all.
It tends to be a chronic problem lasting for many years that tends to come and go with some severity.
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What Triggers Scalp Psoriasis
Scalp psoriasis can be triggered by certain lifestyle habits such as stress, depression, use of certain medicines, or most commonly by skin conditions such as seborrheic dermatitis which is characterized by red scaly patches on the scalp and face. Tinea cruris can also trigger scalp psoriasis on occasion.
Important Scalp Psoriasis Triggers To Avoid
Some people may be free from any symptoms for many years until this disease is triggered by the usual factors.
Common scalp psoriasis triggers may include the following things:
- Heavy and regular alcohol consumption
- Medications that alter blood pressure, for cardio, arthritis, and a few antimalarial drugs
- Rapid withdrawal from the use of corticosteroids
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Practice Gentle Hair Care
No more tangles has to be a priority, but pomades for frizzy hair are a no-no. Dont use harsh shampoos either. Finally, tilt your head back when you rinse so any irritant chemicals in your shampoo splash on less noticeable regions of skin. Board Certified Dermatologist, Dr. Leslie Storey recommends using tar shampoos, Nizoral or Tea Tree Oil Shampoo.
Treatments To Clear Scalp Psoriasis And Stop Hair Loss
The good news is that there are many effective ways to treat scalp psoriasis. Once your skin clears, your hair will usually grow back.
The bad news is that scalp psoriasis can sometimes be difficult to treat. Hair makes the scalp inaccessible for topical therapies, which are thick and gooey and hard to get in and out of your hair.
The practicality of applying a cream, ointment, or foam into the scalp makes it difficult for topical treatment of psoriasis of the scalp, says Dr. Gohara. If you dont wash your hair every day, who the heck wants to slather creams and ointments on their scalp?
This is especially problematic for Black and brown-skinned people, she says, who tend to wash their hair more infrequently.
Treatment depends on the severity of the condition.
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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.
What Type Of Psoriasis Treatment Will I Need
Several treatment options can relieve psoriasis. Creams or ointments may be enough to improve the rash in small areas of skin. If the rash affects larger areas, or you also have joint pain, you may need other treatments. Joint pain may be a sign that you have arthritis.
Your provider will decide on a treatment plan based on:
- Severity of the rash.
- Vitamin A or retinoid creams.
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What Treatments Are More Efficient For Scalp Psoriasis
Before discussing treatment options, it is important to remember that most treatments dont start working until you are using them regularly for at least a couple of weeks.
So persistence is key on this one.
The first thing you can try is special medicated shampoos, it is a cheaper solution, and you can buy over the counter.
They work by removing the scales and proceeding to treat the inflammation and the itch.
An example is Ionil T shampoo, which contains coal tar and salicylic acid.
These work best if you rub them well in the scalp wait for 5 to 10 minutes, then rinse and apply again.
Rinse after another 5 minutes, and then you can use your normal shampoo and conditioner afterward if you dont like the smell of it.
You can use these daily but if they start to hurt your scalp, drop it down to once or twice weekly.
An alternative is to use a plain coal tar shampoo like Polytar Plus if you dont have too many scales on your scalp.
This can be used just like the prior solution.
Coal tar preparations are a solution that has been around for quite some time, and they tend to work very well, but they are a bit messy, and the smell is something that might not please everyone.
Another type of treatment can be medicated anti-fungal shampoos these are very helpful to dandruff or seborrheic dermatitis.
Despite not being so good for Scalp Psoriasis as the coal tar preparations, they can help a little bit as well.
What Can You Do About Scalp Psoriasis
Although there is no cure for scalp psoriasis, there are variety of treatments that can help ease the discomfort and symptoms associated with it such as:
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Medicated shampoos
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Topical medications applied to the scalp, such as tar shampoos and steroid sprays, creams and solutions
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Scale softeners
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Oral or injected medications that boost the immune system
The first line of defense is treatment you use directly on your skin such as medicated shampoos. Shampoos that contain ketoconazole can help remove both dandruff and psoriatic plaques. Ketoconazole is an antifungal agent that can also help people with the dry, scaly skin associated with psoriasis. If you have scalp psoriasis, you may have a higher risk of fungal infections than others who do not have the condition. Ketoconazole is an especially beneficial ingredient that can help protect the scalp from painful yeast infections.
DERMAZOLE shampoo contains ketoconazole, an antifungal/antidandruff best known for its use in treating dandruff and seborrhoeic dermatitis. Use ketoconazole shampoo as instructed by your doctor or as indicated on the product label.
If youre treating the scalp, apply the shampoo to wet hair. Lather it well, leave it for 3-5 minutes to soak into the scalp before rinsing.
If youre using ketoconazole shampoo on an area other than the scalp, apply it to the affected area and let it sit for five minutes. Wash it off thoroughly with water, and then dry your skin.
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How Common Is Scalp Psoriasis
It is common and approximately half of all people with psoriasis also have it on their scalp. The reason it deserves special mention is that it can be more difficult to treat and usually requires specifically formulated treatments.
Psoriasis on the scalp forms in the same way as on other parts of the body but the hair traps the scale and so it does not rub away as it would, for instance, on the elbow. The result is that the scale can quickly build up, causing a thicker plaque which becomes more difficult to treat . This difficulty is compounded by the hair, which acts as a physical barrier obstructing the easy application of creams and ointments to the affected skin. Children can get scalp psoriasis too. Treatments will be much the same as those used for adults. On rare occasions, scalp psoriasis has been known to disappear spontaneously, but it can remain on the scalp for lengthy periods of time too.