How Is Psoriasis Assessed
Psoriasis should be assessed at diagnosis, before your first referral to a specialist, every time you see a specialist and to assess your response to treatment. Psoriasis may be assessed by your doctors using a variety of scores which measure the severity in your skin and joints, how psoriasis is affecting your mood and your activities of daily living and whether you are at risk of heart disease.
These scores include the PASI and DLQI
Other Conditions Mistaken For Scalp Psoriasis
One of the biggest difficulties with scalp psoriasis is that its often easy to mistake for other conditions. The most prominent is dandruff. Scalp psoriasis often comes with flaking and an itchy scalp, both of which are common symptoms of dandruff. The main difference between dandruff and scalp psoriasis is that the latter causes a distinct silver shine along with noticeable dry scales on the scalp.
Scalp psoriasis may also be mistaken for seborrheic dermatitis. This skin condition is characterized by red skin covered with scales that appear white or yellow. It may also be itchy and have skin flakes that stick to the hair shaft. However, seborrheic dermatitis generally results in scales that appear greasy or even moist.
Ringworm, which is actually a fungal infection, not a parasite, can also cause a red, crusty rash to form on the scalp. Unlike scalp psoriasis, this rash usually forms in the shape of a ring.
How Is Psoriasis Diagnosed
Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. Theyll also ask whether someone else in your family has psoriasis and if you recently had an illness or started taking a new medicine.
Rarely, doctors might take a skin sample to check more closely. A can tell the doctor whether its psoriasis or another condition with similar symptoms.
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What Can Trigger Psoriasis
Plenty of everyday things can act as a trigger, causing psoriasis to appear for the first time. Common psoriasis triggers include:
Skin injury, such as a cut or bad sunburn
Infection, such as strep throat
Some medications, including lithium, prednisone, and hydroxychloroquine
Weather, especially cold, dry weather
These triggers can also cause psoriasis flare-ups. Different people have different triggers. For example, periods of intense stress may trigger your psoriasis but cold weather may not.
Thats why its so important for people who have psoriasis to know what triggers their psoriasis. Avoiding triggers can reduce psoriasis flares.
Youll find common triggers and what you can do to avoid them at: Are triggers causing your psoriasis flare-ups?
If you think you have psoriasis, its important to find out. Treatment can help relieve your discomfort and lead to clearer skin. You can find out how board-certified dermatologists diagnose and treat psoriasis at: Psoriasis: Treatment.
Related AAD resources
1 Gottlieb A, Korman NJ, et al. J Am Acad Dermatol 2008 58:851-64.2 Alexis AF, Blackcloud P. J Clin Aesthet Dermatol. 2014 7:16-24.
References Alexis AF, Blackcloud P. Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthet Dermatol. 2014 7:16-24.
All content solely developed by the American Academy of Dermatology
How Do I Know If I Have Psoriasis
Rashes or patches of red, inflamed skin, often covered with loose, silver-colored scales in severe cases, the plaques will grow and merge into one another, covering large areas. Itchy, painful skin that can crack or bleed. Small areas of bleeding where the involved skin is scratched.
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Scalp Psoriasis Vs Dandruff: Whats The Difference
As we mentioned, scalp psoriasis can be confused with dandruff, and in some cases, people assume theyre actually one and the same. However, there are key differences between dandruff and scalp psoriasis. For starters, per the Mayo Clinic, dandruff is caused by a variety of factors, including sensitivity to hair care products, not shampooing enough, shampooing too often, and dry skin. Dandruff can also occur due to irritated, oily skin, and other skin conditions like eczema and psoriasis. Thats right, scalp psoriasis can lead to dandruff, but theyre still two separate skin conditions. Scalp psoriasis is the direct result of a compromised immune system, whereas dandruff can be caused by mishaps in your hair care routine and other skin conditions.
Beyond the differences in their causes, dandruff is described as the flaking skin of the scalp. It typically presents as small white flakes. With plaque psoriasis, aside from the pesky flaking of the scalp and itching, this skin condition is accompanied by thick crusted plaques, that sport a silver-white appearance and severe redness.
Common Types Of Psoriasis
This is the most common form, accounting for about 80 to 90% of cases.
Its symptoms are dry red skin lesions, known as plaques, covered in silver scales.
They normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body.
The plaques can be itchy or sore, or both. In severe cases, the skin around your joints may crack and bleed.
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What Are The Clinical Features Of Psoriasis
Psoriasis usually presents with symmetrically distributed, red, scaly plaques with well-defined edges. The scale is typically silvery white, except in skin folds where the plaques often appear shiny with a moist peeling surface. The most common sites are scalp, elbows, and knees, but any part of the skin can be involved. The plaques are usually very persistent without treatment.
Itch is mostly mild but may be severe in some patients, leading to scratching and lichenification characterised by thickened leathery skin and increased skin markings. Painful skin cracks or fissures may occur.
When psoriatic plaques clear up, they may leave brown or pale marks that can be expected to fade over several months.
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Treatment For Psoriasis On The Feet
If you think that you might have psoriasis on your feet, make an appointment with a podiatrist or a dermatologist. These experts can help determine whether psoriasis or another condition may be causing your dry, flaky, itchy feet. Clinical examination of your skin and possibly a skin biopsy will help confirm the diagnosis.
If psoriasis is determined to be the cause of your symptoms, there are several ways you and your doctor can help alleviate your discomfort. Keep in mind that it may take a while to find the right treatment.
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Is Hair Loss Permanent
In most cases, hair loss as a result of scalp psoriasis is only temporary if the condition is adequately treated.
The only reasons it possibly wouldnt grow back are if you had chronic, severe scalp psoriasis that was left untreated or you had scratched so much or you had done so much damage, you were bleeding or causing sores on your scalp and that could lead to scarring, explains Dr. Warren. If we can calm the psoriasis down, treat it and get it under control, then in most cases, we can get that hair to regrow.
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:
- 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:
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:
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What Do Scalp Psoriasis Flakes Look Like
Scalp psoriasis appears as red, itchy areas with silvery-white scales. Psoriasis in children often first appears on the scalp. You may notice flakes of dead skin in your hair or on your shoulders, especially after scratching your scalp. The scaly patches, which may bleed when removed, may extend beyond your hairline.
Do People With Psoriasis Get It On The Scalp
About 50% of people with psoriasis experience it on their scalp to some degree. Scalp psoriasis is often characterized by a dry, flaking scalp with itching, burning, or soreness. Symptoms can be milder, ranging to more severe, when it can be painful, embarrassing, and spread to the neck, forehead, and behind the ears.
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What You Can Do
Salicylic shampoos and other solutions can help with scales. Doctors can also prescribe high-potency steroids in the form of creams, gels, solutions, and foams. Creams can be greasy, so you may want to try the others on your scalp. It might help to put clobetasol foam, a corticosteroid, directly on damp skin. This is available in a prescription spray, too.
Tips For Managing Scalp Psoriasis
The following tips can help people to manage scalp psoriasis:
Seek treatment: A health professional can provide a topical ointment or oral medication that will help manage symptoms and itchiness.
Treat the scalp gently: People with this condition should avoid washing and combing the hair vigorously, as this can lead to breakage, especially if the hair is fragile due to treatment.
Avoid scratching: Scratching can lead to bleeding and possibly an infection.
Moisturize: Keeping the scalp moist will not cure psoriasis, but it may help improve the appearance of the skin.
Avoid triggers: If possible, individuals should identify their triggers for scalp psoriasis and consider things ways to limit them.
It is important to seek treatment, as this can reduce the risk of further complications, such as hair loss or cracked and bleeding skin on the scalp.
It is difficult to prevent scalp psoriasis, because the exact cause remains unclear.
However, treating the condition as soon as symptoms appear may prevent it from becoming worse.
Scalp psoriasis affects individuals differently. Some people have an occasional flare-up while others deal with the condition frequently.
If a person knows what triggers symptoms for them, they can try to avoid these factors.
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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:
Can A Diet Cure Psoriasis Naturally
- Avoiding environmental factors that trigger psoriasis, such as smoking, and stress, may help prevent or minimize flare-ups of psoriasis. Sun exposure may help in many cases of psoriasis and aggravate it in others.
- Alcohol is considered a risk factor for psoriasis, even moderate amounts of beer. People should minimize alcohol use if they have psoriasis. This is especially important if they are taking medications such as methotrexate or acitretin.
- Specific dietary restrictions or supplements other than a well-balanced and adequate diet are not important in the management of plaque psoriasis.
- Recently, some data has supported that an anti-inflammatory diet that is high in fruits and vegetables and low in saturated and trans fats may help manage psoriasis, although the value in preventing its onset is less certain.
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How To Treat Psoriasis
In order to find the most appropriate medication and therapy the particular case should be discussed with a physician as far as different types of the disease at various stages can be cured in many ways taking into account the peculiarities of the certain health grounds. When the first signs of psoriasis are diagnosed, topical treatment is applied, but if the case is neglected other options can be tried. Biologic drugs are used when there is no response to other methods.
Psoriasis on face treatment includes them also. But, the most common prescription is systemic medications administered orally or by injection. They influence the body in the whole. Nail psoriasis treatment can require additional options like steroids applied at or injected into the nail cuticle. Psoriasis elbow treatment like any other types can include biologics, systemic medications, light therapy and others methods.
There are a lot of ways to cure the disease but none of them provide the full recovery, unfortunately.
Pictures of people with psoriasis
How Do You Treat Psoriasis On Your Face
Because the skin on your face is more sensitive than other parts of your body, the treatment will most likely start out conservative. Your treatment plan will also depend on how severe your symptoms are and if you are experiencing psoriasis sores or plaques on other areas of the body.
Your healthcare provider will recommend using a quality moisturizer on your face, as dryness is a trigger for psoriasis symptoms. Other possible treatments include steroid creams, vitamin ointment, light therapy, and immune therapies.
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What Are Psoriasis Flare
One feature of psoriasis is that its recurring, often seasonally. Other times, the appearance or reappearance of your psoriasis symptoms can be unpredictable, with patterns or triggers changing over time. When your symptoms suddenly reappear or worsen, these are called flare-ups.
You may not have to suffer every time one occurs. Working with your doctor can help you make lifestyle choices to better manage flare-ups.
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Herbal And Natural Remedies
The National Psoriasis Foundation suggest that the following alternative preparations may help reduce the symptoms of psoriasis:
Apple cider vinegar: Applying organic apple cider vinegar directly to the scalp may help reduce itching. However, it can also cause irritation. To avoid this, dilute it in equal parts with water or rinse the scalp after the vinegar dries. Do not use it on open wounds.
Aloe vera: Applying gel or creams containing 0.5 percent aloe vera may help reduce redness and scaling.
Oatmeal: Adding oatmeal to a bath or applying an oatmeal paste to areas with psoriasis helps reduce symptoms in some people, although there is no research evidence to support this.
Tea tree oil shampoo: This may help relieve symptoms, although there is no scientific evidence to prove it. Try a little first, because some people have an allergic reaction to tea tree oil.
Turmeric: Consuming as a spice in food, as a supplement, or in a topical gel may help reduce symptoms or psoriatic activity.
The Office of Dietary Supplements note that turmeric is generally considered safe when taken by mouth or applied to the skin. However, people should check with a doctor before using any complementary therapies or supplements.
Capsaicin ointment: This may help reduce itching by numbing the nerve endings, but it may also cause a burning sensation. More research is needed to guarantee its safety and effectiveness.
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Natural Or Home Remedies
These DIY treatments might help reduce symptoms on your scalp and your body:
Oatmeal.Oatmeal baths arent just for eczema. Add some oatmeal to a lukewarm tub or apply oatmeal paste to help psoriasis flare-ups.
Aloe vera. Gels and creams made with aloe can be super soothing.
Dead Sea salts. Soak the itchiness away with high-quality Dead Sea salts. Pro tip: Slather on the lotion afterwards since salt can dry out your skin a bit.
Capsaicin. This ointment can help reduce itching by numbing nerve endings. But TBH, more research is needed to prove its efficacy.
Apple cider vinegar. Apply some organic apple cider vinegar directly to your scalp to reduce itching. To avoid irritation, dilute it in equal parts water and dont use it on open wounds.
Oregon grape . This product contains herbal oils, emulsifiers, and a coal-tar solution that might ease symptoms, according to a study. But theres limited research to prove its efficacy, and it doesnt have FDA approval.
Tea tree oil. Tea tree oil shampoo might relieve symptoms, but theres no science to back this. Do a patch test first since some peeps are allergic.
Turmeric. According to a research review, topical turmeric is known to reduce itch, lesion size, and pain. Some folks also dig it as a supplement. Its generally considered safe by the Office of Dietary Supplements , but you should still check with your doc before adding a supplement to your diet.