Threat to the Tresses: Scalp Psoriasis

Reviewed by Dr Jaspreet Sarna
Published: April 1, 2021
Updated: March 2, 2023

Scalp psoriasis is a condition that affects the skin and can be seen as scaly and flaky raised patches. Some areas may look like dandruff while other areas might have dry scales with a silvery sheen. The difference of scalp psoriasis vs dandruff is that dandruff could come and go but scalp psoriasis stays for a long time. It could affect the entire scalp or parts of the scalp. It would also spread to the neck, the ears and the hairline on occasions. Scalp psoriasis can at times produce itchiness, scalp pain and a burning sensation on the scalp. Though it does lead to temporary hair loss in the affected areas, psoriasis in general is not responsible for hair loss.

What Causes Scalp Psoriasis

Scalp psoriasis is an autoimmune condition that happens when the immune system ends up attacking the body instead of protecting it. This happens as the immune system sends the wrong signals and the skin cells multiply rapidly as a result. Under normal circumstances cells take weeks to form but with psoriasis cell formation happens within days. This is an unwelcome situation as the body does not have the capacity to handle the excess number of cells. The skin cells multiply on the surface of the scalp to create scaly patches.

Though it has yet to be scientifically established it is believed that there is a genetic component to scalp psoriasis. People who have close relatives with this condition are more likely to develop this condition in the future.

Also, a research report has suggested that the following categories of people have a greater possibility of developing scalp psoriasis.

People who could develop inflammatory tendencies connected with obesity.
Individuals who are dietary issues such as gluten sensitivity.
People who are going through a lot of stress have a greater possibility of having psoriasis.
Those with weakened immune systems like children and HIV positive people are also at greater risk of developing an infection.

The condition of people with scalp psoriasis is aggravated considerably by people with certain issues. Following are some scalp psoriasis causes:

Vitamin D deficiency
Addiction to alcohol
Throat or skin infections or skin injuries
Smoking
People under medication on anti-malarial drugs and iodine among other things.

What Are the Symptoms of Scalp Psoriasis?

The symptoms of scalp psoriasis can differ for all individuals. However, some common symptoms are:

Rashes or certain patches of red, inflamed skin covered with thick silver-coloured scales. A dermatologist can pronounce the verdict by looking at the rash, If the expert is uncertain a biopsy might be required.
Severe itchiness which could impact your daily life and lead to loss of sleep. It could even lead to skin infections.
It could at times cause temporary hair loss in the affected areas.
It could also produce a burning sensation or sting.

Psoriasis does not usually lead to hair loss but if the person scratches the skin it could result in bleeding and probable infection. It could spread to the ears, neck and forehead.

Home Remedies to Get Relief from Scalp Itchiness

Though there are a number of suggested home remedies for scalp psoriasis the efficacy has yet to be proven in the medical domain. The following remedies might be effective for the milder forms of psoriasis but more severe forms might require the intervention of a doctor. Let us look at some home remedies for scalp psoriasis treatment.

Aloe vera: Aloe vera has natural skin healing properties. Creams that have aloe vera are very effective in preventing flaking and inflammation and reduce redness of the scalp. The creams need to be applied at least 3 times a day for a month to realise the benefits. This is the best treatment for scalp psoriasis.
Apple cider vinegar: Dilute 1 tablespoon of apple cider vinegar with 2 tablespoons of water. Rinse the skin immediately afterwards. Do this 3 times a week and the results will be visible in a couple of weeks.
Coconut oil: Coconut oil has a lot of healthy fats. You can massage a few drops of lukewarm oil onto your scalp and wash your hair after 20 minutes. This is also the suggested way on how to get thick hair naturally.
Baking soda: This is one of the most popular treatments for an itchy scalp. Put a tablespoon of baking soda in a glass of water. Stir the mix and rinse your hair with the liquid. This will reduce the inflammation and considerably lessen the itchiness.
Turmeric: Turmeric supplements are also quite effective anti-inflammatory agents and help sooth the skin. They are quite helpful in fighting psoriasis. They can be taken orally or applied to the skin. This is a great method for scalp psoriasis natural treatment.
Garlic: The antioxidants present in garlic rejuvenate the skin and remove inflammation. Mix the crushed garlic pods with aloe vera gel and put it on the affected area. Wash it with cold water after 20 minutes.
Vitamin D: Spending some time in the sun on a daily basis may be quite helpful in absorbing the vitamin D that will help minimise some effects of scalp psoriasis. The sun helps decrease the rate of growth of the cells and helps treat your condition. Do remember to apply sunscreen before you move outdoors though.
Omega-3 fatty acids: Omega-3 fatty acid could be helpful in reducing inflammation associated with scalp psoriasis. Fish oil or flax seeds are rich in this particular ingredient.

Products to Treat Scalp Psoriasis

A number of OTC products are available which help soften the scales in the infected parts and help them peel off. Products which have salicylic acid, lactic acid, zinc pyrithione, urea or selenium sulphide are good for psoriasis problems.

Gently brush your scalp to loosen the scales.
Shampoo with a salicylic acid shampoo to wash off the scales. This is generally considered the best shampoo for psoriasis.
Apply the creams to your scalp when it is damp so that the moisture is retained.

Coal tar products are very useful in reducing itching, inflammation and scaling. They could be available as ointments, gels, shampoos and foams among other things. Massage the coal tar psoriasis shampoo into the scalp and leave it for 5 minutes before washing it off. This is a psoriasis shampoo that works very effectively against dandruff.

Hydrocortisone is very effective in reducing itching and inflammation. For a few patches a mild version works well but for a more serious bout a prescription corticosteroid will be necessary.

You can also apply intralesional steroid injections to reduce inflammation. The doses are injected directly into the affected sections.

When You Seek Medical Help

Doctors could also suggest some topical medication which need to applied directly to the skin and then shampooed and rinsed out. Some examples are:

Anthralin: This needs to be applied once a day for 10 to 30 minutes before washing it off.
Calcipotriene: This is for that additional dose of vitamin D. You can apply it at night and then wear a shower cap. Leave it on overnight and be careful not to get it into your eyes.
Calcipotriene and betamethasone dipropionate: This combines vitamin D and a strong steroid and is to be used once a day.
Tazarotene: Available as a cream, foam or gel, you can use it on cleaned, dry skin. Let it dry before you go to bed and apply a moisturiser afterwards to avoid dryness.

All the medication should be used on doctor’s recommendations only. Do not extend stronger steroids beyond the 2-week cycle without medical supervision.

On occasions your scalp psoriasis can become infected and this could cause crusting, warmth and tenderness. There is also a possibility of a swelling of the lymph nodes, in which case antibiotics might be required.

Ultraviolet Light is also used to deliver light with the help of a device directly to the scalp as part of another treatment procedure.

Depending on the severity of the infection doctors can also suggest the following medication.

Methotrexate: This is helpful in slowing down the pace of an enzyme responsible for fast cell growth.
Oral retinoids: This helps regulate the growth of cells.
Cyclosporine: This helps reduce the immune cell function and prevents the inflammation of psoriasis.
Biologics: This is a specialised medicine that targets those parts of the immune system active in causing psoriasis.

It is suggested that all medicines be taken in the manner directed. Even recommended medications can have side effects such as irritation or redness which could cause the condition to deteriorate. Using a moisturising conditioner after a medicated shampoo is the way to do it.

Scalp psoriasis can be present in different forms. It can be mild and act under the radar or it could also take the form of a severe infection. The severity could lead to loss of sleep and psoriasis hair loss too. Early detection is a possible answer as you start your initial treatment with a scalp psoriasis shampoo. Do remember to visit us at Traya for the correct solutions as we guide you and set you on your way to healthier tresses.