Scalp psoriasis is an autoimmune condition in which your immune system becomes overactive and triggers skin cell growth at a faster-than-usual pace. This causes new cells to pile up before the old ones can shed, causing rough, scaly patches on the skin. While this condition does not cause direct hairfall, scalp psoriasis symptoms such as itchiness, inflammation, and irritation can eventually lead to hairfall and thinning. 

A combination of genetic factors, environmental triggers, stress, infections, and skin injuries causes scalp psoriasis. While this primarily affects the scalp, it can also affect other parts of the body. It is often mistaken for dandruff that just refuses to go away, but there are distinct signs, such as patches of scaly skin across the scalp with a silver, purple, or brown sheen, that can help identify the condition.

Although this condition can be chronic, it is not constant and typically has flare-ups. With the right scalp psoriasis treatment and home remedies, these flare-ups can be effectively managed, and hair fall can be prevented.

In this article, we will get a better understanding of scalp psoriasis, its causes, symptoms, and treatment options. With the right awareness and knowledge, you will not only be able to identify if you are experiencing scalp psoriasis or not, but you will also know when to contact your doctor, how you can care for yourself, and even some home remedies for scalp psoriasis. 

What is scalp psoriasis?

Scalp psoriasis is an autoimmune condition that causes patches of scaly skin across the scalp. While the exact reason is still unknown, it has been found that psoriasis speeds up the skin cell regeneration cycle to 3-4 days. This causes more and more cells to get pushed to the surface before the old cells are ready to shed. The excess cells begin to form a raised, scaly layer on the skin that can appear as a rough patch with a silver sheen. Scalp psoriasis appears in patches all over the scalp and can sometimes be mistaken for dandruff because of its scaly nature.

Normally, our skin cells follow a regeneration cycle that usually lasts for about 40 to 56 days. During these weeks, new cells are generated and gradually get pushed to the surface, where they replace the outermost layer. Under this normal process, old skin cells are shed, and the new layer is revealed. In scalp psoriasis, this cycle speeds up drastically, occurring within just a few days. The old and new cells together form layers of packed cells on the surface, which gives scalp psoriasis its scaly appearance. 

Scalp psoriasis affects men and women equally. The signs can start to appear as early as 15 years of age, but can also appear later in life. Let us now take a closer look at how and why scalp psoriasis causes hair loss.

What are the symptoms of scalp psoriasis hair loss?

Scalp psoriasis by itself does not cause hair loss, but living with it can severely impact your hair. It is an instinct to scratch your head when it feels itchy, flaky, or irritated. However, this repeated friction can cause scalp inflammation, which can weaken your hair follicles, making hair more brittle and prone to breakage. 

Early signs and symptoms of scalp psoriasis 

If you think you’re undergoing this condition, here are a few scalp psoriasis symptoms to look out for:

• Plaques or patches on the scalp that have a scaly appearance. These plaques tend to have a silvery sheen but can vary in colour, ranging from red to brown or even purple, depending on your skin tone.
• Flaky skin that might look like dandruff.
• Itchy scalp.
• Scalp inflammation with some burning or pain.
• Dry skin on the scalp that is prone to cracks.

As mentioned earlier, in most cases, psoriasis affects the whole body and not just the scalp. If you notice patches or plaques on other parts of your body, such as the back of your neck or your elbows, there is a high possibility that it is psoriasis. These patches tend to be more stubborn than dry skin and don’t improve with regular moisturisers. 

What can trigger scalp psoriasis?

Scalp psoriasis occurs in phases of flare-ups followed by calmer periods. One way to control scalp psoriasis is to manage its triggers, some of which are as follows:

• Stress: One of the most common triggers of psoriasis, stress triggers the release of chemicals called neuropeptides. These can prompt skin cells to start dividing, which can further worsen inflammation. The experience of psoriasis can be stressful in itself; however, it is important to remember that managing your stress can help prevent flare-ups. Try meditation, deep breathing or taking a walk to help keep your stress levels down. 
• Medications: Antimalarial drugs, beta-blockers, and certain targeted therapies may cause a scalp psoriasis flare-up. 
• Tobacco and alcohol: Both smoking and drinking alcohol can increase inflammation and cause oxidative stress. If you are already prone to psoriasis, these habits can trigger a flare-up. Cutting these out of your life could make a big difference in keeping scalp psoriasis under control.
• Infections and injuries: These can activate the immune system, which in turn can cause a psoriasis flare-up. While this is not something you can always avoid, you can try to stay healthy and safe as best you can.
• Cold weather: Lower humidity can dry skin and trigger a psoriasis flare-up. Lower sunlight during the winter months can also cause a vitamin D deficiency, which can lead to skin irritation.
• Diet: Certain foods can trigger an allergic reaction, which can also cause a psoriasis flare-up. Identifying and eliminating these foods from your diet can help keep things under control. You can talk to your doctor about getting checked for allergies so you know exactly what to avoid.

Scalp psoriasis treatment: Everything you should know

Once your doctor has confirmed a diagnosis of scalp psoriasis, they can plan a course of action to manage the condition and help reverse hair loss. Here are some scalp psoriasis treatment options to treat your scalp and control the autoimmune disease:

• Topical creams: Several creams can help soothe scalp itchiness and reduce some patches. Some of these topical creams may contain steroids, which your doctor can prescribe if necessary.
• Medicated shampoo: Your doctor might recommend a shampoo to control scalp psoriasis symptoms. The active ingredients in these shampoos are either salicylic acid, which helps remove the patches, or tar, which slows cell growth.
• Light therapy, also called phototherapy, uses ultraviolet light to treat scalp psoriasis. The UV light slows down cell division and prevents the buildup of psoriasis plaques. 
• Oral medication: Oral systemic treatments target the immune system and prevent it from triggering psoriasis.
• Injectables: Certain medications, including biosimilars and biologics, are administered by injection. These drugs also work by modulating the immune system to prevent it from causing psoriasis.  

Home remedies for scalp psoriasis 

Aside from the treatment plans mentioned above, you can also follow some home remedies for scalp psoriasis that can prevent hair loss:

• Be gentle with your scalp. When shampooing your hair, massage your scalp gently with your fingertips to avoid irritating the skin. Also, try to avoid scratching your head as this can cause brittle hair to break. 
• Always use a conditioner when you wash your hair. The medicated shampoos used to treat scalp psoriasis can often have a drying effect on the scalp and hair. To prevent further drying and breakage, use a conditioner after every wash. You might need to experiment with different brands to find a conditioner that keeps your hair moisturised without irritating your scalp.
• Don’t blow-dry your hair. The heat from a blow dryer can irritate the scalp and increase hair breakage. You can gently towel-dry your hair or let it air-dry while detangling your strands with your fingers. Don’t wipe your scalp with the towel, as this rubbing action could cause hair to come loose.
• Keep your head protected when going out in the sun. Sunburn can worsen scalp inflammation, making it more painful and leading to increased hair loss. Wearing a loose hat or using an umbrella to shade yourself can help prevent sunburn.
• Patch-test all new hair products before you start using them. To do a patch test, apply a small amount of the product to a small section of your scalp and wait for at least a few hours. If you don’t have a reaction to the product, it is safe to use on the rest of your head. Do, however, wait for up to 2 days before actually using the product, as the allergic response can sometimes be delayed. 
• Use a soft-bristle brush on your hair and avoid applying too much pressure to your scalp. You can gently brush your hair out to style and detangle it, then use the brush on your scalp to remove some of the scaly skin. 
• Use a hair growth supplement to support stronger and healthier hair that does not break or fall easily. You can try Traya’s Ultimate Hair supplements combo for complete hair nutrition.

Psoriasis might be a lifelong condition, but it does not have to affect your quality of life. More often than not, psoriasis involves occasional flare-ups that can be managed with the right treatments. 

Frequently Asked Questions

1. Is hair loss from scalp psoriasis permanent?

No, hair loss from scalp psoriasis is not permanent if treated early. As long as you take good care of your hair and avoid scratching or harsh treatments that can affect your scalp, you can considerably reduce hair fall. When there is no flare-up, hair should grow normally.

2. How long after I start treatment for scalp psoriasis will my hair start to grow back?

With the right treatment, it should take about 3 to 6 months for your hair to grow back after hair loss from scalp psoriasis. 

3. Can I prevent scalp psoriasis?

While it is not possible to prevent psoriasis completely, you can control the flare-ups by avoiding your triggers. Learning what triggers your psoriasis flare-ups and avoiding them can make flare-ups fewer and further apart, and less bothersome.

4. Does scalp psoriasis treatment cause hair loss?

Yes, in some cases, the medication used to treat psoriasis can cause hair loss. If you notice your hair loss increases while using the treatment, you can talk to your doctor about changing the dose or switching to a different treatment.

5. How often can I wash my hair if I have scalp psoriasis?

If you are using a medicated shampoo, wash your hair according to your doctor’s instructions. You may need to use it daily or every other day for the best results. Your doctor might also advise using a medicated shampoo on some days and a regular one on others. 

References:

1. https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-hair-loss
2. https://www.psoriasis.org/about-psoriasis/#causes-triggers 
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC12185110/
4. https://www.psoriasis.org/scalp/#prevention
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC5774610/
6. https://www.psoriasis.org/life-with-psoriasis/#:~:text=People%20with%20psoriasis%20are%20at,Get%20outside%20help. 
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC5829341/#:~:text=Stress%20is%20one%20of%20the%20best%2Dknown%20triggers%20for%20psoriasis,with%20psoriasis%2C%20Singh%20et%20al. 
8. https://www.psoriasis.org/scalp/#diagnosis
9. https://www.psoriasis.org/advance/smoking-and-psoriasis/#:~:text=Why%20this%20unhealthy%20habit%20can,American%20Lung%20Association%20(ALA).

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