Understanding Scalp Psoriasis

In mild cases, scalp psoriasis may be almost invisible or entirely unnoticeable. However, in severe cases, individuals experience intense physical discomfort due to an itchy, inflamed scalp with raised patches and scaly buildup that sheds like dandruff, often leading to emotional distress and self-consciousness.

Around 7.5 million Americans are affected by psoriasis, with about half experiencing scalp psoriasis at some stage [source: National Psoriasis Foundation]. Psoriasis is a lifelong condition, marked by recurring flare-ups and periods of reduced symptoms or remission.

Psoriasis, a non-contagious immune system disorder, occurs when T cells (T lymphocytes) mistakenly attack healthy skin cells instead of defending against harmful bacteria or viruses. This accelerates the skin cell growth cycle, reducing the time it takes for new cells to reach the surface from weeks to just days. This rapid process results in thick, scaly patches forming on the skin [source: Mayo Clinic].

Psoriasis manifests in various forms, with plaque psoriasis being the most prevalent. This type is characterized by red lesions and silvery scales. Scalp psoriasis, a subtype of plaque psoriasis, can appear as a single patch, multiple patches, or cover the entire scalp. It may also extend to the forehead, neck, or behind the ears.

Scalp psoriasis lesions can range from barely noticeable to severely inflamed and swollen. The silvery-white scales resemble dandruff, and symptoms may include burning, temporary hair loss, dry scalp, and itching. Not all symptoms occur in every case, and hair loss is typically temporary, often caused by excessive scratching or harsh scale removal [source: American Academy of Dermatology].

While scalp psoriasis can be distressing, treatments are available to slow rapid cell growth, eliminate scales, and address plaques. This article explores the disorder's causes and discusses both medical and home-based treatment options.

Causes of Scalp Psoriasis

The exact cause of psoriasis remains unknown, but genetics are thought to be a significant factor. About one-third of individuals with psoriasis have a family member who also suffers from the condition. Other contributing factors include obesity, medical issues like HIV or frequent infections such as strep throat, smoking, and high stress levels [source: Mayo Clinic].

Environmental influences also contribute to psoriasis. Many patients report that specific triggers can cause flare-ups or exacerbate existing symptoms. Common triggers include infections, skin injuries like cuts or sunburns, cold climates, alcohol intake, stress, and certain medications [source: Mayo Clinic].

Living with psoriasis can range from a minor inconvenience to a major disruption of daily activities. The psychological impact is significant, particularly when the condition is visible, as with scalp psoriasis. Many individuals experience depression, anxiety, and stress, often leading to social withdrawal due to the stigma associated with the condition.

The following sections outline various effective treatments for managing scalp psoriasis. While some individuals find relief with over-the-counter solutions, others may require prescription-based therapies. Continue reading to explore these options in detail.

Scalp Psoriasis Treatments

While scalp psoriasis has no cure, its symptoms can be effectively managed. Treatment often starts with topical medications. For instance, Anthralin is applied to the scalp, left briefly, and then rinsed off. Common side effects include skin irritation and staining, which can affect more than just the skin. Psoriatec, a 1 percent anthralin cream, is known to reduce staining [source: National Psoriasis Foundation].

Vitamin A and D derivatives are also effective for treating scalp psoriasis. Calcipotriene (Dovonex), derived from vitamin D, is used overnight with a shower cap or plastic wrap. Tazarotene (Tazorac), a vitamin A derivative, comes in gel or cream form and is applied before sleeping. Topical steroids, or corticosteroids, are another option, available in gels, foams, and lotions of varying strengths [source: National Psoriasis Foundation].

For psoriasis affecting both the scalp and other body areas, oral or injectable medications may be prescribed. Options include cyclosporine, methotrexate, corticosteroids, oral retinoids, or vitamin D derivatives. Biologics, or immunomodulators, are reserved for severe cases and work by disrupting immune cell communication. Examples include alefacept, efalizumab, etanercept, infliximab, and ustekinumab [sources: American Academy of Dermatology and Mayo Clinic].

In September 2009, the FDA approved Stelara, an injectable medication for moderate to severe plaque psoriasis. Stelara targets proteins responsible for excessive skin cell production and reduces inflammation. It requires injections every 12 weeks after initial doses, offering a less frequent treatment schedule compared to other injectables. However, it carries risks such as increased susceptibility to serious infections and a potential higher cancer risk [source: Hitti].

Some individuals with scalp psoriasis may never require prescription medications. Discover effective at-home treatment options in the following sections.

Home Remedies for Scalp Psoriasis

Those with mild to moderate scalp psoriasis may find relief using over-the-counter products or home-based solutions.

Salicylic acid, commonly found in soaps and shampoos, is often used to soften scales, making them easier to remove. However, it may weaken hair shafts, leading to potential breakage or temporary hair loss.

Heated olive oil can also help soften scales. Apply it to the scalp, then wrap your head in a towel for several hours or use a hair dryer. Other over-the-counter options for softening scales include products containing urea, lactic acid, or phenol.

Tar-based products, primarily coal tar and occasionally wood tar, are effective for treating scalp psoriasis. Available in various forms, such as shampoos, these products can have a strong odor and may stain bedding, clothing, or light-colored hair. Apply tar products to the scalp, leave them on for a specified time, and rinse off. Using a non-medicated conditioner afterward can help reduce the tar smell [source: National Psoriasis Foundation].

Phototherapy, whether administered at home or by a professional using tools like an excimer laser, is another effective treatment for scalp psoriasis. Natural sunlight or handheld UV combs can also deliver light therapy. The National Psoriasis Foundation's website offers a database to help find the most effective treatments for the scalp or other areas [source: National Psoriasis Foundation].

Whether you opt for prescription medications, over-the-counter products, or home remedies, the National Psoriasis Foundation advises that if the treatment feels more burdensome than the condition itself, it may be too harsh, and adjustments to your treatment plan should be considered [source: National Psoriasis Foundation].