Scalp psoriasis is a serious issue to sufferers of psoriasis.
Scalp psoriasis can be found in up to half of all psoriasis sufferers. The condition can range anywhere from a fine dandruff-like flaking of the skin on the scalp to severe plaques the cover much of the scalp and extend into the areas of the face, ears and neck.
The constant flaking and peeling of the skin on the scalp makes wearing dark clothing very difficult as the flakes rain on the shoulders and give an unsightly appearance akin to dandruff.
A common concern among patients is that either the scalp psoriasis itself or the effects of constant scratching will precipitate hair loss.
This is an understandable but unfounded concern; hair loss is not an outcome of this disease.
This condition is typically diagnosed by visual inspection from a physician or dermatologist.
In some instances where the visual evidence for psoriasis is scant, a skin biopsy may be performed.
Treating this condition is fundamentally similar to body-wide psoriasis treatment. However, given the distinct location of scalp psoriasis, a few special treatment options exist.
There are several medicated shampoos, oils, foams and liquids to help treat scalp psoriasis. A common ingredient found in shampoos for this application is salicylic acid. This common over-the-counter medication is often used to treat acne. It is thought to encourage skin sloughing and thus may help to reduce plaque severity and smooth out the skin. Some common side effects include reddening, itchiness and skin irritation.
Another treatment option for scalp psoriasis is coal tar. This is perhaps the oldest treatment for this condition. Coal tar stains things easily and smells quite profoundly. As such, its use is typically short-term.
Phototherapy (light therapy) is also available to sufferers of this disease. However, some dermatologists find this treatment too cumbersome as it requires the use of special comb-like attachments and a subsequent need to continually inspect the scalp for cancerous formations, which, owing to the hair, is time-consuming and difficult.
Interestingly, an off-label application of the anti-fungal drug ketoconazole is to take it during acute flare-ups of this condition. Apparently it is quite effective! It is important to experiment with as many different treatment options as possible, starting with the least invasive and least toxic.
Other therapies include everything from intense systemic treatments to modulation of psoriasis diet factors, exercise and stress management. Since scalp psoriasis is fundamentally still psoriasis, it is important to adopt lifestyle changes that augment the body’s ability to heal itself.