How Psoriasis And Psoriatic Arthritis Affect The Scalp
For many patients, the scalp is the only part of the body where psoriasis occurs or its the first location where the autoimmune disease develops.
Research shows that at least a quarter of people with plaque psoriasis, the most common type of psoriasis, initially present with lesions on the scalp.
Its very common for psoriasis to affect the scalp statistics show a range of 40 percent to 80 percent of people with psoriasis have scalp involvement, says Mount Kisco, New York, dermatologist David Bank, MD, who is also an assistant clinical professor of dermatology at Columbia Presbyterian Medical Center in New York City. It may occur in isolation or with psoriasis in other areas.
Scalp psoriasis can run the gamut from mild to severe .
Sometimes, in addition to the scalp, plaques also cover nearby areas such as the forehead, back of the neck, and the skin around the ears.
How Do Health Care Professionals Diagnose Scalp Psoriasis
The fact that the scalp is a hair-bearing area in most people produces challenges in diagnosis as well as treatment. If scaling plaques are present on portions of the body in a distribution characteristic of psoriasis, then the diagnosis of the scalp disease is much easier to make.
The most important consideration in treating scalp psoriasis is getting an effective medication into the skin. Both the hair and any scale covering the disease act as an impediment to treatment. Removal of the scale in a nontraumatic fashion is very important. This can be accomplished by shampooing frequently. Using tar, selenium, or salicylic acid-containing shampoos can be helpful. This may have to be done at least twice a day initially if the scale is sufficiently thick. Gently rubbing off the scale with the fingertips and not the nails is important.
Chemical Scalp Psoriasis Treatments
If youre looking for an over-the-counter fix to control your scalp psoriasis, you can always opt for shampoos containing salicylic acid . Generally, the salicylic acid in the shampoo will help slow down the growth of skin cells, reduce inflammation, and remove dead skin from psoriatic plaques. Although chemical shampoos are effective, they may contain sulfates, which can make your hair very dry. So, youll need to use a very moisturizing conditioner after using the salicylic acid shampoo.
For a more severe chemical scalp psoriasis treatment, you can use topical steroids. However, a dermatologist must prescribe these high-potency steroids, which can be in the form of cream, gel, or solution. From experience, topical corticosteroids worked well for me, but I stopped using it because the side effect of it possibly absorbing into my bloodstream was unsettling. So make sure you discuss all potential side effects with your dermatologist before using this treatment.
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Pro Strategies For Managing Scalp Psoriasis
Scalp psoriasis is a common form of psoriasis, affecting between 45 percent and 56 percent of those in the U.S. living with the disease. Aside from causing uncomfortable symptoms including raised, scaly patches, flaking, and itching scalp psoriasis can spread to other areas of the head, neck, and ears, causing it to be particularly noticeable.
Psound Bytes, the National Psoriasis Foundations podcast, recently invited Tirsa Quartullo to discuss scalp psoriasis. Quartullo, a board-certified family nurse practitioner with Arizona Dermatology and Cosmetic Surgery, weighed in on over-the-counter treatments and tips for managing scalp psoriasis.
Can Scalp Psoriasis Cause Hair Loss
Some people with scalp psoriasis may experience hair loss. This is usually due to the inflammation and irritation caused by the condition, which can lead to hair follicles becoming damaged and stunted.
However, it’s important to note that not everyone who has scalp psoriasis will lose their hair. In fact, most people only have a mild form of the disease that doesn’t cause any noticeable hair loss.
If you are experiencing significant hair loss as a result of scalp psoriasis, speak to your doctor about possible treatment options. There are many different treatments available for both scalp psoriasis and hair loss, so there is no need to suffer in silence.
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Coconut Or Avocado Oil
Coconuts and avocadoes are filled with healthy fats that boost skin health. Massage a few drops of either type of oil, cool or lightly heated, onto your scalp and put on a shower cap. Wait 20 minutes, remove the cap, then wash your hair as usual. This can reduce and remove some of the scaling associated with the condition.
What Is The Treatment
There are many treatment options that can help scalp psoriasis and often a combination approach using a number of different treatments may be required until the symptoms have settled. It is important to remember to continue to treat the scalp even if hair falls out. Hair usually grows back once the inflammation and scale has cleared.
Treatments can be time-consuming and you may find them easier if you ask someone to help you. It is important to choose one that suits your lifestyle carrying out intensive treatments over the weekend, for example, when you have more free time. Psoriasis is not curable, but the signs and symptoms can be well controlled.
It can take at least eight weeks until you gain adequate control of the plaques, whichever treatment you use. Remember to try to treat psoriasis daily when it is active.
If, however, you have seen no improvement after 4 weeks continuous treatment, you should return to your doctor or nurse for further assessment.
Once you have achieved clearance, it is important to maintain the improvement. This can usually be done with regular use of a tar shampoo and or by moisturising the scalp occasionally with an oil or emollient. Some people find daily treatment of the scalp an advantage in keeping the scales from returning, but this would be a personal reference depending on your circumstances. If you have no success in controlling your scalp psoriasis, ask your GP to refer you to a specialist.
Vitamin D analogues
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Symptom: Red And White Patches
The most common form of the disease is plaque psoriasis. It looks like areas of thick, swollen, red patches with well-defined edges. On top of these areas are the silvery-white scales. It’s easy to knock them off and cause bleeding, so be gentle with yourself when you comb your hair, shampoo, or put on and take off hats.
Systemic Treatments And Biologics
Patients who have troublesome scalp psoriasis that does not respond to scalp-targeted medications might consider the wide range of treatments that work on the entire body: the pills, injections, and infusions typically used for moderate to severe plaque psoriasis.
Most of the biologics have clinical data demonstrating their effectiveness in treating psoriasis of the scalp, and the others have extensive anecdotal evidence of effectiveness. Many of the latest biologics, in fact, have been able in clinical trials to obtain total resolution of scalp lesions for many psoriasis patients over a period of weeks or months. Read more about biologics for treating psoriasis.
Other systemic treatments can also improve scalp psoriasis. Data from a clinical trial of the PDE4-inhibitor pill Otezla show it improved scalp psoriasis for almost half of patients after four months.
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Dont Be Afraid To Speak Up About Symptoms And Treatment Options
Inform your doctor know immediately if you notice plaques in your scalp. Ignoring these symptoms could worsen the disease and increase the risk of hair loss. You may also want to talk with your doctor about systemic drugs, which target the entire body including the scalp, without having to apply topical treatments directly.
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Safety And Side Effects
Keep in mind that these products wont cure scalp psoriasis, but they may help manage flare-ups.
If your condition worsens, its best that you check in with your doctor. Some cases of scalp psoriasis are more severe and may require prescription shampoos.
As with any new product, be sure to do a patch test before using a scalp psoriasis shampoo over your whole head. To do a patch test, put some product on the inside of your wrist and wait 24 hours. Keep an eye out for any signs of irritation.
Coal tar might not be safe to use during pregnancy or on infants, so its always best to talk with your doctor first.
Using some of these shampoos alone can be drying to your hair because coal tar and salicylic acid strip away oils. Find a good conditioner and make sure that youre keeping your hair and scalp moisturized.
Kenkoderm, Head & Shoulders, and Vanicream have conditioners that pair with their respective shampoos. As for other shampoos, you can pair them with moisturizing or intensive care conditioners.
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Natural Scalp Psoriasis Treatments
Like many other conditions, natural remedies can be used in treating scalp psoriasis at home.
Essential oils such as tea tree oil or peppermint oil are antibacterial, antifungal and anti-inflammatory. Adding a few drops in your oil mix and applying it directly on your scalp can help soothe the itchiness caused by scalp psoriasis. Not to mention, that minty feeling on your scalp feels amazing! For a bonus tip, you can also add drops of tea tree oil or peppermint oil to your shampoo or use shampoos that have these oils as their main ingredients.
Did you know that apple cider vinegar contains antiseptic and disinfective properties? Well, this is why ACV is a great natural scalp psoriasis treatment that can help reduce itchiness and soreness caused by scalp psoriasis. When using ACV to treat your psoriasis, dont apply it directly on your scalp because it might burn, especially if the affected area is already an open wound. So, always mix it with some water to cut out the sting. A great way to implement ACV in your hair-care routine is by using it as a rinse after shampooing and before applying your conditioner.
Coconut Oil To Loosen Psoriasis Scales
While it may be a good add-on to your psoriasis treatment plan, coconut oil isnât a stand-alone solution.
For psoriasis medications like steroids to work well, itâs best to soften the hard scales so the meds can get to the skin below. Coconut oil can help soften and loosen the scales first.
Scalp psoriasis tends to have the hardest scales because your hair traps them in place and theyâre not easy to see or treat. They can get bigger and tougher over time. Hereâs how to use coconut oil to help with the scales on your scalp:
- Spread the oil over your scalp, focusing on scaly areas.
- Gently massage the oil into the scales.
- Wrap your scalp in a towel or shower cap.
- Leave it on for 30 to 60 minutes, or overnight.
- Wash your hair and scalp with normal, anti-dandruff, or tar shampoo and leave on for five minutes.
After treating with VCO, it should be easier to loosen and remove some scales gently. Do it while your scalp is still damp and the scales are the softest and loose. Then:
- Put a plastic comb flat against the scale and gently rub it in a circle.
- As the scale loosens, try to comb it out of your hair.
- Wash your hair to remove any leftover scales.
Donât pull too hard or too quickly. Doing so can hurt your skin, cause bleeding, or make you lose hair. After youâve taken the scaly layer off, apply your prescription treatment.
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Whats The Best Treatment For Wet Dandruff
The best treatment for wet dandruff depends on the cause. However, since the condition occurs due to oil buildup on the scalp, treatment generally includes more frequent washing of your hair with mild shampoos and taking a break from styling products. If your wet dandruff is tied to a skin disorder, you should visit your doctor to get the best treatment for your condition.
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How To Treat Scalp Psoriasis At Home
Its important to note that home remedies can help ease symptoms but theyre not proven cures. The following home treatments are generally safe and may help you reduce the symptoms of mild to moderate scalp psoriasis. Those with more aggressive forms of the condition should consult a doctor before starting home treatment.
What Are The Common Symptoms Of Scalp Psoriasis
Before we move on to finding solutions on how to cure psoriasis, letâs look at the symptoms of scalp psoriasis.
â¢ Hair loss â¢ Scaly, red, bumpy patches â¢ Silvery-white scales
Looks familiar right? You wonât be faulted to think of the symptoms of psoriasis to be similar to dandruff, since flaking, itching and dry scalp occur in both conditions. However, in psoriasis, these symptoms are not just limited to the scalp it can affect other parts of the body as well.
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Try A Parting Of The Ways
When applying a product, part your hair to expose your scalp so you can target plaques directly, says Fran Klapow, a hairstylist from Long Island, New York, who has scalp psoriasis. Repeat this sectioning piece by piece so you can treat your scalp without getting the gooey stuff all over your hair.
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.
What Else Is There To Know About Scalp Psoriasis
Scalp psoriasis can really disrupt someone’s life and overall well-being. While you might think it’s solely a condition that affects the skin, in some cases, psoriatic arthritis can occur especially if the psoriasis is left untreated. According to the National Psoriasis Foundation, out of the 8 million people with psoriasis, approximately one-third of them will develop psoriatic arthritis, affecting the joints and the tendons. Having psoriasis doesn’t guarantee a psoriatic arthritis diagnosis, but, unfortunately, the risk is higher. If you’re concerned, visit a rheumatologist to screen for the condition and catch it early if you can.
Keeping the scalp soothed and calm is integral to a healthy head of hair. Whether you’re dealing with scalp psoriasis or not, steering clear of astringent chemicals and highly perfumed products is the way forward. Invest in a hair wellness system that takes a gentle, natural and effective approach to maintain your mane and keep your crowning glory glossy and happy.
Treatment You Receive At A Dermatologists Office Or Clinic
If the psoriasis fails to clear with treatment applied to the scalp or you have thick psoriasis on your scalp, your dermatologist may recommend the following.
Injections of corticosteroids: Your dermatologist can inject a corticosteroid directly into the scalp psoriasis. While this can be effective, its use is limited to a few times.
Excimer laser and other light treatments: This laser can treat psoriasis in difficult-to-treat areas like the scalp, feet, and hands. When used to treat the scalp, your dermatologist may use a device that looks like a blow dryer. A benefit of using this to treat scalp psoriasis is that this laser treats only the areas that need it.
The drawback to this treatment is that you will need to travel to your dermatologists office or a psoriasis clinic two or three times per week. Each treatment session takes about 10 minutes. Most patients need to continue these visits for several weeks. If your schedule wont permit this, be sure to tell your dermatologist.
While getting these treatments, you may also need to use another treatment at home.
Excimer laser treatment is usually painless, but possible side effects include redness and sunburn-like pain.
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What Causes Scalp Psoriasis
Scalp and other forms of psoriasis occur when the immune system doesnt work properly. Skin cells grow too quickly, growing within days rather than weeks. The body cant shed these skin cells quickly enough to match the new growth. They pile up on the skins surface, causing psoriasis.
People with family members who have scalp psoriasis are more likely to have the condition themselves. Those with HIV, stress, obesity, and those who smoke are also more likely than others to have this condition.
Common triggers that set off or worsen flare-ups of scalp psoriasis include:
- infections, including strep throat or skin infections
- skin injuries, such as cuts, scrapes, insect bites, or severe sunburn
Article Summary: Scalp Psoriasis Is Highly Bothersome And Hair Makes It Harder To Treat But There Are A Number Of Prescription Treatments In A Variety Of Formats Including Sprays Foams Gels And Shampoos To Help Treat The Scalp Effectively As Well As Treatments For The Whole Body That Have Demonstrated Strong Success In Treating Scalp Psoriasis
Psoriasis of the scalp is very common. Nearly 80% of psoriasis patients develop plaques on the scalp at some point in their life with psoriasis.
Scalp psoriasis is especially distressing to many patients. It can be extremely itchy, and when psoriasis extends beyond the hairline onto the face and around the ears or down the back of the neck, it is highly visible. In some cases, it can also cause temporary loss of hair in places where the psoriasis patches are thick on the scalp. Add to this the difficulty in applying medicine only to psoriasis patches, often covered by hair, without also treating the healthy skin and its not surprising that patients are eager for effective treatments.
Fortunately, there are a variety of medications that when applied directly to scalp psoriasis, are able to reduce or resolve it for a period of time and many of the newest psoriasis treatments, designed to treat psoriasis all over the body, have demonstrated excellent clearance of scalp psoriasis as well. Over-the-counter products can play an important supporting role.
Our message for those suffering with the frustration, itch, and pain of scalp psoriasis is: dont lose hope, as there are options available today that will likely provide you substantial relief from your scalp psoriasis.
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