Thursday, August 11, 2022

I Have Psoriasis On My Scalp

What Are The Common Signs Of Scalp Problems

ASK UNMC! I have psoriasis on my scalp. What can I do to alleviate the flaking?

Most scalp conditions result in dry, oily, or flaky skin, as seen with dandruff, and might lead to hair loss or skin rash. In addition, any abnormality like a bump followed by pain tingling, itchiness, numbness, bruising, pain, and swelling can be a symptom of a scalp issue.

Because these symptoms are common among various scalp conditions, specific causes are difficult to pinpoint. However, the most common causes for various scalp issues are a buildup of cosmetic products on the scalp, infrequent cleaning, increased stress, and certain climate or environmental factors.

What Is Scalp Psoriasis When Can Scalp Psoriasis Begin

Psoriasis is an inflammatory disease of the skin that is estimated to affect about 2.2% of the adult population. In children, the onset of psoriasis can be before the age of one year but peaks around 5-8 years. Psoriasis produces scaly, itchingbumps on the skin. Some people may have a genetic predisposition to psoriasis. The genes affected seem to be involved with control of the immune system. Psoriasis appears as red scaling, slightly raised bumps that merge to form plaques. Psoriasis classically appears on the elbows and knees, but it can affect any part of the skin. The scalp is also characteristically affected in many people. Like psoriasis anywhere on the body, scalp plaques produce excess scale and can itch. Severe disease can cause a loss of scalp hair, which usually will return if the disease can be controlled. Scalp psoriasis somewhat difficult to treat when the scalp is covered with hair sufficient to act a barrier to the application of topical medications.

What Factors Trigger Psoriasis

Certain factors may trigger or aggravate psoriasis symptoms. It is preferable to identify these factors so that they can be avoided to the greatest extent possible.

These precipitating factors include:

  • Topical calcineurin inhibitors :
  • The U.S. Food and Drug Administration has not approved them for psoriasis, and they have not been proven effective for plaque psoriasis, but they may be used off label for psoriasis that affects the face and intertriginous areas, where they may be effective and allow people to avoid chronic corticosteroid use.
  • Although no definitive cause and effect relationship has been established, the FDA issued a warning about a possible link between these medications and cases of lymphoma and skin cancer in children and adults.
  • It is known to be beneficial and is used in the treatment of moderate-to-severe psoriasis or severe psoriasis.
  • Natural sunlight , ultraviolet B radiation, and psoralen plus ultraviolet A radiation are more common options.
  • Treatment with a high-energy excimer laser is effective and safe for treating localized psoriasis while requiring fewer office visits and sparing uninvolved skin.
  • To improve efficacy, phototherapy can be combined with other treatments.
  • Phototherapy may increase the risk of skin cancer.
  • Systemic therapy:
  • People with moderate-to-severe, severe or treatment-resistant psoriasis, as well as those with psoriatic arthritis, may require this treatment.
  • Nonsteroidal anti-inflammatory drugs :
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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.

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    Foods Containing Refined Carbohydrates

    Is this scalp psoriasis : Psoriasis

    Refined carbohydrates are highly processed . Theyve been stripped of fiber and whole grains and tend to contain a lot of sugar, which can cause your blood sugar to spike. Refined carbohydrates also increase advanced glycation end products, which are substances in your blood that can lead to inflammation.

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    How Can You Measure Inflammation In The Body

    While certain foods are known to cause inflammation, not everyone reacts the same way to these foods. Ive had some patients who felt that wheat was making their psoriasis worse. Another patient noticed more flare-ups when she ate nuts, says Wesdock.

    Some tests can measure inflammation with biomarkers, which are substances in your blood that spike when your body reacts a certain way to foods such as fats or sugar. For example, a simple test can check for increased levels of C-reactive protein in your blood. The liver makes extra CRP if theres inflammation in your body. Doctors might use this test to determine how likely you are to develop a chronic condition like heart disease.

    As you adjust your diet to ease psoriasis symptoms, be sure to work with your psoriasis doctor to monitor symptoms and inflammation levels.

    How Common Is Scalp Psoriasis

    It is common and approximately half of all people with psoriasis also have it on their scalp. The reason it deserves special mention is that it can be more difficult to treat and usually requires specifically formulated treatments.

    Psoriasis on the scalp forms in the same way as on other parts of the body but the hair traps the scale and so it does not rub away as it would, for instance, on the elbow. The result is that the scale can quickly build up, causing a thicker plaque which becomes more difficult to treat . This difficulty is compounded by the hair, which acts as a physical barrier obstructing the easy application of creams and ointments to the affected skin. Children can get scalp psoriasis too. Treatments will be much the same as those used for adults. On rare occasions, scalp psoriasis has been known to disappear spontaneously, but it can remain on the scalp for lengthy periods of time too.

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    Be Aware Of Itching Or Burning Sensations

    Another common symptom of scalp psoriasis is an itching or burning sensation around the affected areas. This can be a result of skin cracking or flaking. Whatever you do, don’t scratch at your scalp if you feel these sensations. Doing so could irritate your condition further and lead to complications down the line. In addition, it could cause additional scalp soreness or pain.

    What Is The Difference Between Scalp Eczema And Scalp Psoriasis

    Watch me treat my scalp psoriasis at home (…again)

    Scalp eczema and scalp psoriasis can look very similar. Theyre both inflammatory skin conditions. Scalp psoriasis typically has well-defined plaques, while scalp eczema is much itchier, even before you see the rash.

    Your healthcare provider can tell the difference between scalp eczema and scalp psoriasis during an examination.

    A note from Cleveland Clinic

    Scalp psoriasis is an autoimmune condition that causes thick patches of skin to develop on your scalp or the skin around your scalp. You may feel self-conscious, and it can be unpleasant if its itchy or painful. However, it isnt contagious, and treatments can help your symptoms improve. Its important to pay attention to your skin, including your scalp. Contact your healthcare provider as soon as you notice any plaques developing on your scalp.

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    How Is Scalp Psoriasis Treated

    Some shampootreatments can be bought over the counter, however, if your scalp is coveredwith thick scale or doesnt clear up, do consult your GP. There is a wide rangeof topical treatments that can beprescribed including coal tar, dithranol, salicylic acid, steroid creams andointments, Vitamin D based treatments, as well asoils for moisturising the scalp, such as coconut oil. Various scalp treatments are available in cream, ointment,mousse, gel or shampoo formulations. If your scalp psoriasis is particularly difficult to treat, yourGP may refer you to a Dermatologist, Dermatology Nurse Specialist, or GP with aSpecial Interest in skin.

    Topical Steroids Reduce Psoriasis Inflammation

    Best for: Mild to moderate psoriasis

    Why it works: Topical steroids work by reducing the inflammation thats driving the skin changes seen in psoriasis, Daveluy says. This type of treatment for scalp psoriasis is likely to be a liquid instead of a cream. When your hair is wet, create a part and apply a small amount. Then create a new part right next to it, and apply again, and keep doing this until your whole scalp has been treated, he says. A shower cap may also be worn to keep the product from staining pillowcases.

    Topical steroids can be bought or prescribed at different strengths, depending on your symptoms. Some people may also need steroid injections for short-term treatments.

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    Moderate To Severe Psoriasis Treatments

    Your doctor may prescribe steroids, lotions, solutions, sprays, or foams to treat moderate to severe scalp psoriasis. Some topical treatments are applied directly to the skin, then shampooed and rinsed out, including:

    • Anthralin . Apply this cream once a day for 10 to 30 minutes.
    • Calcipotriene . This is a prescription form of vitamin D. Apply it at night and cover your scalp with a shower cap. Leave it on overnight. Don’t get it in your eyes.
    • Calcipotriene and betamethasone dipropionate . This is a combination of a type of vitamin D and a strong steroid in a suspension or ointment. You use it once a day. Don’t get it in your eyes.
    • Tazarotene . This vitamin A treatment comes in a cream, foam, or gel form. If using it at night, put it on clean, dry skin, and let the medication dry before you go to sleep. Applying a moisturizer after the medication may help prevent drying.

    Follow your doctor’s directions for all medications. Don’t use stronger steroids for more than a 2-week cycle without your doctor giving you the OK.

    Do Use Natural Products

    Psoriasis of the scalp

    The best natural products for your hair and scalp are usually the ingredients you can also ingest. As a child, I remember my grandmother using apple cider vinegar to grease my scalp, as it can help with infections and scaling. Other scalp-friendly products include olive oil, coconut oil, and avocado.

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    Foods That Contain Gluten

    Research suggests that people with psoriasis tend to have higher rates of celiac disease. In people with celiac disease, gluten triggers an autoimmune response that causes the body to attack tissues in the small intestine. People with celiac disease need to avoid gluten completely, though some people without the disease have found that reducing gluten in their diet lessens psoriasis flare-ups.

    Topical Vitamin D Calms The Immune Response

    Best for: Mild to moderate psoriasis

    Why it works: These medications work by calming the immune response and telling the skin cells to grow and turn over at a regular rate, Daveluy says. Vitamin D analogues calm your overactive immune response, which is causing the excess skin cell production that leads to psoriasis. Vitamin D analogues , including calcipotriene and Rocaltrol , can be part of liquid scalp treatments or may be combined with a topical steroid. The combination product is particularly effective and useful for mild to severe scalp psoriasis, he says.

    Slowing the growth of skin cells may cause the plaques to become thinner and less scaly. Psoriasis occurs when the immune system misfires and starts overacting creating inflammation inside the body. Vitamin D may also work by shifting the balance of your immune system and putting it in a more neutral and healthy state.

    In addition to treatments containing forms of synthetic vitamin D, some people with scalp psoriasis find relief using topicals that contain retinoids including Tazorac .

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    Look For Scaly Patches Of Skin

    The best way to look for this particular psoriasis symptom is to feel around on your scalp. Youre looking for patches of skin particularly in areas you might not see in the mirror that feel raised, bumpy, or scaly in nature. These bumpy patches of skin are the result of overactive skin cell growth. Its believed that an autoimmune issue is the cause of this skin buildup. When skin grows so quickly like that, your body cant shed cells fast enough. If you feel small patches or large areas of scaly skin on your scalp, its likely psoriasis.

    Hats Scarves And A New Hairstyle Can Mask Psoriasis

    How I treat scalp psoriasis

    Best for: All psoriasis

    Why it works: In general, you can wear any kind of hat or scarf with scalp psoriasis. But you should avoid tight headwear or hats that rub and cause friction, Daveluy says. This can cause the psoriasis to flare due to the trauma. He also advises wearing white or light colors that dont show flaking.

    Wearing your hair a certain way may hide some of the redness and scales of psoriasis. Though you might be nervous about going to a barber or a salon, many hairstylists are familiar with scalp psoriasis. Just mention your condition in advance so you and your stylist can talk about any special requirements, such as gentle treatments and avoiding injury to the scalp area.

    A hat or scarf may also prove useful if you are experiencing temporary hair loss that sometimes occurs with scalp psoriasis. This hair loss usually happens when a person is too aggressive when removing plaque scales in other words, pulling out hairs when using a comb to remove the excessive skin cells that make up a plaque.

    Psoriasis itself does not cause hair loss, but your hair can enter a resting stage known as telogen when you are under stress. When too much of your hair goes into telogen at once, fewer hair follicles are available to grow new hair. As a result, you may notice more hair on your hairbrush than usual. Thats another reason why you might want to try keeping your stress levels in check.

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    What Medications Or Treatments Are Used To Treat Scalp Psoriasis

    Your healthcare provider may prescribe the following as a cream, lotion or gel to treat mild cases of scalp psoriasis:

    In more severe or widespread cases of scalp psoriasis, your healthcare provider may prescribe:

    • Medicine injections. Your healthcare provider will use a thin needle to inject medicine into your skin, a vein in your arm or directly into your plaques. These medicines may include adalimumab, etanercept or ustekinumab.
    • Oral medicines. Oral medicines are pills or tablets you swallow with water. These medicines may include acitretin, cyclosporine or methotrexate.
    • . Phototherapy uses ultraviolet light , usually ultraviolet B , from special lamps. The ultraviolet light waves in sunlight can help certain skin disorders, including scalp psoriasis.

    Treating scalp psoriasis may be difficult. Your body is unique, and it might not respond to certain treatments. Talk to your healthcare provider about the best treatment for you.

    Helpful Hints For Managing Scalp Psoriasis

    Brush and comb hair gently and regularly

    Buy some pillow case protectors or keep a supply of old pillow cases for times when you are using treatments

    Give all treatments a good chance to work – weeks rather than days

    Always read the instructions carefully on all treatments, as they can differ in how they should be applied

    Tell your GP or Dermatologist if any treatment is causing you problems or discomfort

    Try different hairstyles to cover any psoriasis on thehairline

    Try using an oil to soften the scalp and make scaling easier to lift – olive or coconut oil for example

    Wearing light coloured clothes on the top half of your body will help to disguise falling scales

    Keep up to date with new treatments – the Psoriasis Association has details

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    It Can Affect The Scalp Hairline Forehead Back Of The Neck And Skin Around The Ears

    Did You Know?

    Symptoms may include fine scaling that looks like dandruff, or appear as thick, crusted plaques that cover the entire scalp. Other skin disorders, such as seborrheic dermatitis, may resemble psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis looks yellowish and greasy. Scalp psoriasis is common in patients of color, but treating it can be particularly tough due to the hair type.

    Scalp psoriasis may be an indicator of psoriatic arthritis , as many people have both. If you think you have scalp psoriasis, see a dermatologist to diagnose scalp psoriasis and visit a rheumatologist to screen for psoriatic arthritis.

    No matter how severe your scalp psoriasis is, there are options for treating the itching and flakes รข from over-the-counter shampoos and topicals to light therapy, oral treatments and biologics.

    Do People With Psoriasis Get It On The Scalp

    Psoriasis of the scalp

    About 50% of people with psoriasis experience it on their scalp to some degree. Scalp psoriasis is often characterized by a dry, flaking scalp with itching, burning, or soreness. Symptoms can be milder, ranging to more severe, when it can be painful, embarrassing, and spread to the neck, forehead, and behind the ears.

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    What Are The Different Types Of Psoriasis

    There are different types of psoriasis. However, chronic plaque psoriasis is by far the most common and typical type.

    The Primary Care Dermatology Society has published a Treatment pathway see Further Reading below. This has several pictures that may be useful, as well as a clear plan for treatment of the different areas and types of psoriasis. This includes often difficult to treat areas such as the face, the hands and the genital area.

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    You Are Not Alone: Finding Support For Scalp Psoriasis

    By joining MyPsoriasisTeam, the social network and online support group for those living with psoriasis, you gain a support group more than 88,000 members strong. Scalp psoriasis is one of the most-discussed topics.

    How does scalp psoriasis affect your life? Has your doctor prescribed treatments to manage your symptoms? What helps you look and feel good? Share your tips and experiences in a comment below or on MyPsoriasisTeam.

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