What You Should Know About Plaque Psoriasis
This is the type youre probably thinking of when someone mentions psoriasis. Its characterized by clearly demarcated, raised, red, scaly patches called plaques that appear most commonly on your elbows, knees, scalp, and back .
Because it accounts for 80% of all cases, plaque psoriasis tends to get the most press. Its the type addressed in most psoriasis drug commercials, and celebs including reality star Kim Kardashian and singer Cyndi Lauper have both been vocal about being plagued with plaques.
What You Should Know About Scalp Psoriasis
If youre scratching your head over an itchy scalp condition that wont clear up with a traditional dandruff shampoo, you may have scalp psoriasis. This type can go hand-in-hand with plaque psoriasis , or even appear in those who dont have any history of the skin disorder at all.
Its often confused with dandruff, because, well, it itches and causes flakes, only these flakes are typically silvery-white and scaly. You might also have painful red scales or silver plaques on your head. In severe cases, scalp psoriasis appears as thickened, crusty patches of skin not only on the hairline, but also on the forehead, back of the neck and near the ears.
How Is Psoriasis Treated
Psoriasis is usually treated by a dermatologist . A rheumatologist may also help with treatment. Treatments can include:
- ultraviolet light from the sun or from home or office treatments. But in some children, sunlight can make psoriasis worse.
- creams, lotions, ointments, and shampoos such as moisturizers, corticosteroids, vitamin D creams, and shampoos made with salicylic acid or coal tar
- medicines taken by mouth or injected medicines
A doctor might try one therapy and then switch to another, or recommend combining treatments. It’s not always easy to find a therapy that works, and sometimes what works for a time stops helping after a while.
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What Are The Symptoms Of Plaque Psoriasis On The Scalp
Psoriasis symptoms can occur anywhere on a persons scalp, and the back of the head is a common place for plaques to develop. There may be just one patch on the scalp or multiple patches in different places. In some people, plaques might extend outside the area of the scalp that is covered in hair. For example, they might occur on the forehead at the edge of the persons hairline, around the ear area, or on the back of the neck at the bottom of the hairline2.
Just like other areas affected by psoriasis, symptoms on the scalp can be mild, moderate, or severe. For people with mild symptoms, psoriasis on the scalp can be relatively thin with light scales, covering only a small part of the head. For people with more severe symptoms, the plaques may become much thicker and cover a larger area of the head.3
Systemic Treatments And Uv Light
If you have moderate to severe psoriasis elsewhere on your body, one of these medications may help:
- Methotrexateslows an enzyme involved in the rapid growth of skin cells.
- Oral retinoids help control the growth of cells.
- Cyclosporinelowers the immune system function, and therefore helps to reduce the inflammation of psoriasis.
- Biologics target specific parts of the immune system that are overactive in psoriasis.
Talk with your doctor about the potential side effects of these treatments.
Ultraviolet light is another treatment option. Hair can block the light from reaching your scalp, so if you have thick hair, it may help to part it in rows. Hand-held devices can directly deliver light to your scalp.
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Is It Scalp Psoriasis
Some other skin conditions can cause similar symptoms.
Seborrheic dermatitis, or cradle cap, often affects babies. It causes a patchy, red rash that looks greasy or moist to form on the scalp.
Ringworm, a fungal infection, can cause a crusty, red rash to form on the scalp, usually in the shape of a ring. With scalp psoriasis, the affected patches of skin are scaly and dry and do not usually form a ring.
Psoriasis, including scalp psoriasis, is a common condition that appears to develop when the immune system sends the wrong signals to the body.
When the immune system sends these messages to the skin cells, the cells multiply too quickly.
Normally, new cell formation on the scalp may take weeks. With psoriasis, cells form within days. This makes it difficult for the body to shed the excess cells. As the skin cells build up on the surface of the scalp, they form scaly patches.
The of scalp psoriasis is unknown, but research suggests there is a genetic link.
People who have a family member with the condition have a higher risk of developing scalp psoriasis.
In 2016, published by nutritionists noted that psoriasis may be more likely in people who have:
- inflammatory factors that occur with obesity
- dietary factors, such as gluten sensitivity
The National Psoriasis Foundation note that a number of other factors may trigger a flare-up of symptoms in people who are prone to scalp psoriasis.
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.
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What Are The Risk Factors For Plaque Psoriasis
Anyone can get plaque psoriasis, but there factors that can put you at increased risk:
- Family history if one parent has plaque psoriasis this increases your risk of getting it. If both parents have it this increases your chances even more.
- High stress can affect your immune system and as plaque psoriasis is caused by problems in the immune system, high stress can increase your risk of developing plaque psoriasis
- Smoking can increase your risk of developing plaque psoriasis and also can increase how severe your plaque psoriasis can become.
How Can You Tell If You Have Scalp Psoriasis Vs Dandruff
The color that red, pink or purple color is very distinguishing of scalp psoriasis, says Dr. Gohara. So are the dry, thick plaques, which can be silvery in color. Scalp psoriasis can also spread beyond the hairline and behind the ears. A dermatologist can help you determine what condition you have.
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:
Things To Avoid If You Have Scalp Psoriasis
Scalp psoriasis can be very uncomfortable, but find the right treatment and avoid these 6 pitfalls, and you can keep your scalp inthe best condition possible.
1. Dry skinKeep your scalp hydrated by using a moisturizing shampoo every time you wash your hair.
2. Itching and scratchingNever pick at scales or sore patches of skin Ââ this will make the condition worse!
3. Dry, cold weatherThe weather can have a big effect on psoriasis. Cold, dry weather can make the symptoms appear worse, so make sure to wrap up warm in winter and consider getting a humidifier to take the edge off the dry air.
4. Certain medicationTell your doctor about any medication you take and ask whether it might affect your psoriasis.
5. StressStress is often linked with flare-ups, so try to reduce stress and anxiety. Meditation and yoga are a good place to start.
6. AlcoholItâs thought that excessive alcohol consumption may worsen psoriasis symptoms, so drink in moderation. If youâre taking psoriasis medication, check whether itâs okay to drink alcohol while taking them.
How should you treat scalp psoriasis?Scalp psoriasis is a somewhat rare skin disorder, affecting about 3% of the population. If you havenât yet been diagnosed with the condition, itâs worthwhile to check to see if your symptoms are the result of a more common scalp flaking disorder like seborrheic dermatitis.
Try using Clinical Strength Shampoo for seborrheic dermatitis.
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Where Does Psoriasis Show Up
Psoriasis can show up anywhereon the eyelids, ears, mouth and lips, skin folds, hands and feet, and nails. The skin at each of these sites is different and requires different treatments.
Light therapy or topical treatments are often used when psoriasis is limited to a specific part of the body. However, doctors may prescribe oral or injectable drugs if the psoriasis is widespread or greatly affects your quality of life. Effective treatments are available, no matter where your psoriasis is located.
At least half of all the people who have psoriasis have it on their scalp.
Scalp psoriasis can be very mild, with slight, fine scaling. It can also be very severe with thick, crusted plaques covering the entire scalp. Psoriasis can extend beyond the hairline onto the forehead, the back of the neck and around the ears.
Other skin disorders, such as seborrheic dermatitis, may look similar to psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis appears yellowish and greasy.
Psoriasis on the Face
Facial psoriasis most often affects the eyebrows, the skin between the nose and upper lip, the upper forehead and the hairline. You might need a biopsy to confirm that it is psoriasis.
Around the eyes
In the ears
Hands, Feet and Nails
Main Symptoms Of Psoriasis
Psoriasis typically causes patches of skin that are dry, red and covered in silver scales. Some people find their psoriasis causes itching or soreness.
There are several different types of psoriasis. Many people have only 1 form at a time, although 2 different types can occur together. One form may change into another or become more severe.
Most cases of psoriasis go through cycles, causing problems for a few weeks or months before easing or stopping.
You should see a GP if you think you may have psoriasis.
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Are There Complications Of Psoriasis
In some people, psoriasis causes more than itchiness and red skin. It can lead to swollen joints and arthritis. If you have psoriasis, you may be at higher risk of:
- Use medicated shampoo for scales on your scalp.
Other steps you should take to stay as healthy as possible:
- Talk to your healthcare provider about lowering your risk for related conditions, such as heart disease, depression and diabetes.
- Lower your stress with meditation, exercise or seeing a mental health professional.
Shampoos And Scalp Medications
For the scalp, products that you apply directly to the scalp are a good starting point. Medicated salicylic acid and coal tar shampoos are over the counter. If those dont work, prescription topicals are available.
Medicines meant for use on the scalp usually come in shampoo, liquid, or foams, for easier application through your hair. Leave-on products work better than shampoos, but they might not be practical for styled hair.
Some common topical prescription medicines for psoriasis are below.
When you first see a doctor for scalp psoriasis, youll probably get a prescription for a topical steroid. Steroids work quickly to calm inflammation and improve psoriasis symptoms. Unfortunately, psoriasis tends to flare when you stop using them, and its not safe to keep using topical steroids continuously. Side effects of topical steroids can include:
Thinning of the skin
To avoid this, your doctor might rotate your treatment or have you alternate medications. Topical steroids commonly prescribed for psoriasis include:
There is data that the combination works better than either one alone. But since these products contain betamethasone, there is a risk of steroid side effects if you use them continuously for too long.
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Can Psoriasis Cause Dandruff
People with scalp psoriasis may experience flaking from the scalp that can look very much like dandruff. Both can cause itching and flaking on the scalp however, dandruff is caused by a fungal infection and scalp psoriasis is an autoimmune condition9. Dandruff-like flaking happens when the layer of silvery scale covering the top of a plaque flakes off in small pieces. A range of medicated shampoos and topical treatments is available for softening and treating the scalp plaques to reduce the amount of flaking.
For more information on the symptom of dandruff
What To Do About Dandruff
Most cases of dandruff can be easily banished using an over-the-counter medicated shampoo, conditioner, lotion or foam, Mayo Clinic and AAD point out. There are several different ingredients that target the flakes, and you may need to experiment a bit to find which one works best for you.
I like tar shampoos, which are good for decreasing inflammation, says Dr. Rokhsar, adding a caution that the tar may discolor blond or light hair. Another ingredient he likes is salicylic acid, which is good for decreasing flakiness.
Dr. Sodha recommends zinc or selenium-based products, both antifungal. Ketaconozole is another antifungal ingredient in some over-the-counter anti-dandruff shampoos. Use the product two to four times a week for a few weeks, and then if you see improvement or resolution, switch to once or twice a week for maintenance.
There are various products available that aid in the treatment of scalp psoriasis. These products are
Shampoos Oils and Coal Tar
Most shampoos contain an important ingredient, salicylic acid. These shampoos not only reduce itchiness but they also prevent skin dryness. Use of coal tar for treating psoriasis on the scalp goes back many centuries. It is quite effective for achieving the desired results. Steroids can also be used for treating the worst forms of psoriasis.
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How Do You Treat Psa
If you have this condition, youll want to see a rheumatologist, a doctor who specializes in arthritis. Treatments can range OTC non-steroidal anti-inflammatory drugs such as Advil to disease-modifying antirheumatic drugs , including methotrexate, that work by slowing your immune system and your bodys inflammatory response. If those dont work, biologics may be considered.
How Is Plaque Psoriasis On The Scalp Treated
For some people, having scalp psoriasis may cause self-consciousness or embarrassment at times. The good news is that there are various treatment options available for people to try, and many people find that they are able to manage the condition effectively.
However, treating psoriasis on the scalp can be more challenging than treating it on other parts of the body because the hair can make it difficult for treatments to reach the affected area on the scalp.1
In many cases, your healthcare provider will recommend that you combine treatments or cycle through several different types of treatment.2 This is because a persons psoriasis can change over time, and a treatment that worked well at the beginning may gradually stop working if it is used for a long period of time.
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If It’s Scalp Psoriasis Are There Lifestyle Factors To Consider
One thing people should be aware of is that stress can worsen psoriasis, because stress increases the hormone cortisol, which in turn increases inflammation, says Dr. Gohara. So it makes sense to focus on whatever you can do to lower your tension level, whether that means taking yoga classes, practicing mindfulness, carving out time to relax and read or reaping the benefits of daily reflective walks.
Another concern among those with scalp psoriasis is whether its safe to dye ones hair. I would never tell someone to avoid coloring their hair, but its true that psoriasis tends to emerge in areas of the body that are under pressure or trauma, says Dr. Gohara. Hair dye, styling products and chemicals can cause trauma to one’s skin. So yes, people with scalp psoriasis can get a flare up from coloring their hair. Its a good idea to have a conversation with your stylist about using gentle formulas.