Treating the Symptoms and Living With the Condition
About 50% of psoriasis sufferers experience psoriasis of the scalp, ranging from mild, itching and scattered red spots to thick, burning patches of silvery scales that spread onto the face and neck. The severity of your scalp psoriasis will determine the best course of treatment, and although it can take some time to bring the symptoms under control, many patients are able to manage and even improve their condition in the long run.
The Most Effective Treatments for Scalp Psoriasis
There’s no universal treatment for scalp psoriasis, but there are several possible ways to reduce or eradicate the symptoms. Typically, it’s best to begin with a milder form of treatment, working up to more powerful medications as needed. Here are a few:
- Medicated shampoos. In order to get the outbreak under control, first try to dissolve and remove the scales. Shampoos containing tar and salicylic acid are the most effective, working with the water to soften and break up the thickened skin. Once the plaques are loosened, gentle combing should free them from the hair. You can continue to use medicated shampoo twice weekly to prevent future flare-ups.
- Topical ointments. Applying topical creams or foams directly to the scalp once you’ve lifted the heavy scale can have a swift and noticeable effect on psoriasis symptoms. Prescription lotions that contain coal tar, Calcipotriene (derived from vitamin D), and Tazarotene (derived from vitamin A) will reduce redness and itch, and steroid medication can be used sparingly.
- When topical creams fail, doctors can administer a course of targeted ultraviolet (UV) light to the plaques, with the help of special devices like UV combs. It can be easier to treat scalp psoriasis when your hair is short, since there is less of a barrier for creams and light to penetrate.
Severe cases of scalp psoriasis may not respond to topical treatment or light therapy. These cases will call for a more invasive approach to eradicate the plaques:
- Immunosuppressant medication. Oral medications like corticosteroids, cyclosporine or methotrexate can suppress the overactive immune response that’s causing your psoriasis outbreak. However, they do bring with them the risk of side effects, like liver damage and psychological changes, so close monitoring is crucial.
- The most recent additions to psoriasis treatment are biologics, medications that can help prevent the over production of skin cells that lead to skin plaques and scales. Biologic drugs are typically delivered by injection or infusion.
Complications of Scalp Psoriasis
Psoriasis on the scalp is generally superficial in nature, but in some cases, the itching, flaking and dryness can lead to more serious problems:
- Infection. The urge to scratch can be irresistible, and excessive scratching can break the skin, leaving it prone to infection. If you’re aggravating your scalp to the point of bleeding, you’ll need to adjust your hair care and management routine.
- Hair loss. Frequent scratching and picking can lead to temporary hair loss, but the hair most often grows back. Scalp psoriasis does not cause permanent balding.
- Low self-esteem. In many cases, the embarrassing flaking can affect confidence and self-esteem, sometimes to the point of depression. It can help to talk with other psoriasis sufferers about coping with the physical effects of the condition, and find ways to stay positive.
Living with scalp psoriasis can be physically and emotionally challenging, and although it’s a chronic disease that will call for long-term management, you don’t have to deal with constant flare-ups. Work with your doctor and a dermatologist to adapt your treatment plan according to your changing needs and you’ll very likely be able to keep the symptoms under control.