Your Scalp Psoriasis Questions Answered
With contributions from Angela Finlay.
Scalp psoriasis is one of those "hidden" health conditions that can end up being quite uncomfortable and sometimes embarrassing for the person suffering from it.
It can see you regularly and absent-mindedly scratching or picking at your scalp, or it can often cause what looks like dandruff to be ever-present in your hair. It's one of those things that may come and go in the form of flare-ups, and there's no hard and fast reason why an onset occurs.
While keeping in mind that there aren't any absolute rules around scalp psoriasis, here is a selection of commonly asked scalp psoriasis questions answered.
What Is Scalp Psoriasis?
About 50% of people diagnosed with psoriasis suffer from scalp psoriasis. Scalp psoriasis is a skin condition that appears as raised pink skin lesions on, you guessed it, your scalp. However, it's not always limited to just your scalp. It can flare up on your neck, behind or inside your ears. These patches can often be quite flakey.
One crucial thing to factor into your understanding of scalp psoriasis is that scalp psoriasis is not contagious. Your friends won't suddenly get scalp psoriasis because they stood too close to you or anything like that.
There are various severities of scalp psoriasis as well. Sometimes you may only suffer from a mild case of scalp psoriasis, which you may be able to easily manage with home treatments. It can appear anywhere in the affected areas, but not be too painful or intrusive.
Other times you may suffer from a severe flare-up, which can be both painful and unpleasant appearance. Often, when you have a severe flare-up, it's better to go to the doctor so they can take a look and potentially prescribe you medicated treatments instead of home treatments, which tend to have a faster impact on lighter cases.
How scalp psoriasis occurs is through incorrect immune system signals. Your immune system sends signals to your skin cells on your scalp, and they multiply rapidly, which causes the build-up of skin lesions in the area. But why does this occur?
What Causes Scalp Psoriasis?
As is often the case with any type of psoriasis — there's no hard and fast information around what are the primary causes of scalp psoriasis. There are many things thought to trigger scalp psoriasis, and it's all quite a process of elimination when flare-ups occur at this stage until further research uncovers more evidence. Here are a few of the considered causes of scalp psoriasis.
Stress is one of those things that can manifest even when you don't realize, and when you're under stress, your body and your health can take a blow too. Stress is considered to be one of the triggers of psoriasis, and it's even more stressful because once you're suffering from it, you tend to get more stressed about it, which makes it even harder to manage it.
It can be helpful to identify what may be causing the increased levels of stress in your life and see if you can make a plan to reduce this. Although, with many of our jobs, there's not a lot of room to tailor our situation and stress levels during our working hours, but finding a way to cope outside of this period of time can be helpful to help reduce regular flare-ups.
Weakened Immune System
A weakened immune system is especially noticeable when people who have psoriasis get sick often with something like a cold or strep throat. When the immune system is weakened, it can be a sign of a correlation between this and a scalp psoriasis flare-up.
There is some research behind the connection between smoking and increased chances of suffering from psoriasis. It also appears that there may be a higher risk for women who smoke.
According to research, there's also a correlation between the length of time a person smokes and the risk of suffering psoriasis. The longer the period of smoking, the higher the risk of suffering from psoriasis.
Alcohol is likely to trigger psoriasis and also interrupt any psoriasis treatment. It is known to affect your immune system, and considering psoriasis is an autoimmune disease, having a weakened immune system can mean psoriasis is more likely to flare-up.
Skin Cuts and Injuries
A situation where something as small as suffering from a graze or a mosquito bite can trigger the onset of psoriasis is often known as the Koebner phenomenon. It essentially means that if your skin is injured, it can trigger a psoriasis flare-up to appear in that location.
For example, if your scalp is scratched or irritated, the risk of suffering from a psoriasis flare-up in that location increases significantly. It's likely to occur in one out of every four people who have psoriasis.
Possible Complications With 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.
How Is Scalp Psoriasis Treated?
There’s no universal treatment for scalp psoriasis, but there are several possible ways to reduce or eradicate the symptoms.
For example, there are many options for people to try at home, which tends to work better for less severe cases that are a bit easier to manage. There is also a range of medicated treatments that can be prescribed by doctors that can be used to treat more severe cases of scalp psoriasis flare-ups.
Home Treatments for Scalp Psoriasis
Considering it's a lot harder to keep your scalp moisturized, these natural remedies can help to ease the itch and remove some of the inflammation and scales.
Although not the most pleasant-smelling product (some may disagree), coal tar is known to help reduce redness and take some of the sting out of scalp psoriasis.
Coal tar can be poured directly into a bath, which you just soak in for several minutes, or you can apply it directly to the affected areas to help reduce inflammation. Also, be sure not to leave coal tar on your skin and remove it after a few minutes.
Apple Cider Vinegar
Apple cider vinegar is a great natural remedy for scalp psoriasis itch. You do have to be careful with how it's applied as it can burn if not used correctly and carefully. To reduce the risk of burning, try to mix the apple cider vinegar with equal parts of water. Then you can apply the apple cider vinegar remedy to the irritated area to try to reduce the itch or itchiness.
When you want to loosen and remove the scales caused by scalp psoriasis and relieve psoriasis-related itchiness, using Epsom salts can be a natural go-to treatment. The best way to use Epsom salts is to add them to a warm bath and soak in the tub for a while.
Turmeric is known for its anti-inflammatory qualities. It has been used in traditional medicines to reduce many of the issues related to scalp psoriasis, including inflammation and skin issues. There are many ways to use turmeric, from cooking, drinking to taking it in a supplement form.
There's an array of medicated psoriasis treatment options. These come in the forms of topical lotions right through to oral medications.
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.
There are various topical treatments, and often doctors will suggest alternating between a couple of types of topical treatments.
I've found that with my scalp psoriasis, alternating between a steroid ointment and hydrocortisone cream tends to work best for me. I'm not continually applying steroids to my skin, but my treatment tends to allow for my skin to heal rapidly.
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 overproduction of skin cells that lead to skin plaques and scales. Biologic drugs are typically delivered by injection or infusion.
In this form of treatment, ultraviolet light is administered carefully to the skin under controlled situations. Exposure to UV light is considered to be good for psoriasis, but it's not ideal to go and lie in the sun for long periods of time. This form of treatment should be carried out by a medical professional.
How to Cope With Scalp Psoriasis
There are many ways to cope with scalp psoriasis. It all depends on who you are as a person and which approach you'd like to explore further. Thankfully, there are so many ways to cope with and get on with your life even with scalp psoriasis that most aren't also listed. It's all about what feels right for you.
Practice Relaxation and Reduce Stress
One thing to remember with psoriasis is that it doesn't respond well to stress. To speed up recovery time, and to ensure your scalp psoriasis flare-up doesn't get any worse, it's important to practice self-care, and ensure your body is getting plenty of time to relax and repair.
To practice relaxation, you could consider looking into yoga or meditation. Both of these can help to calm your mindset and encourage exercise and mindfulness. There's a lot of focus on controlling your breathing, and in doing so, you can help to reduce the amount of stress your body feels.
Work on Your Confidence
This one can be easier said than done, especially when you're dealing with a particularly visible and painful flare-up of scalp psoriasis.
Often, when I'm dealing with a flare-up of this nature, I tend to wear my hair down, and if the season is cool enough, wear a scarf to hide any flare-up on my neck. Other times I can't be bothered with this maintenance and decide to grin and bear any looks I may get.
Having confidence in your appearance is so important. It will remind you that you're not your flare-up and that it is only temporary.
Lastly, with confidence comes knowledge. If you're confident enough to be able to continue on while your flare-up is visible, it may be a good chance to educate those who may ask what it is about scalp psoriasis.
As mentioned, a scalp psoriasis flare-up isn't permanent. A flare-up will come and go, every time with different levels of severity. The thing to keep in mind is that this flare-up isn't forever. You will get past this one with time and patience.
By staying calm and patient, and with the right combination of treatments, you may find that your scalp psoriasis flare-up will ease faster.
The Bottom Line...
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.