Scalp Psoriasis and Hair Loss: Prevention & Treatments

If you have psoriasis and notice your hair falling out, you’re not alone: scalp psoriasis can indirectly cause hair loss. The good news? Scalp psoriasis hair loss is temporary, and your hair will likely grow back once your skin heals.

Psoriasis is an autoimmune disease that causes your skin to develop thick, crust-like plaques and scaly patches, which can be itchy and discolored.

When psoriasis affects your scalp, it may cause temporary hair shedding. Psoriasis-related hair loss is also called psoriatic alopecia.

There’s no cure for psoriasis, but certain medications and lifestyle changes can help reduce flare-ups. This can give your scalp a chance to heal, allowing your hair to grow back.

Below, we explain how psoriasis causes hair loss and cover a few science-backed techniques for treating scalp psoriasis hair loss.

Psoriasis is a chronic autoimmune disease that’s relatively common. According to the National Psoriasis Foundation, eight million Americans and 125 million people worldwide are affected by psoriasis.

The most common type is plaque psoriasis, a skin condition in which skin cells build up and form crusty, scaly patches. These patches of thickened skin may feel dry and itchy.

Psoriasis can develop anywhere on your body, but it usually affects the elbows, knees, palms, feet, back, face, and scalp.

This thickened, scale-like skin is caused by a change in how your body produces new skin cells. Instead of producing cells at a normal speed, your immune system signals to your skin to create new cells too quickly.

Your skin repairs and rejuvenates itself through a process called cellular turnover. As part of this process, new skin cells created in the lower layers of your skin travel upwards to the outermost layer, known as the epidermis, and replace old, dead skin cells.

For most people, the cellular turnover process takes around one month. However, this process occurs much faster if you have psoriasis — your skin completes its turnover cycle in just a few days.

Because these skin cells grow so fast, your body can’t fully shed the new cells. Instead, they build up in thick, scale-like skin on certain areas of your body and contribute to psoriasis flare-ups.

Scalp psoriasis is a common form of psoriasis that affects the scalp. According to a 2016 study published in Clinical and Experimental Dermatology, between 45 percent and 56 percent of people with psoriasis also have scalp psoriasis.

In addition to affecting your scalp, this type of psoriasis can extend onto your forehead and the back of your neck.

Scalp psoriasis usually occurs in flare-ups, which can vary in length and severity. If you have psoriasis that affects your scalp, you may notice that your symptoms come and go when you’re exposed to specific triggers.

Symptoms of Scalp Psoriasis

The signs and symptoms of scalp psoriasis include patches of skin that look unusual compared to the rest of your scalp.

Generally, the affected areas of your scalp can be:

• Flaky and dandruff-like

• Thick, scaly, and crusted

• Discolored (red or dark-colored)

• Painful, burning, or stinging

• Itchy and uncomfortable

• Bleeding (if you scratch it often)

If you have psoriasis on your scalp, you’ll likely have it on other parts of your body, too. If you’re not sure whether you have psoriasis or another skin disorder, it’s a good idea to make an appointment with a healthcare professional.

Can psoriasis cause hair loss? Yes, especially in severe cases. Scalp psoriasis doesn’t cause hair loss directly, but scratching your scalp excessively or pulling at the affected areas of skin (for example, to remove scaly skin) can cause temporary hair loss.

Unlike hair loss caused by male pattern baldness, scalp psoriasis hair loss doesn’t occur in a particular pattern — in other words, it isn’t the type of hair loss that causes a receding hairline or a bald spot that spreads from the crown of your head. Instead, it can occur in patches anywhere on your scalp.

Fortunately, hair loss during a psoriasis flare-up is usually temporary. Once your psoriasis is under control, your hair will probably grow back.

If you’re not sure what’s causing your hair to shed, it’s best to make an appointment with a healthcare provider (like a dermatologist or a general practitioner). They can help identify whether scalp psoriasis is to blame for your hair loss.

While there’s no cure for psoriasis, you can manage your flare-ups using scalp psoriasis treatments. These treatments can make your symptoms less severe and help you endure flare-ups without excessively scratching your scalp, which damages your hair.

Along with healthy hair care habits, these psoriasis treatments can help you regrow hair you lose from psoriasis hair loss.

There are a number of prescription and over-the-counter psoriasis treatments like:

• Oral medications, such as methotrexate, apremilast, or cyclosporine

• Corticosteroid injections

• Biologic drugs like etanercept, which are given via IV or injection

• Topical medications, like retinoid creams or topical steroids

• Moisturizers, ointments, and lotions to reduce itching

Make sure to closely follow the treatment plan provided by your healthcare provider and take all your medications as prescribed.

If a particular medication isn’t working as well as you’d like or you’re experiencing intolerable side effects, it’s a good idea to reach out to your healthcare provider and explore other treatment options.

Medicated Shampoos

Medicated psoriasis shampoos often contain ingredients like:

• Salicylic acid, which can soften and gently exfoliate dead skin cells, making it easier to remove psoriasis plaques

• Coal tar, which can soothe inflammation, reduce itchiness, and slow down skin growth 

• Clobetasol propionate, a potent corticosteroid that reduces inflammation and itchiness

While you can purchase some of these medicated shampoos over the counter, others require a prescription.

Phototherapy

Phototherapy, or light therapy, can help soothe symptoms of scalp psoriasis.

A healthcare professional might recommend spending a few minutes in the sun every day — a free way to get your daily dose of ultraviolet (UV) light.

But if your hair is thick or you have severe scalp psoriasis, you might need phototherapy. These treatments are usually done in a dermatologist’s office.

Identify Your Psoriasis Triggers

Stress, weather, illness, and certain foods can all trigger psoriasis flare-ups. Some medications may also aggravate flare-ups.

If you have psoriasis, identifying triggers can help you reduce flare-ups and respond to them more quickly. Try keeping a record of your flare-ups and possible triggers so that you’re ready to treat any symptoms as quickly as possible.

Avoid Scratching Your Scalp

Scratching your scalp during a psoriasis flare-up can damage your skin and worsen hair loss. We know it’s not easy to avoid the temptation to scratch, but some topical treatments may soothe your itchiness.

If you scratch, try cutting your fingernails short, which can reduce the effectiveness of scratching. For best results, file your nails so they’re smooth and less likely to damage your skin.

Avoid Heat Styling or Harsh Chemicals

The American Academy of Dermatology recommends gentle, simple hair care habits to reduce psoriasis flare-ups and encourage hair growth.

Try to avoid heat styling. Blow drying your hair can make your scalp overly dry, worsening your psoriasis symptoms. Instead, let your hair dry naturally after you finish showering. You can also pat your hair dry with a microfiber towel.

Harsh chemicals can also irritate your scalp psoriasis. Avoid harsh relaxers, hair dye, perms, and gels.

Lastly, don’t wear tight hairstyles (like overly restrictive ponytails, cornrows, or man buns). These can pull on your scalp, worsening hair loss and causing hair breakage. It can also irritate your scalp.

Psoriasis can develop on many parts of your skin, including your scalp, forehead, and the back of your neck. You probably know this condition for its itchiness and the plaques it causes, but there’s also a link between scalp psoriasis and hair loss.

• Psoriasis causes hair loss — but only indirectly. This is because excessive scratching can damage your hair.

• Scalp psoriasis hair loss is temporary. Your hair will likely grow back once your scalp has had the chance to heal.

• There are many treatment options. While you can’t cure scalp psoriasis, treatments like medicated shampoos, phototherapy, and prescription oral medications can help reduce flare-ups.

Although psoriasis-related hair loss can be frustrating, it’s important to remember that there are ways to manage your psoriasis flare-ups.

The first step is to schedule an appointment with a healthcare provider. They can examine your skin and give you a diagnosis. They can also help you explore your treatment options and give you expert medical advice on managing your flare-ups.