According to the National Psoriasis Foundation, eight million Americans and 125 million people worldwide are affected by psoriasis.
According to the National Psoriasis Foundation, eight million Americans and 125 million people worldwide are affected by psoriasis. Between 45 and 56 percent of those people have scalp psoriasis, which is also sometimes called plaque psoriasis.
But what is scalp psoriasis? Scalp psoriasis is a chronic autoimmune condition that causes skin cells to build up quickly and form crusty, scaly patches on the scalp.
Below, we’ll cover what causes scalp psoriasis, its symptoms and risk factors, and how to diagnose, treat, and prevent it.
The symptoms of scalp psoriasis are similar to the symptoms of psoriasis on any other part of your skin. However, in this condition, they’re limited to (unsurprisingly) your scalp.
Thick, silvery-white skin scales. Skin buildup leads to scaling, which is often silver or white and shiny. It can flake off and cause itching or discomfort.
A painful, burning, itching, or stinging sensation on the scalp. Psoriasis often causes discomfort, including itching. Scratching your scalp can then lead to bleeding.
Cracked skin. Psoriasis can cause the skin of the scalp to dry out or crack. It can also cause redness or areas of discoloration.
Dry skin on the scalp. Plaques that develop on the scalp — and sometimes the back of your neck — can cause the scalp to feel tight or dry.
Scalp psoriasis symptoms can vary from mild to severe.
Scalp psoriasis, like other types of psoriasis, is an autoimmune condition. This means nothing you do or don't do can cause it. However, certain triggers can lead to flare-ups.
Immune system dysfunction: Psoriasis is an autoimmune condition that causes the immune system to mistakenly attack skin cells, leading to inflammation. It also causes rapid production of skin cells, which build up into scaly plaques on the scalp that are essentially excess skin cells.
Genetics: Psoriasis has a strong genetic component, which means you're more likely to develop it if someone in your family has the condition. Research indicates that multiple genes are involved in developing psoriasis, so there’s not one “psoriasis gene.”
External triggers: Certain things — such as cold weather, stress, smoking, or alcohol — may exacerbate scalp psoriasis. We’ll explore these triggers further in the section below.
As we said, scalp psoriasis is an autoimmune condition with a genetic component. However, there are certain risk factors that can either trigger psoriasis to appear or cause it to worsen. These include:
Age. Although psoriasis can occur at any time, research shows it often follows two peaks of onset: the first occurs between 20 and 30 years old and the second between 50 and 60 years old.
Certain medications. Certain drugs, such as beta-blockers and lithium, may trigger or worsen psoriasis symptoms.
Cold, dry weather. Cold or dry weather may trigger scalp psoriasis flare-ups because it dries out the skin. There is also less sunlight in colder months, and UV rays can help treat psoriasis.
Other infections. Certain infections like strep may make the body more vulnerable to psoriasis flare-ups.
Smoking and alcohol consumption. Some research indicates that smoking or consuming alcohol is correlated with more severe cases of psoriasis.
Stress. High stress levels can weaken the immune system, making psoriasis flare-ups more likely.
Other immune disorders. People with psoriasis often have other autoimmune conditions, such as lupus, celiac disease, or Crohn’s disease.
If you suspect you are experiencing scalp psoriasis, it’s important to see a dermatologist for a diagnosis, which is the first step in starting a treatment plan. Here’s how they’ll typically diagnose scalp psoriasis:
Medical and lifestyle questions. Your healthcare provider will ask about your medical history, including whether you’ve ever been diagnosed with a different autoimmune condition. They may also ask about the products you use, your stress levels, and whether you smoke or drink alcohol regularly,
Exam. The dermatologist will examine your scalp for flaking, plaques, or irritation. They may also look at your skin and nails for signs of psoriasis.
Scalp biopsy. A scalp biopsy involves removing a small patch of skin from the scalp to examine it more closely under a microscope. This is generally done to rule out other skin conditions like eczema, seborrheic dermatitis, or tinea capitis.
Many people want to know how to permanently cure scalp psoriasis. Unfortunately, there is no known cure for psoriasis. However, there are treatment options that can keep the condition under control.
Oral medications, including methotrexate, acitretin, apremilast,), or cyclosporine
Topical medication, including calcipotriene (a synthetic form of vitamin D)
Injectable or IV biologic drugs, including etanercept, adalimumab, and ustekinumab
Certain immunosuppressant medications, including ciclosporin
Prescription topical treatments, including betamethasone
Phototherapy, also called light therapy, is often used to defend against psoriasis. Exposure to ultraviolet (UVB) rays is thought to help reduce skin inflammation, slow skin cell growth, and minimize the appearance of psoriasis plaques.
Phototherapy could be as simple as spending a few minutes in direct sunlight daily — as long as a healthcare professional recommends it.
Some people with psoriasis also get treatment with a specially designed lightbox or excimer laser that emits narrowband UVB light. In some cases, you may need to soak your scalp in a bath containing a medication called psoralen or take the medication orally before treatment — psoralen makes the skin more sensitive to UV light, which makes phototherapy more effective.
There are medicated shampoos specially formulated to help treat psoriasis. Some are available over the counter, while others require a prescription.
Common ingredients in shampoos made to combat psoriasis include:
Salicylic acid, which helps soften and gently exfoliate dead skin cells, making it easier to remove psoriasis plaques
Coal tar, which soothes inflammation, reduces itching, and slows excessive skin growth
Clobetasol propionate, a powerful corticosteroid that alleviates inflammation and itchiness
Over-the-counter (OTC) topical products like moisturizers, lotions, or certain shampoos can help reduce the symptoms of psoriasis. You can check out the National Psoriasis Foundation’s Seal of Recognition for OTC products that “have been created or are intended to be non-irritating and safe for people with psoriasis.” OTC products may be best for cases of mild scalp psoriasis.
If you have questions about psoriasis treatments or want to learn more about potential side effects, consult your healthcare provider.
Because scalp psoriasis is an autoimmune condition, it’s very difficult to prevent completely. However, there are some things you can do to reduce the chances of a severe flare-up.
Avoid psoriasis triggers. Triggers vary by person but often include weather changes, stress, smoking, and alcohol consumption. Whatever your triggers are, stay away as much as possible.
Try not to scratch the scalp. Scalp psoriasis can be itchy, but scratching can cause the skin to crack or bleed and delay healing.
Avoid products made with harsh chemicals. The American Academy of Dermatology recommends gentle hair care habits to reduce psoriasis flare-ups. Products made with artificial fragrances or phthalates can trigger psoriasis, and coloring, perming, or relaxing hair can also trigger flares.
Avoid tight hairstyles. These pull tightly on the scalp, causing irritation. Over time, overly tight hairstyles can also lead to a type of hair loss known as traction alopecia.
Avoid heat styling. Hot tools like blow dryers, curling irons, or straighteners can dry the scalp and cause irritation.
Manage stress. Learning to manage stress through activities like meditation or yoga can be very effective, as stress is a common trigger for flare-ups.
Stay consistent with medication. If your healthcare provider prescribes medication, use it as directed to avoid unnecessary flare-ups.
Psoriasis is a fairly common skin condition, and while having scabs on scalp can be uncomfortable, there are things you can do to manage scalp psoriasis.
Identifying triggers, such as stress or weather changes, can help manage flare-ups and improve your scalp health. You can also work with a healthcare provider to find an effective scalp psoriasis treatment option, such as medicated shampoos, topical ointments, and light therapy, depending on the severity of the condition.
If you want to learn more about scalp psoriasis and hair loss, our guide has you covered. You can also learn more about common scalp conditions affecting men or why you may be experiencing soreness across the entire scalp.
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