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Scalp Psoriasis : Causes, Symptoms and Treatment

Scalp psoriasis is a common skin disorder that makes raised, reddish, often scaly patches. It can cause everything from a single patch and mild scaling to crusting on the entire scalp — sometimes extending onto the back of the neck, forehead, around the nose, in the beard area, or behind or inside the ears.

While psoriasis can affect any skin surface, about half of the estimated 7.5 million Americans with psoriasis have it on their scalp. Occasionally the affected area is limited to the scalp, however, this is uncommon.

Scalp psoriasis can be mild and almost unnoticeable. But it can also be severe, last a long time, and cause thick, crusted sores. Intense itching can affect your sleep and everyday life, and scratching a lot can lead to skin infections and hair loss.

As with other types of psoriasis, we do not know what causes it however, doctors believe it is the result of an immune condition that causes skin cells to grow too quickly and build up into patches. In the case of psoriasis, white blood cells known as T cells mistakenly attack the skin cells.

In a typical body, white blood cells are deployed to attack and destroy invading bacteria and fight infections. This mistaken attack causes the skin cell production process to go into overdrive. The sped-up skin cell production causes new skin cells to develop too quickly. They are pushed to the skin’s surface, where they pile up.

This results in the plaques that are most commonly associated with psoriasis. The attacks on the skin cells also cause red, inflamed areas of skin to develop.

Thus you cannot contract psoriasis from another person, but you may be more likely to get scalp psoriasis if it runs in your family. There’s no cure for psoriasis, but you can take a number of steps to manage it.

Scalp psoriasis can be mild and almost unnoticeable. But it can also be severe, last for an extended duration, and cause thick, crusted sores. Intense itching can affect your sleep and everyday life, and scratching a lot can lead to skin infections and hair loss.

Symptoms

Symptoms of mild scalp psoriasis may include only slight, fine scaling. Symptoms of moderate to severe scalp psoriasis include:

• Scaly, red, bumpy patches
• Silvery-white scales
• Dandruff-like flaking
• Dry scalp
• Itching
• Burning or soreness
• Hair loss

Hair loss is a common problem experienced by those with scalp psoriasis. Often this hair loss is the result of damage to the hair shaft or hair follicles and not a result of the psoriasis itself. This damage can occur from rubbing, scratching or excessive combing, and from chemicals or ingredients in treatments and products as well as the stress that goes along with the condition.

Hair loss related to psoriasis and psoriasis treatments is almost always temporary. Normal hair growth will usually return once your psoriasis is effectively managed and irritants from rubbing, scratching, and treatments have been reduced or stopped. It is only in very rare cases that the hair follicles may be damaged and the hair may no longer grow.

If you have mild scaling, it may improve on its own, however, if your symptoms are more advanced you will need treatment. It can take a couple of months or longer to get more severe dandruff under control. Once you do, you may be able to keep it from flaring with special shampoos or moisturizers.

Your treatment will depend on:

• How severe it is
• How it has responded to treatment before
• Whether you have psoriasis elsewhere on your body
• How much hair you have

While there is no cure for this autoimmune disease, it can be put into remission and there are treatments available that can help ease, and or eliminate your psoriasis symptoms. These include home remedies to calm the skin, topical and oral medications, and light therapy.

Home Remedies

If you suffer from psoriasis, it is possible that an underlying cause is a Vitamin D Deficiency and we encourage you to have your vitamin D level tested right away, and to work with your doctor to bring your levels up to an optimum range. Vitamin D3 is very inexpensive and readily available however, the best source of vitamin D is sun exposure. In fact one of the treatments for psoriasis is ultraviolet (UV) radiation. It used to be that the only place psoriasis patients could get UV radiation was a dermatologist’s office, and it often cost several hundred dollars per treatment. When tanning parlors began to appear, psoriasis patients realized they could utilize commercial sunbeds and get some relief of their symptoms. Some people think that this commercial conflict — between dermatologists and tanning parlors — is the reason dermatologists have so forcefully condemned sun tan parlors. It may take three months or so to correct the deficiency, but that may be all it takes to end your psoriasis.

To learn more about the link between Vitamin D and psoriasis, please visit Harvard Health.

If you’re suffering from disease, the number one recommendation for the treatment of psoriasis would be Red and Infrared Light Therapy, followed by a healthy diet, avoiding alcohol as well as acidic and inflammatory foods, minimizing stress, supplementing with Omega-3 Fish Oils and Magnesium, reducing your toxin burden, and maintaining a healthy body weight all help to manage psoriasis symptoms.

Topical Treatments

If the aforementioned recommendations fail to put your psoriasis into remission, the next line of defense is treatment you use directly on your skin: medicated shampoos, creams, gels, lotions, foams, oils, ointments, and soaps. You can get some of these products over the counter, but stronger versions require a prescription.

Over-the-counter products often contain one of two medications approved by the FDA for psoriasis:

• Salicylic acid
Coal tar

Prescription products for scalp psoriasis may have higher concentrations of either or both of these, as well as other FDA-approved medications, such as:

Anthralin, an older prescription medication
• Antimicrobials, which treat bacterial or yeast infections that can come with scalp psoriasis
Calcipotriene, a strong derivative (different form) of vitamin D. See Is Psoriasis Another Symptom of Vitamin D Deficieny?
• Calcipotriene and betamethasone dipropionate (a vitamin D derivative combined with a strong steroid)
• Other topical steroids
Tazarotene, a derivative of vitamin A To work, these treatments must be put on your scalp, not just your hair. Follow the directions exactly until your skin heals, a process that can take 8 weeks or more. Once your psoriasis has cleared, you can help keep it from coming back by shampooing regularly or twice-weekly with a product that has coal tar or other medications.

Office Treatments

If you have mild scalp psoriasis on a few areas, your doctor or dermatologist may consider injecting steroids directly into those areas.

If your symptoms don’t respond to topical treatments, phototherapy with a laser or non-laser light source, such as photobiomodulation aka red light therapy may help. For example, the excimer laser focuses high-intensity light on affected areas and avoids the surrounding healthy skin. Ultraviolet (UV) light — sometimes delivered with a hand-held device called a UV comb — can be used to treat the entire scalp. If you have very thin hair, or a shaved head, your doctor may recommend exposure to natural sunlight for brief periods.

Medications for Severe Scalp Psoriasis

If you have moderate to severe scalp psoriasis, your doctor may prescribe an oral medication or one that is injected. Oral medications include:

• Corticosteroids
• Cyclosporine (Sandimmune)
• Methotrexate (Rheumatrex)
•  A strong form of vitamin A called a derivative (Soriatane)

The latest class of FDA-approved medications are called biologics. These drugs, which you get by injection or IV, may keep your skin from making too many cells. According to the American Academy of Dermatology, seven biologics may work:

adalimumab (Humira)
etanercept (Enbrel)
guselkumab (Tremfya)
infliximab (Remicade)
ixekizumab (Talz)
secukinumab (Cosentyx)
ustekinumab (Stelara)

Living With Scalp Psoriasis

There is no cure, but many treatments can help symptoms, control flare-ups, and prevent it from coming back. People who follow their treatment plan rarely have to endure severe scalp psoriasis for long.

Psoriasis support groups can also offer valuable tips to help medical treatments work better and ease the stress and sadness that this common condition can cause.

Psoriasis Support Group
Psoriasis Support
Natural Remedies for Psoriasis
Psoriasis Support and Inspiration

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