Scalp psoriasis is characterized by a red plaque with silvery-white scales on the scalp. It affects about 50 percent of the population and is common in people with plaque psoriasis.
Apart from the scalp, scalp psoriasis may extend to the:
- Hairline
- Back of the neck
- The skin around the ears
While there aren’t different types of scalp psoriasis, there are multiple types of psoriasis that can affect the scalp, which include:
- Chronic stationary psoriasis is present as small pimples, discoloration and plaques that mainly appear on the scalp, genital area, navel area and back.
- Plaque psoriasis is present as elevated, inflamed lesions (abnormal growth of tissue) covered with a silvery-white scale that appear on the elbows, knees, lower back and scalp.
- Guttate psoriasis is present as a small, coin-like lesion with a fine silver-white buildup (scale) that is mainly found on the trunk but can also appear on the face and scalp.
What are some of the triggers for scalp psoriasis?
Scalp psoriasis, like all psoriasis, is related to certain genetic defects that affect parts of the immune system. While environmental factors may trigger the condition, it’s initially developed in genetically predisposed individuals.
Furthermore, scalp psoriasis may have the same triggers as other psoriatic conditions, such as:
- Skin injury (cuts, scrapes or surgery)
- Emotional stress
- Streptococcal or other infections that affect the immune system
- Certain prescription medications (such as lithium and beta-blockers) taken over short or long term periods
- Cold weather, when people have less exposure to sunlight and humidity
- Scalp psoriasis is also more common when one is constantly exposed to hot, dry indoor air
What are the symptoms of scalp psoriasis?
Psoriasis can appear as a small, pinkish-red patch or manifest as flakes that cover the entire scalp. Some of the noticeable signs of scalp psoriasis include:
- Reddish or pinkish patches on the scalp: Patches are noticeable, thick and inflamed.
- Dandruff-like flaking and silvery-white scales: Dandruff in scalp psoriasis is different from regular dandruff because psoriasis flakes are silvery and powdery, and can creep beyond the hairline.
- Dry scalp: The scalp tends to crack and bleed.
- Itching: Itching may range from mild to intense, with some people feeling a burning sensation.
- Bleeding: Scratching too vigorously can lead to bleeding.
- Temporary hair loss: Scratching the scalp or using force to remove the scale can cause hair loss. However, after the scalp psoriasis clears, hair usually regrows.
How is scalp psoriasis treated?
Scalp psoriasis can cause a lot of discomfort and embarrassment to the person suffering from it. However, treatment can bring relief to some extent. While some people may get relief from a medicated shampoo or solution, others may have to consult a dermatologist.
The following types of treatment can help reduce scalp psoriasis:
- Medicines applied to the scalp, which may include:
- Zithranol-RR (anthralin)
- Dovonex (calcipotriene)
- Taclonex (calcipotriene and betamethasone dipropionate)
- Vectical (calcitriol)
- Tazorac (tazarotene) in the form of gels or solutions
- Medicated shampoos containing salicylic acid
- Scale softeners, such as urea
- Injections containing steroids given in the scalp
- Ultraviolet (UV) light treatments
- Biologics and other medicines that work throughout the body, including methotrexate, cyclosporine, retinoids, etc.
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Medically Reviewed on 7/29/2021
References
Cole GW. Scalp Psoriasis (Psoriasis of the Scalp). MedicineNet. https://www.medicinenet.com/scalp_psoriasis/article.htm
American Academy of Dermatology. Scalp Psoriasis: Diagnosis and Treatment. https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-treatment
American Academy of Dermatology. Scalp Psoriasis: Diagnosis and Treatment. https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-treatment
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