Scalp Psoriasis

Scalp psoriasis is one of the most common skin conditions that affects millions worldwide. This persistent issue causes redness, scaling, and discomfort on the scalp, often extending beyond the hairline. It's not just a physical nuisance; scalp psoriasis can also take an emotional toll, impacting self-esteem and quality of life. 

This blog dives into the signs and symptoms, explores the underlying causes, and discusses various scalp psoriasis treatment options. 

What is Scalp Psoriasis? 

Scalp psoriasis is a persistent autoimmune skin condition that can affect anyone, regardless of age. It causes the skin cells on the scalp to reproduce too quickly, leading to the formation of thick, discoloured patches known as plaques. These plaques can be itchy and painful. They often extend beyond the hairline to the forehead, the back of the neck, and behind and inside the ears. 

Symptoms of Scalp Psoriasis 

Scalp psoriasis manifests in various ways, ranging from mild to severe, including: 

• There are reddish patches on the scalp, varying in size and visibility. Some may be small and easily concealed by hair, while others can be large, thick, and inflamed, covering the entire scalp. 
• Another common symptom is the presence of silvery-white scales, which can look similar to dandruff. However, scalp psoriasis differs from dandruff because it causes a distinct silvery sheen and dry scale on the scalp. 
• Intense itching, sometimes interfering with daily activities and sleep. 
• Psoriasis causes dry scalp, sometimes to the point where the skin cracks and bleeds. 
• Temporary hair loss due to vigorous scratching or forceful scale removal 
• In more severe cases, scalp psoriasis can extend beyond the hairline, affecting the forehead, the back of the neck, and the skin around the ears. These areas may develop raised, discoloured plaques with a white or silvery surface of dead skin cells. 

Psoriasis Scalp Causes 

Scalp psoriasis develops from an overactive immune system. In people with this skin disorder, the immune system attacks normal skin cells, causing inflammation. This inflammatory response leads to an accelerated growth cycle of skin cells. While new skin cells typically grow every 28 to 30 days, in individuals with scalp psoriasis, this process occurs every three to four days. The rapid buildup of new cells replacing old ones creates the characteristic thick patches of skin associated with the condition. The following are other contributing factors: 

• Several environmental factors also contribute to the onset and exacerbation of scalp psoriasis. These triggers can include skin trauma, sunburn, or stress. 
• Viral and bacterial infections 
• Some medications, such as lithium, prednisone, and hydroxychloroquine, have been associated with triggering psoriasis symptoms. 

Risk Factors for Scalp Psoriasis 

Scalp psoriasis can affect anyone, but certain factors increase the likelihood of developing this condition. 

• Family history 
• Smoking tobacco 
• Alcohol consumption 
• Stress and depression 
• Obesity 
• People with other autoimmune diseases 
• Complications of Scalp Psoriasis 

While primarily affecting the skin, scalp psoriasis can result in various complications that extend beyond the visible symptoms, such as: 

• Hair loss 
• Infection of the open sores and cracks in the skin caused by scalp psoriasis 
• Chronic inflammation can lead to skin thickening and scarring 
• Itching and irritation can disturb sleep, leading to fatigue 
• Mental health issues like self-consciousness, stress, anxiety, and depression 

Diagnosis 

The diagnosis process typically begins with a visual inspection of the scalp and other areas of the skin. The doctor looks for telltale signs such as red or purple bumpy patches, silvery-white or grey scales, and dandruff-like flaking. 

They might inquire about recent illnesses, stress levels, medication changes, or hair products that could have triggered a flare-up. 

Sometimes, the doctor may perform additional tests to rule out other conditions with similar symptoms. These tests may include: 

• Allergy tests 
• Skin biopsy 
• Blood tests 

Treatment for Scalp Psoriasis 

The following are different treatment options for scalp psoriasis: 

• Topical Treatments: 
  • Medicated shampoos that contain ingredients like coal tar, salicylic acid, or zinc pyrithione 
  • Corticosteroids 
• For moderate to severe cases, doctors may recommend other topical treatments such as: 
  • Calcipotriene: A synthetic form of vitamin D 
  • Tazarotene: A vitamin A derivative 
  • Anthralin: A tar-like substance that slows skin cell growth 
  • Systemic Medications: Oral retinoids, methotrexate, and cyclosporine. 
  • Phototherapy: Light therapy uses ultraviolet light to slow skin cell growth and reduce inflammation. 

When to See a Doctor 

It's essential to seek medical attention if: 

• New symptoms develop 
• Symptoms don't improve after treatment 
• Plaques look infected (red, purple, grey or white skin; irritation and swelling) 

Home Remedies for Scalp Psoriasis 

While home remedies cannot cure scalp psoriasis, they can help alleviate symptoms and complement traditional treatments. These include: 

• Creams containing 0.5% aloe can reduce itching, inflammation, and flaking when applied up to three times daily. 
• Coconut oil's healthy fats help soften thick plaques and soothe irritation. 
• Adding a cup of raw, unflavoured ground oats to a warm bath and soaking for at least 15 minutes can help reduce scalp psoriasis symptoms. 
• Mahonia aquifolium, or barberry or Oregon grape, has shown potential in reducing inflammation and other psoriasis symptoms. 
• Tea tree oil helps alleviate inflammation and discolouration associated with scalp psoriasis. 
• Incorporating 1.5-3 grammes of turmeric into one's daily diet, either as a supplement or in cooking, may help reduce psoriasis symptoms. 

Prevention of Scalp Psoriasis 

Individuals can take several proactive steps to lower the frequency and severity of flare- 
ups: 

• Individuals should keep their skin well-hydrated. 
• Use virgin coconut oil and aloe vera gel to soothe irritated skin and reduce inflammation. 
• Individuals should focus on gentle care and avoid trauma to the skin 
• When bathing, it's best to avoid very hot water 
• Moderate sun exposure can be beneficial, as ultraviolet rays slow the growth of skin cells. 

Conclusion 

Living with scalp psoriasis not only affects physical health but it also touches emotional wellness. However, people can take control of their condition by staying informed, exploring various treatment options, and maintaining a healthy lifestyle. Remember, while scalp psoriasis is a long-term issue, it doesn't define a person. With patience, persistence, and the proper support, many find ways to thrive despite the challenges it presents. 

FAQ's 

1. How can I tell if I have psoriasis on my scalp? 

Scalp psoriasis presents distinct characteristics that set it apart from other scalp conditions. People with light to medium skin tones often notice raised, reddish or salmon- coloured patches with white scales. On darker skin, these patches may appear purple with grey scales. The affected areas can be a single patch or several, sometimes covering the entire scalp. Scalp psoriasis can extend beyond the hairline to the forehead, the back of the neck, and behind or inside the ears. 

2. What is the root cause of scalp psoriasis? 

Scalp psoriasis stems from an immune system issue. In people with this condition, the immune system acts against healthy skin cells, causing inflammation. This inflammatory response leads to an accelerated growth cycle of skin cells. 

3. What is the difference between scalp psoriasis and dandruff? 

While both conditions can cause flaking of the scalp, there are several key differences: 

• Psoriasis is long-lasting, while dandruff may come and go. 
• Psoriasis tends to produce flakes that are more scaly or powdery. 
• Psoriasis patches can extend past the hairline to the forehead, the back of the neck, or the skin around the ears, while dandruff typically remains confined to the scalp. 
• Psoriasis is an autoimmune condition. It happens when white blood cells attack skin cells. Dandruff often results from excess oil on the scalp. 
• Scalp psoriasis typically requires more intensive treatment compared to dandruff. 

4. What is the difference between scalp psoriasis and scalp eczema? 

While scalp eczema and scalp psoriasis share some similarities, they are distinct conditions. Scalp eczema typically presents as dry, scaly skin with red or grey patches. On the other hand, psoriasis usually shows thick layers with much clearer edges than scalp eczema, often appearing as scaly patches that can be silvery, white, or red. 

5. Can psoriasis be cured in hair? 

Currently, there is no known cure for scalp psoriasis. However, various treatments can effectively manage symptoms and improve quality of life. These treatments include: 

• Topical treatments 
• Corticosteroids 
• Phototherapy 
• Systemic medications 

6. What happens to untreated scalp psoriasis? 

If left untreated, scalp psoriasis can worsen over time and lead to various complications: 

• The symptoms may become more severe, with increased scaling, itching, and discomfort. 
• The condition may extend beyond the scalp to other areas of the body. 
• Open sores and cracks in the skin can become infected. 
• Untreated scalp psoriasis can significantly affect a person's self-esteem. 

Dr. Parag Aradhey

MBBS, DNB (MED), DNB (Neurology), MNAMS
Ganga CARE Hospital Limited, Nagpur

To Book an Appointment, call:

+91 406 810 6585