Scalp Psoriasis

Psoriasis is a common chronic, non-contagious and autoimmune skin disease. It is characterised by red, scaly, swollen patches on the skin (plaques), often seen on the scalp.

Scalp psoriasis can appear alone or in conjunction with other types of psoriasis. The back of the head is a prominent area for psoriasis, however, it can affect multiple parts of the scalp or the entire scalp. If a person has a scaly, itchy, and irritated red scalp, then they may have scalp psoriasis.

A thick crust along with a red thickened skin plaque indicates scalp psoriasis. The psoriasis can be asymptomatic or extremely painful. It is often a long-lasting skin problem, though its severity and scope frequently change. Although scalp psoriasis might cause temporary mild localised hair loss, it does not cause permanent baldness. Scalp psoriasis can be related to psoriatic arthritis.


Symptoms of Scalp Psoriasis

The following are the scalp psoriasis signs and symptoms:

  • Patches on the scalp: Patches on the scalp are often raised, inflamed, crusted, thick, and reddish and mostly covers the entire scalp.
  • Flaking and silvery-white scale: There is scaling of the skin and it appears like dandruff-like flaking or silvery-white scale similar to dandruff.
  • Dryness: The scalp gets very dry and cracks easily.
  • Itching: Itchy skin patches are common. Itching might be moderate in some people and severe in others.
  • Bleeding: Scratching the scalp may result in bleeding. It can also aggravate the psoriasis patches.
  • Burning sensation: Scalp psoriasis is frequently associated with burning sensation and feeling of discomfort. The patches may become painful in rare circumstances.
  • Temporary hair loss: While psoriasis itself does not cause hair loss, scratching the scalp repeatedly might cause some hairs to fall off. However, hair usually comes back once the condition is resolved.

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    When to see a doctor?

    Anyone who develops a new red rash should seek medical attention. A dermatologist will examine the affected area and ask about psoriasis symptoms, medical issues, and family history.

    A dermatologist may be able to identify scalp psoriasis just by looking at the rash, or a skin biopsy test may be necessary to rule out other conditions. Scalp psoriasis may flare up from time to time, but with proper treatment, the symptoms can be controlled.


    Causes

    Psoriasis has an unknown specific cause. But medical experts believe the cause of scalp psoriasis to be an immune system disorder. Overactive immune system cells stimulate the skin cells to grow at a faster rate than the body can shed them, consequently the cells pile up as plaques on the skin resulting in inflammation and redness of skin.

    On average, skin cells regenerate every 28 to 30 days. New skin cells grow and travel to the skin surface every three to four days in scalp psoriasis patients. The replacement of old cells with new cells results in thick and crusty areas on skin.

    Scalp psoriasis can run in families, it is observed that certain genes have been associated with psoriasis. An individual with psoriasis also has a family member with the same skin condition.

    Environmental risk factors might include skin damage, sunburn, medicines, stress, and other inflammatory or autoimmune health issues, which parents may pass down to their children.


    Risk Factors of Scalp Psoriasis

    People who have psoriasis are more likely to develop scalp psoriasis. A family history of psoriasis increases the chances of developing scalp psoriasis. Scalp psoriasis can occur at any age, although women appear to be more susceptible to this skin disorder.

    Although it is still unknown what causes scalp psoriasis, smoking and stress are regarded to be two of the most common risk factors. Scalp psoriasis is most likely caused by a hereditary predisposition.


    Complications of Scalp Psoriasis

    Scalp psoriasis complications include:

    • Hair loss:It can be caused due to damage to hair follicles, severe scaling, and frequent scratching. Huge clumps of hair may fall off when the scalp is injured. Certain scalp psoriasis treatments, as well as stress can worsen hair loss.
    • Bleeding: Itching, pain and discomfort are common symptoms of scalp psoriasis. Scratching or removing scales can cause bleeding and pain.

    Prevention of Scalp Psoriasis

    It is possible to keep away scalp psoriasis by following the below-given preventive measures:

    • Seek treatment: This is a crucial step in preventing psoriasis issues like hair loss and damaged skin. A doctor may recommend one or two topical medications in addition to an oral, injectable, or infused treatment.
    • Treat the scalp gently: Avoid excessive washing and combing of the hair. Because this might cause hair to break and hair loss, especially if the hair is delicate.
    • Avoid scratching: Scratching of scalp should be avoided because it can lead to bleeding and infection.
    • Avoid triggers: It is necessary to identify and avoid triggers that increase psoriasis symptoms.
    • Following the treatment plan: Because symptoms may take longer to improve, therefore it is important to apply topical drugs on a constant and daily basis.

    Diagnosis

    There are no definitive lab tests or imaging investigations for psoriasis. An evaluation of the symptoms and a review of the medical history are used to make the diagnosis. The medical history will help the doctor in identifying the disease risk factors (such as family history, smoking, stress and other autoimmune disorders), as well as other alternative reasons for the symptoms.

    If the condition is severe and/or resistant to treatment, a dermatologist may do an in-office skin biopsy test to obtain a tissue sample for investigation. Unlike other skin disorders such as eczema, the cells will seem thick and compacted (acanthotic) under a microscope.


    Treatment

    While there is no treatment for scalp psoriasis, a dermatologist can prescribe drugs and recommend over-the-counter medicines to relieve itching, dryness, flaking and pain. The doctor may recommend the below given therapies:

    • Topical creams and solutions
    • Light therapy
    • Vitamin supplements
    • Emollients like liquid paraffin
    • Topical corticosteroids
    • Coal tar and salicylic acid based lotions
    • Vitamin D analogues

    As psoriasis is an autoimmune disorder, oral medicines that work on the entire body may provide the most effective treatment. Oral medications that improve the immune system may be recommended in more severe cases or when topical therapy is ineffective.


    Lifestyle changes and self-care

    • Take any over-the-counter medicines or prescription drugs that the doctor has prescribed for severe itching and skin irritation.
    • Bathe or shower in lukewarm (not hot) water. Limit the time in the water to less than 15 minutes, and use moisturizer or emollients soon after softly towelling your hair dry.
    • Use conditioner after every shampoo wash to keep the scalp and hair nourished and clean.
    • To avoid skin irritation, comb the hair gently.
    • Moisturize the scalp or affected areas with a lotion or ointment multiple times each day, particularly after a bath or shower.
    • Wear caps or other headwear only when absolutely essential.

    Do's and Don’ts

    Do you have an itchy, flaky red scalp? Scalp psoriasis is more than just a dry scalp; it's an autoimmune condition. Of course, it's important to recognise the symptoms of scalp psoriasis so that patients can get treatment from a trained dermatologist. Proper skin care is essential if you have scalp psoriasis. It can ease pain and keep symptoms from getting worse. Following these dos and don'ts can help to prevent or reduce the psoriasis disease symptoms.

    Do’s Don’ts
    Use shampoos that contain tar or salicylic acid. Scratch the sore patches of the scalp.
    Avoid using hair products containing harmful chemicals. Drink excessive alcoholic drinks and smoke.
    Use hair products containing natural ingredients only. Wear dark coloured clothes.
    Bath in lukewarm water. Use hot water directly on the scalp.
    Moisturize your scalp with prescribed lotions and ointments. Ignore new symptoms and flare-ups.

    Follow the do's and don'ts for scalp psoriasis to have good scalp health and to lead an overall healthy lifestyle. A healthy scalp gives rise to healthy hair. Hence it's necessary to maintain good scalp health. Talk to a dermatologist if you detect any redness, itching, flakiness, pain, irritation, or excessive hair loss. The skin doctor can diagnose if there is an underlying health problem or if a change in hair care routine is required.


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    Care at Medicover Hospitals

    At Medicover, we have the best team of dermatologists who work together to provide Scalp Psoriasis treatment with utmost precision. Our highly skilled healthcare team utilises the latest medical approach, diagnostic procedures and advanced healthcare technologies to treat various skin conditions and ailments. For treating psoriasis, we adopt a multi-disciplinary approach, provide comprehensive care to the patients, and attend to all their medical needs for faster and sustained recovery.


    Citations

    https://www.psoriasis.org/scalp/
    https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-shampoo
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683126/
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