The sudden appearance of scales and flaky skin over most of the body would devastate just about any high school sophomore â€” and thatâ€™s how it was for Christine Patrice.
â€œI looked like something was wrong with me,â€ said Patrice, who took to wearing long pants and sweatshirts even on 90-degree days. What really got to her though was her scalp. â€œIt used to flake terribly,â€ she said. â€œI would peel it out of my hair â€” it grossed me out.â€
In the 12 years since her diagnosis, the now 28-year-old beauty blogger has read everything she could find on scalp psoriasis and hair care and, largely through experimentation, has learned a few tricks not only to help her scaly skin (UV treatments worked best in high school), but also her flaky scalp. Patrice has moved well past the stigma of beauticians refusing to style her hair for fear they might â€œcatchâ€ the autoimmune disorder, finding her own tips for beautiful hair with scalp psoriasis.
Indeed, David Pariser, MD, a dermatology professor at Eastern Virginia Medical School and former president of the American Academy of Dermatology, said heâ€™s known of children forced out of swimming pools out of similar ignorance. â€œIt can be a tremendous source of social embarrassment,â€ he said.
Scalp Psoriasis and Hair Care: OTC and Prescription Treatments
While psoriasis can affect the entire body, it often shows up on the scalp, which can include the area behind the ears, the back of the neck, and even the forehead and other areas of the face. Scalp psoriasis symptoms include dry or brittle hair, tremendous itching, and dandruff-like flakes falling on your clothes.
If scalp psoriasis and its accompanying inflammation are severe enough, you might experience hair loss, although with proper treatment, the hair should grow back. â€œIt doesnâ€™t destroy the roots,â€ Dr. Pariser explained.
Scalp psoriasis management often starts with over-the-counter shampoos. Alison Ehrlich, MD, a professor of dermatology at the George Washington University School of Medicine and Health Sciences and director of the George Washington Psoriasis Clinic in Washington, D.C., recommended shampoos with key ingredients â€” ketoconazole, which reduces yeast organisms that can further inflame the scalp; salicylic acid to help slough off scales; and tar to help reduce the inflammation, which ultimately will reduce the number of scales.
Prescription treatments, including topical steroids, vitamin D derivatives, and tar preparations, are available as oils, gels, foams, lotions, and sprays, Dr. Ehrlich said.
A Natural Regimen for Christina Patrice and Scalp Psoriasis
Patrice prefers natural treatments to using steroids because of potential side effects, including redness and thinning of the skin, although Pariser said these concerns apply more to the face and other areas where the skin is already relatively thin.
Largely through experimentation, Patrice recommends these tips for beautiful hair with scalp psoriasis:
Try henna. Though henna is a hair-coloring product and not a psoriasis treatment, Patrice found her scalp virtually scale-free after just one treatment. â€œIt boggled my mind,â€ she said. Initially she used it just to condition her hair, but she now applies it monthly to manage her psoriasis. In fact, she would use it more often, she said, except that applications are labor- intensive, and the henna has to stay on the hair for several hours or even overnight. She mixes the henna with coconut oil to soften the scales and create a sweet-smelling conditioner. Any 100 percent henna treatment will do, she said.
Cleanse with a natural shampoo. Patrice strongly recommends using Shea Moisture African Black Soap Shampoo on the blog Black Girl Long Hair: â€œThe black soap and plantain enzymes definitely provide relief in terms of reducing itching and inflammation, much like coal tar. The willow bark extract has the same exfoliating effect as salicylic acid, and the tea tree oil provides that necessary anti-bacterial/anti-fungal layer of protection.â€ She uses the shampoo, sometimes with Shea Moisture African Black Soap Purifying Mask conditioner, two to three days a week. The products rinse out well, she said, and can be used on all hair types.
Rotate products. After a while, psoriasis will â€œadaptâ€ to a certain product, Patrice noted on her blog. So, she rotates even her most effective products, sometimes washing with just a sweet-smelling conditioner for a month before going back to Shea Moisture.
Avoid sulfates. Though Patrice acknowledges that shampoos that contain coal tar and salicylic acid can help reduce psoriasis scales, she said these products all also contain sulfates, which can dry the hair and lead to breakage. Trader Joeâ€™s Tea Tree Tingle shampoo and conditioner are both sulfate-free, as are the WEN products, which Patrice also recommended.
Try tea tree oil. While all-natural, anti-bacterial, anti-fungal tea tree oil does not relieve the psoriasis itself, it can help keep the scalp from infection that results from frequent scratching. Patrice recommends tea tree oil in 100 percent concentration, mixed with coconut oil and applied directly to the scalp.
Though Patrice has accepted that her scalp may never be flake free, she's learned enough about scalp psoriasis management to allow her to wear her long, curly hair however she pleases. Most important, she said, is educating yourself about the various products: â€œI always read the ingredients."
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