Scalp Psoriasis? Tips You Can Try Today

If you have scalp psoriasis, you may see red, itchy areas with white scales on your scalp. These plaques can extend beyond your hairline. You may also see flakes of skin in your hair or on your shoulders.

Scalp psoriasis affects more than half of those who have psoriasis, according to the National Psoriasis Foundation (NPF). Besides discomfort, the condition can trigger feelings of emotional stress as a result of the visible plaques and the flakes on your clothes.

There’s no cure, but there’s a lot you can do to feel and look better. “I always remind my patients that they’ll need to continue treating it to keep it under control,” says the dermatologist Steve Daveluy, MD, an assistant professor at the Wayne State University School of Medicine in Detroit.

Here are a few treatments that may help you manage scalp psoriasis. Just be sure to consult with your doctor before trying them to make sure they’re right for you.

Anti-Itch Treatments Can Spell Relief

Best for: Mild to severe psoriasis

Why it works: “Itching, scratching, and picking are the worst things for psoriasis [because] psoriasis thrives in areas of trauma and irritation,” explains Alan Menter, MD, the dermatology department chair at Baylor University Medical Center in Dallas.

Anti-itch strategies for your scalp include shampoos containing menthol, ice packs or cold wraps, over-the-counter steroid creams, relaxation techniques, and, for severe itching, prescription medications. Over time, other treatments should also lessen the itch.

A medicated shampoo with active ingredients such as topical steroids, salicylic acid, Nizoral (ketoconazole) (an antifungal medication), zinc pyrithione, or Blue Lagoon algae may be helpful as well.

Some people with scalp psoriasis find relief from itching by mixing up a home remedy of equal amounts of apple cider vinegar and water and dabbing the solution on their scalp two to three times a week. However, you should avoid this remedy if your scalp is cracked or bleeding.

Salicylic Acid Works as a Peeling Agent

Best for: Mild psoriasis

Why it works: Salicylic acid is a key ingredient in over-the-counter anti- dandruff shampoos, acne medicines, and callus and wart removers. Because it’s a keratolytic, or peeling agent, it’s often used to treat scalp psoriasis. Salicylic acid also helps with the itching by managing the abnormal turnover of cells in the skin, causing those excess skin cells to soften and come off.

Dr. Daveluy says that shampoos containing salicylic acid can be effective in combination with topical steroids. “The salicylic acid dissolves and removes the flakes so the topical steroid can penetrate the skin instead of being absorbed into the flakes,” he explains.

Be aware that strong salicylic preparations can cause irritation if left on the skin for too long.

Coal Tar Is One of the Oldest Psoriasis Remedies

Best for: Mild to severe psoriasis

Why it works: “We actually don’t know exactly how coal tar works, but it’s one of the oldest treatments for psoriasis,” Daveluy says. “In mild scalp psoriasis, it may be the only treatment necessary to keep it under control.”

If your scalp psoriasis is more severe, you can combine coal tar with other treatments. Talk to your doctor about how best to use coal tar products. You might need to leave the shampoo in your hair for several minutes, several hours, or even overnight.

Dr. Menter sometimes advises patients to put the product in their hair, cover it with a shower cap (to prevent spilling and staining), and then use a heat treatment that might help the shampoo work best.

In addition to shampoos, coal tar is an ingredient in ointments, creams, gels, and soaps.

Because it can irritate, redden, and dry the skin, you should test products containing coal tar in a small area at first.

Topical Steroids Reduce Psoriasis Inflammation

Best for: Mild to moderate psoriasis

Why it works: “Topical steroids work by reducing the inflammation that’s driving the skin changes seen in psoriasis,” Daveluy says. This type of treatment for scalp psoriasis is likely to be a liquid instead of a cream. When your hair is wet, create a part and apply a small amount. Then create a new part right next to it, and apply again, and keep doing this until your whole scalp has been treated, he says. A shower cap may also be worn to keep the product from staining pillowcases.

Topical steroids can be bought or prescribed at different strengths, depending on your symptoms. Some people may also need steroid injections for short-term treatments.

Topical Vitamin D Calms the Immune Response

Best for: Mild to moderate psoriasis

Why it works: “These medications work by calming the immune response and telling the skin cells to grow and turn over at a regular rate,” Daveluy says. Vitamin D analogues calm your overactive immune response, which is causing the excess skin cell production that leads to psoriasis. Vitamin D analogues (or forms of activated vitamin D), including calcipotriene and Rocaltrol (calcitriol), can be part of liquid scalp treatments or may be combined with a topical steroid. “The combination product is particularly effective and useful for mild to severe scalp psoriasis,” he says.

Slowing the growth of skin cells may cause the plaques to become thinner and less scaly. Psoriasis occurs when the immune system misfires and starts overacting — creating inflammation inside the body. Vitamin D may also work by shifting the balance of your immune system and putting it in a more neutral and healthy state.

In addition to treatments containing forms of synthetic vitamin D, some people with scalp psoriasis find relief using topicals that contain retinoids (vitamin A derivatives) including Tazorac (tazarotene).

Ultraviolet Light Therapy Can Treat Psoriasis Plaques

Best for: Mild to moderate psoriasis

Why it works: When sunlight penetrates the top layers of the skin, the ultraviolet (UV) radiation bombards the DNA inside skin cells and injures it. This can cause wrinkles, aging skin, and skin cancers. However, these same damaging effects can destroy the skin cells that form psoriasis plaques

Stress Management Reduces Psoriasis Flares

Best for: All psoriasis

Exercise both increases the body’s production of endorphins (chemicals that improve mood and energy) and reduces levels of the body’s stress hormones such as adrenaline and cortisol. So more exercise may prove helpful for overall stress and for fewer and less-severe flares.

Some people with psoriasis experience stress relief through acupuncture or yoga. Connecting with others who have the disease through support groups might also help in dealing with issues of stress. Ask your doctor or check with your local hospital to find a group. Or consider connecting with others online. The National Psoriasis Foundation sponsors an online support community where people affected by psoriasis can connect, exchange information, or meet others.

Hats, Scarves, and a New Hairstyle Can Mask Psoriasis

Best for: All psoriasis

Why it works: In general, you can wear any kind of hat or scarf with scalp psoriasis. But you should “avoid tight headwear or hats that rub and cause friction,” Daveluy says. “This can cause the psoriasis to flare due to the trauma.” He also advises wearing white or light colors that don’t show flaking.

Wearing your hair a certain way may hide some of the redness and scales of psoriasis. Though you might be nervous about going to a barber or a salon, many hairstylists are familiar with scalp psoriasis. Just mention your condition in advance so you and your stylist can talk about any special requirements, such as gentle treatments and avoiding injury to the scalp area.

A hat or scarf may also prove useful if you are experiencing temporary hair loss that sometimes occurs with scalp psoriasis. This hair loss usually happens when a person is too aggressive when removing plaque scales — in other words, pulling out hairs when using a comb to remove the excessive skin cells that make up a plaque.

Psoriasis itself does not cause hair loss, but your hair can enter a resting stage known as telogen when you are under stress. When too much of your hair goes into telogen at once, fewer hair follicles are available to grow new hair. As a result, you may notice more hair on your hairbrush than usual. That’s another reason why you might want to try keeping your stress levels in check.

The Latest in Psoriasis

Picking at Your Psoriasis Scales? Do This Instead

It’s tempting to peel and pick at those itchy scales, but if you can help it, there are better ways to cope.

What Black Patients Need To Know About The Effects of Psoriasis

Psoriasis can look differently on darker skin than on lighter skin — and knowing how to spot the symptoms is an important first step of the treatment ...

Ways to Protect Your Eye Health — and Preserve Your Vision — With Psoriasis

How to keep the skin condition from negatively impacting your vision.

7 Ways to Take the Stress Out of Your Next Hair Salon Visit if You Have Scalp Psoriasis

Scalp psoriasis symptoms can make a routine trip to the hair salon stressful. But with the right approach, you can have an easier visit — and a healthy...

Do You Need a COVID-19 Vaccine Booster if You Have Psoriasis?

Psoriasis drugs that work by suppressing the body’s immune response may raise the risk of COVID-19 complications. If you’re already immunized, can a booster...

Psoriasis Awareness: A 2021 Special Report

Psoriasis flares have been on the rise in 2021, according to a survey of ishonest readers who have the skin condition. Here’s what might be to ...

Psoriasis: How to Deal with Cracked, Bleeding Skin

Take these steps to heal your skin and avoid future fissures.

Your Psoriasis Diet: Best Foods for Spring and Summer

Ready to break out your favorite warm-weather recipes? Here are delicious anti- inflammatory ingredients you should consider using.

Read more on: beauty, skin, psoriasis, psoriasis treatment, scalp psoriasis