Does Scalp Psoriasis Embarrass You? Youre Not Alone

Like a lot of people, I learned how to cut my own hair during the pandemic. When California initiated COVID-19 lockdowns, my hair salon closed for seven months. Even when it reopened, I continued to trim my hair at home because I was concerned about exposure to the virus, which was still spreading widely in my community.

I know a lot of people were unhappy about giving up salon visits, but my feelings were mixed. That’s because I’ve been embarrassed about my scalp psoriasis for almost my whole life and have always worried about a new hairdresser’s reaction to it.

Social Anxiety and Dark Suits

My earliest memories of scalp psoriasis date back to haircuts in grade school. I was so ashamed that I would let only my dad cut my hair. He said that he modeled his haircutting technique after his method of shearing hedges in the yard.

Those hedge-like haircuts left me with a good dose of self-loathing and social anxiety when I went to school and played sports. I absolutely dreaded school pictures. Still, back then I’d rather face the ridicule of my classmates than go to a barbershop.

Scalp Psoriasis Is Stubborn

A few years ago, during a dermatology clinic visit, my doctors noticed my worsening scalp psoriasis. The dermatology resident who saw me first took an extra-long look and, at the end of his assessment, asked if my scalp was the most irritating aspect of my skin condition.

When I mentioned the scalp irritation to my dermatologist, he also examined it closely and simply said, “Scalp psoriasis is one of the most difficult to treat.”

For the most part, my current psoriasis treatments, including the biologic Skyrizi, are more effective at treating my scalp than methods I used in the past. I’m glad to leave behind the dime-sized scalp plaques and creeping psoriasis on my forehead, neck, and ears. I cannot imagine going back to those days.

But my scalp psoriasis is stubborn. My worst scalp psoriasis symptom now is the itchiness that keeps me awake some nights. I’m also annoyed at the smaller flakes that leave behind a thin layer of scales on my laptop keyboard, the seat in my car, and bed pillows.

Scalp Psoriasis Treatments Take Time and Effort

There is no cure for scalp psoriasis, and often a combination of treatments is necessary to manage the condition.

I first saw improvement in my scalp psoriasis after starting systemic medication like methotrexate, cyclosporine, and injectable biologics. Even with those strong drugs, I have needed to add other therapies in combination, such as medicated topical oils, foams, and tar shampoos.

Some treatments are effective but take time and effort. One involves wetting my head, applying the oily medication to my scalp, and wearing a shower cap for at least four hours. Other treatments, like phototherapy, demand special equipment or care.

Going Back to the Hairdresser?

Until I find an even better combination of treatments to manage my scalp psoriasis, I’ll need to continue brushing off the flakes. I’m glad, though, that my feelings of embarrassment have improved with greater self-confidence and more effective psoriasis treatments.

I’m even looking forward to the day when I can finally go back to the hair salon.

You can read more about my experiences on my website, PsoHoward.

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