Psoriasis is a chronic skin disorder and typically presents with large patches and plaques with varying degrees of itch and pain. The typical lesions show large number of silver scales on the skin. Psoriasis most often occurs on the elbows, knees, back, face, palms, and soles of the feet. And sometimes it even occurs on the scalp. There are millions who suffer from scalp psoriases.
Scalp psoriasis may either occur alone or in combination with body psoriasis. When it affects the scalp, the psoriasis is generally found at the back and sides. Sometimes only isolated lesions are seen on the scalp but it is not uncommon to have the entire scalp affected. In the majority of scalp psoriasis, the lesions are obvious despite the camouflage from hair. Psoriatic lesions generally cause flaking of the skin and make it appear like someone has severe dandruff.
Sometimes the scalp lesions may be itchy but are not painful. Hair loss is not a typical feature of scalp psoriasis but can occur to some degree. Scalp psoriasis is life long problem. Because of its obvious visual impact, the condition can lead to social isolation depression and lack of confidence.
Scalp psoriasis is difficult to treat. The presence of the hair and the thickness of the plaques make it difficult for the mediation to reach at the base of the plaque. Scalp psoriasis is usually treated with topical medications in the form of shampoos, lotions, creams, foams, and oils. The following are used to treat scalp psoriasis:
Shampoos: There are many types tar shampoos that can be used. Despite the few complaints about product safety, tar shampoos have been used for many decades and they are generally safe. When used regularly. Tar shampoos decrease the plaque formation and scaling.
Also available are medicated shampoos containing salicylic acid. This shampoo helps to reduce the dead cells and removes scales.
Tazorac: This Vitamin A derivative is frequently used for the treatment of scalp psoriasis. it is available as a cream or gel and is applied once a day. This medication is inhibits the rapid skin cell growth. It can also cause skin irritation.
Topical steroids: When the psoriasis is active, topical steroids are helpful. The potent steroids can be applied thinly over the scalp and help reduce the redness and inflammation. Besides being available as a cream and lotion, topical steroids are also available as foams which can easily be applied. Topical steroids, such as cortisone creams, may slow down the rapid growth of skin cells and decrease the swelling associated with the rashes.
Cortisone oils are also available for wide spread scalp psoriasis. The oil is typically applied at night and covered with a dressing or a shower cap.
Anthralin: These products are effective but are very irritating to the skin. They can only be applied for a short time initially and the time can be gradually increased. Anthralin can also stain everything in site.
Calcipotriene: This new products is used in combination with steroids and is somewhat effective. Calcipotriene (Dovonex) helps regulate skin cell production. Many users claim that the product is not effective.
UV light: UV light is effective for psoriasis everywhere on the body. The same applies to the scalp. However, the hair almost always obstructs the light from getting through to the scalp. However, we now have combs which have attachments for UV light. The hair can be combed with the UV light on and the scalp can be treated at the same time.
Steroid injections: Steroid injections are not widely used for scalp psoriasis. The scalp is a sensitive area and can result in pain. However, small localized lesions can be injected with steroids.
Systemic steroids: Oral steroids can be used to treat severe psoriasis but they have potent side effects. One should always weigh the benefits versus the risks of these drugs before starting them orally.
Do not scrub the scalp. Skin breaks can worsen the psoriasis.
Certain medications like steroids can be covered with a shower cap. They are more effective this way.
Always use medicated shampoo and rub it well into the scalp