Treating scalp psoriasis
What Is Scalp Psoriasis?
How Do You Treat Scalp Psoriasis?
There’s no cure for scalp psoriasis, but there are ways to manage its symptoms. “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.
According to data published in February 2019 in the journal Cochrane Database of Systematic Reviews, a combination of treatments works best against scalp psoriasis. (5)
Treatments for scalp psoriasis may include the following:
Methotrexate, oral retinoids, cyclosporine, biologics, and ultraviolet light may be used if psoriasis is also on other parts of the body.
“Phototherapy works by reducing the inflammation,” says Dr. Daveluy, but he cautions that it’s less effective with scalp psoriasis than with psoriasis elsewhere on your body. That’s because the scalp doesn’t respond the same way. Hair blocks some or all of the light, but you may achieve better results if you part your hair in many rows.
This may be injected into scalp lesions that are mild and appear in few areas.
These are often used in conjunction with other treatments.
The first step in treating scalp psoriasis effectively involves removing or lifting thick scales, which helps medication penetrate the plaques and clear them up.
"One common way to do this is by using keratolytics treatments, which contain active ingredients, such as salicylic acid, urea, lactic acid, or phenol, that are designed to dissolve skin flakes or scales," says Strachan.
"Another way to soften and loosen scalp scales is to apply oils, lotions, creams, or ointments to a damp scalp," she adds.
Once the psoriasis scale has been softened, you can carefully remove it with a fine-tooth comb or brush.
"Gently comb the scalp in a light circular motion, holding the comb almost flat against the scalp," advises Strachan.
"Once the scale is loosened, shampooing is a good way to get the scale away from your scalp and out of your hair. But be gentle. Brushing or combing too vigorously can break the skin and lead to an infection. It can also break hair off at the scalp, causing temporary hair loss."
Shampoos with ingredients such as tar and salicylic acid also may be helpful. (6) "Liquid or foam topical medication [like steroids and calcipotriene] are easy to apply to the scalp," says Strachan.
Shampoo — both with and without coal tar medication — are available to treat scalp lesions. “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.”
But severe flares may require the use of oral medication in conjunction with such topical treatments.
Topical treatments for scalp psoriasis include:
Before starting any topical scalp treatment, Strachan suggests applying a test patch of the medication to an inconspicuous spot on your head.
"In some cases, treatments may cause irritation or temporary hair loss," she says. "Your hair should grow back.
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