Psoriasis can be a difficult condition to deal with, especially when it appears on the scalp. Symptoms can include redness, itching, and flaking, which can be embarrassing and uncomfortable. However, there are steps you can take to manage your symptoms, gain your confidence back, and improve your quality of life.

What is Scalp Psoriasis?

Scalp psoriasis is a type of psoriasis that affects the scalp, hairline, ears, and neck. About 50% of psoriasis sufferers have scalp psoriasis.

Symptoms of scalp psoriasis include:

- Fine flakes or dandruff- in mild scalp psoriasis

- Thick crusty plaques- in more severe cases

- Itching

- Dry scalp

- Redness

- Burning sensation

- Infections- a risk for severe cases

- Hair loss- in some severe and persistent cases

Understand the Condition and its Triggers

The first step in coping with psoriasis on your scalp is to understand the condition and its triggers. Psoriasis is caused by an overactive immune system that leads to the rapid growth of skin cells. This can result in patches of thick, scaly skin that can be itchy and painful. Triggers for psoriasis can include stress, infections, and certain medications. By understanding your triggers, you can take steps to avoid them and reduce the frequency and severity of your symptoms.

The cause of scalp psoriasis is unknown, but the following are risk factors:

- Family history- Around 40% of scalp psoriasis cases are thought to be hereditary.

- Diet- Scalp psoriasis is more common in those with food intolerances such as a gluten sensitivity

- Smoking- Smoking increases the risk of scalp psoriasis and the severity of symptoms.

- Stress- High-stress levels are associated with scalp psoriasis

It is uncommon to have psoriasis on the scalp alone, but it is possible. It can range from mild cases to severe, where some sufferers find the itching so unbearable that they struggle to sleep. Scratching can lead to infection or even hair loss. Fortunately, hair grows back once psoriasis subsides.

Scalp psoriasis can be one of the more difficult types of psoriasis to treat, but some sufferers do find relief from changing their diet, adding supplements, and taking regular bath salts.

If you think you have scalp psoriasis, get an official diagnosis from your doctor. The appearance can be like some Types of Eczema, in particular Seborrheic Dermatitis. This type of eczema appears more yellowish in colour, rather than the white/silver flakes associated with scalp psoriasis. An accurate diagnosis will lead to a more effective treatment plan.

Scalp psoriasis comes with a risk of infection. Signs of this to look out for include redness, a warm sensation, excessive scales, and tenderness. If you think your scalp psoriasis may have become infected you should speak to your doctor as soon as possible. They will be able to prescribe antibiotics which will clear the infection, and prevent it from spreading to your lymph nodes.

Some mild cases of scalp psoriasis go away on their own. If you have more severe or persistent scalp psoriasis, there are treatments available.

Develop a Skincare Routine for your Scalp

Developing a skincare routine for your scalp can help manage psoriasis symptoms and improve overall scalp health. Start by using a gentle, fragrance-free shampoo and conditioner. Avoid harsh chemicals and ingredients that can irritate the scalp, such as sulfates and alcohol. Consider using a medicated shampoo or scalp treatment recommended by your doctor or dermatologist.

Try medicated shampoos with coal tar or salicylic acid. Shampoos containing salicylic acid can soften scales, making them easier to remove. Coal tar shampoos work by slowing skin growth, which reduces scaling and itching. Neutrogena T/Gel Therapeutic Shampoo is a popular choice available to purchase through Amazon, with many users reporting some relief from itching. Massage the shampoo into your scalp and leave for 5-10 minutes before rinsing off. Try a new shampoo for 8 weeks before you determine whether or not it is effective. Once you see an improvement, you can switch back to your regular shampoo, and use the medicated one once or twice a week. Coal tar shampoos do not have a particularly pleasant scent! If this bothers you, use a standard shampoo afterward. Use a good hydrating conditioner as medicated shampoos can be very drying.

It's also important to keep your scalp moisturised, so consider using a scalp oil or moisturiser. Be sure to talk to your doctor or dermatologist about the best skincare routine for your specific needs. Leave the oil on your scalp overnight. Your partner and your pillowcases probably won’t appreciate it but leaving oil overnight is great for loosening flakes. Organic coconut, almond, or argan oil are some of the best oils to use for scalp psoriasis. For a more convenient option, try M-Folia Scalp Oil- a special blend of essential oils formulated specifically for eczema + psoriasis affecting the scalp.

Seek Medical Treatment and Support

While there is no cure for psoriasis, there are many medical treatments available to help manage symptoms. Medical advice is essential. Your doctor can then plan your treatment + prescribe ointments, foams, shampoos, etc. where appropriate. Be honest with your doctor about what is and isn’t working. This may include topical creams, oral medications, light therapy, or a combination of treatments.

In addition to medical treatment, seeking support from others who understand what you're going through can be helpful. Consider joining a support group or connecting with others online who have psoriasis on their scalp. Our Instagram community is super friendly and supportive (@droughtskin).

Connect with Others who have Psoriasis

Living with psoriasis on your scalp can be isolating, but connecting with others who have the same condition can provide a sense of community and support. Consider joining a local support group or connecting with others online through forums or social media groups. You can share your experiences, ask for advice, and offer support to others who are going through similar challenges. Remember, you are not alone in this journey.

Practice Self-Care and Stress management techniques

Managing stress is an important part of coping with psoriasis on your scalp. Stress can trigger flare-ups and make symptoms worse. Practicing self-care and stress management techniques can help reduce stress and improve your overall well-being. Some effective techniques include meditation, deep breathing exercises, yoga, and regular exercise. It's also important to prioritise self-care activities that you enjoy, such as taking a relaxing bath, reading a book, or spending time with loved ones. Remember, taking care of yourself is an important part of managing your psoriasis symptoms.

Other Ways To Treat Scalp Psoriasis

-         Tell your hairdresser- It’s a little embarrassing at first, but your hairdresser can advise the best products to use, and take extra care with sensitive areas.

-         Dry your hair carefully-Air dry whenever possible. Hairdryers can further dry out the scalp. Try letting your hair air dry for a couple of hours and then giving it a quick blast on the cool setting to blow away any remaining flakes. If you are towel-drying, pat gently rather than vigorously rubbing your scalp.

- Be careful with bleach- Ask for your hairdresser's advice. Some people can have an adverse reaction to a full head bleach because of broken skin and irritation. Taking an antihistamine before an appointment helps. Go for foils so the hair colour does not make direct contact with your scalp. If you can- avoid bleach altogether.

- Exfoliate- During your daily bath, use an exfoliating mitt and rub it very gently over your ears and hairline. This loosens any flakes. Do not do this if you have a severe case of scalp psoriasis or any broken skin. Another effective way to exfoliate the scalp is by using a scalp brush. Gently massage the areas affected by psoriasis with the brush, being careful not to apply too much pressure. This will help to remove the build-up of dead skin cells and improve circulation to the scalp. Another way to exfoliate the scalp is by using a gentle exfoliating scrub. Look for a product that contains natural exfoliants such as sugar or salt, as well as soothing ingredients like aloe vera or tea tree oil. Apply the scrub to the affected areas and gently massage in circular motions. Rinse thoroughly with water and follow up with a gentle shampoo. It's important to remember that exfoliation should not be performed too frequently, as over-exfoliating can cause further irritation to the skin. It's recommended to exfoliate the scalp once a week and monitor how your scalp reacts to the treatment.

- Wear pale colours- If you are self-conscious about flakes, avoid wearing black and other dark colours. Flakes are barely noticeable against white or pale fabrics. 

- Hair Styles- One of the most effective ways to hide scalp psoriasis is to style your hair in a way that covers the affected areas. For example, if the psoriasis is clustered around your hairline, you may want to consider a fringe or a side parting that covers that area. Similarly, if the psoriasis is scattered across your scalp, a top knot or bun can work to hide it from view.

- Use scalp treatments as directed- Apply as often as directed, using the specified amount. You may find treatments the most effective just after you wash your hair, as flakes can get in the way of the treatment being properly absorbed. Apply Vaseline along your hairline/forehead area prior to application to stop any getting on unaffected skin. Don’t overdo it. This could lead to weaker hair and skin irritation.

- Avoid picking at or scratching scales- It’s tempting to want to get rid of as many flakes as possible, but this is a bad habit that will do more harm than good long term. Picking at scales can result in infection or a flare-up. Keep fingernails short and filed to prevent you from scratching too hard.

- Brush away flakes- Brushing your hair with scalp psoriasis can help remove the flakes and reduce the itchiness. However, it's important to choose the right brush. Avoid using brushes with stiff bristles, as this can irritate the scalp and worsen the symptoms. Opt for soft-bristled brushes instead. After washing your hair, gently detangle your hair with a wide-tooth comb to avoid pulling on the scalp, which can cause further irritation. Start by brushing from the ends of your hair and working your way up towards the roots. Be gentle and avoid applying too much pressure to the scalp. Brush in one direction, using smooth strokes. Avoid back-combing or using circular motions, as this can cause tangling and tenderness. Brush your hair twice a day, once in the morning and once before bed. This will help remove any loose flakes and reduce the itch. Remember to wash your brush regularly to prevent bacteria buildup.

- White Lie- If anyone notices your scalp psoriasis, pretend you have just overdone the dry shampoo!

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