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Scalp Psoriasis

Scalp psoriasis is a common skin disorder that makes raised, reddish, often scaly patches. It can pop up as a single patch or several, and can even affect your entire scalp. It can also spread to your forehead, the back of your neck, or behind your ears.

You can’t catch scalp psoriasis from another person. As with other types, we don’t know what causes it. Doctors believe it comes from something wrong with your immune system that causes skin cells to grow too quickly and build up into patches. You may be more likely to get scalp psoriasis if it runs in your family.

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About half of the estimated 7.5 million Americans with psoriasis – which can affect any skin surface – have it on their scalp. Sometimes the scalp is the only place they have it, but that’s uncommon.

Scalp psoriasis can be mild and almost unnoticeable. But it can also be severe, last a long time, and cause thick, crusted sores. Intense itching can affect your sleep and everyday life, and scratching a lot can lead to skin infections and hair loss.

Symptoms

Symptoms of mild scalp psoriasis may include only slight, fine scaling. Symptoms of moderate to severe scalp psoriasis include:

  • Scaly, red, bumpy patches
  • Silvery-white scales
  • Dandruff-like flaking
  • Dry scalp
  • Itching
  • Burning or soreness
  • Hair loss

Scalp psoriasis itself doesn’t cause hair loss, but scratching a lot or very hard, picking at the scaly spots, harsh treatments, and the stress that goes along with the condition can lead to temporary hair loss. Fortunately, your hair usually grows back after your skin clears.

If you have any of these symptoms, see your doctor or dermatologist. He may simply take a look or do a skin biopsy to rule out similar conditions like seborrheic dermatitis.

Topical Treatments

The first line of defense is treatment you use directly on your skin: medicated shampoos, creams, gels, oils, ointments, and soaps. You can get some of these products over the counter, but stronger ones require a prescription.

Over-the-counter products often contain one of two medications approved by the FDA for psoriasis:

Prescription products for scalp psoriasis may have higher concentrations of either or both of these, as well as other FDA-approved medications, such as:

  • Anthralin, an older prescription medication
  • Antimicrobials, which treat bacterial or yeast infections that can come with scalp psoriasis
  • Calcipotriene, a strong derivative (different form) of vitamin D
  • Calcipotriene and betamethasone dipropionate (a strong steroid)
  • Other topical steroids
  • Tazarotene, a derivative of vitamin A

To work, these treatments must be put on your scalp, not just your hair. Follow the directions exactly until your skin heals, which can take 8 weeks or more. Once your psoriasis has cleared, you can help keep it from coming back by shampooing daily or twice-weekly with a product that has coal tar or other medications.

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