Psoriasis Health Center

Scalp Psoriasis

Office Treatments for Scalp Psoriasis

If you have mild scalp psoriasis that involves only a few areas, your doctor or dermatologist may consider injecting the lesions with steroid medications.

If you have scalp psoriasis that's failed to respond to topical treatments, phototherapy with a laser or non-laser light source may be helpful. The excimer laser focuses high-intensity light on affected skin while sparing unaffected skin. Ultraviolet (UV) light -- sometimes delivered with a hand-held device called a UV comb -- can be used to treat the entire scalp. If you have very thin hair, or a head that is shaved, your doctor may recommend brief periods of exposure to natural sunlight.

Medications for Severe Scalp Psoriasis

If you have moderate to severe scalp psoriasis, your doctor may prescribe an oral medication or one that's delivered by an injection or infusion. Oral medications include:

• Corticosteroids
• Cyclosporine
• Methotrexate
• Oral vitamin A derivative
• Oral vitamin D derivative

Because these medications can cause serious side effects, including liver damage, their use requires careful monitoring of patients by doctors. It's also important for patients to know that oral vitamin derivatives are different and more powerful than vitamin supplements bought over the counter. Ordinary vitamin A and D supplements are not useful for scalp psoriasis.

The newest class of FDA-approved medications for scalp psoriasis are called biologics. These medications, which are delivered by injection or infusion, may modify the immune system in ways that help prevent the over-production and build-up of skin cells. According to the American Academy of Dermatology, four biologics may be effective for scalp psoriasis:

• alefacept (Amevive)
• efalizumab (Raptiva)
• etanercept (Enbrel)
• infliximab (Remicade)

In November 2009, the FDA approved another biologic -- ustekinumab (Stelara) -- for the treatment of psoriasis.

Living With Scalp Psoriasis

Although scalp psoriasis can't be cured, there are many treatments available that can help relieve symptoms, control flare-ups, and prevent recurrences. People who follow their doctor or dermatologist's treatment plan rarely have to endure severe scalp psoriasis for extended periods of time. In addition, psoriasis support groups can offer valuable self-care tips to help maximize the effectiveness of medical treatments and minimize the psychological distress caused by this common condition.