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Treating Scalp Psoriasis

At least half of people with psoriasis have it on their scalp. The skin cells on your scalp grow too quickly and make powdery scales called plaques. The areas around them can be red and itchy.

Scalp psoriasis can cause everything from mild scaling to crusting on the entire scalp -- sometimes extending onto the forehead, around the nose, in the beard area, or behind or inside the ears.

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If you have mild scaling, it may get better on its own. Sometimes, though, you'll need treatment. It can take a couple of months or longer to get more severe dandruff under control. Once you do, you may be able to keep it from flaring with special shampoos or moisturizers.

There's no cure for psoriasis, but you can take a number of steps to manage it.

Your treatment will depend on:

  • How severe it is
  • How it has responded to treatment before
  • Whether you have psoriasis elsewhere on your body
  • How much hair you have

Treatment: Where to Start

The most common treatments for mild cases are medications that you put directly on your scalp. If you have a more severe case or have psoriasis elsewhere on your body, you may need a medication that treats your whole body. You can take these medications by mouth or injection.

If your psoriasis doesn't respond well after repeated use of one medication, your doctor may replace or combine it with another type of treatment.

One of the first steps is to soften and remove scales. This makes it easier for medications to do their job.

  • Apply over-the-counter (OTC) products to your scalp to help soften scales and make them easier to peel off. Look for products with the active ingredients salicylic acid, lactic acid, urea, zinc pyrithione, or selenium sulfide.
  • Gently loosen the scales with a brush or fine-toothed comb.
  • Shampoo your scalp to remove the scales, using a salicylic acid shampoo or soap.
  • Apply thick moisturizers like petroleum jelly to your scalp while it's still damp.

To apply medication:

  • Put petroleum jelly on cotton balls and put them into your ears to keep medications out.
  • Use medications sparingly. They may cause skin irritation and can weaken hair shafts, causing temporary hair loss.
  • With an oil or lotion, part your hair and drip the medication onto your scalp.
  • With a cream or ointment, rub it right into your scalp.
  • Covering your scalp with a shower cap for a short period of time may help some medications work better, but check with your doctor first.
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