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Treating Scalp Psoriasis

At least half of the people who have psoriasis have it on the scalp. If you do, it means the skin cells on your scalp are growing too quickly, creating powdery scales called plaques on your scalp. They can be surrounded by areas of redness and itching.

Treatment for scalp psoriasis varies. That's because it can range from mild scaling to severe crusting on the entire scalp -- sometimes even extending onto the forehead, neck, or around the ears. Treating scalp psoriasis also differs from person to person, depending on:

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  • Its severity
  • Its responsiveness to treatment
  • Whether you have psoriasis elsewhere on your body
  • How much hair you have

Sometimes scalp psoriasis gets better without treatment. If yours doesn't, this guide can help you find the right treatment for you. It can take a couple of months or longer to get scalp psoriasis under control. But once you do, you may be able to keep it from returning with special shampoos or moisturizers.

Scalp Psoriasis Treatment: Where to Start

The most common treatments for mild scalp psoriasis are topical medications applied directly on the scalp. However, if you have more severe psoriasis or have psoriasis elsewhere on your body, you may need to take a systemic medication by mouth or injection. If your scalp psoriasis responds poorly to a medication after repeated use, your doctor may combine or replace it with another type of treatment.

One of the first steps in treating scalp psoriasis is to soften and remove scales. This makes it easier for medications to penetrate and clear the disease.

To soften scales:

  • Apply salicylic acid gels to scales to make them easier to remove. Other scale softeners contain active ingredients such as urea, lactic acid, or phenol.
  • 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 emollients such as petroleum jelly or thick creams, oils, lotions, or ointments while scalp is 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.
  • Cover your scalp with a shower cap to enhance effectiveness of medication, but only if directed by your doctor to do so.

To reduce itchiness:

  • Use a conditioner after shampooing.
  • Limit using hot tools for styling.
  • Use wet towels, cold packs, or cold water on itchy spots.
  • Try over-the-counter tar shampoos or shampoos with menthol, topical steroids, or oral antihistamines.

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