Psoriasis, the skin disease that plagues around 7.5 million Americans, can lead to unsightly flare-ups anywhere on the body, but it can be particularly embarrassing when it occurs on the scalp, where it's harder to hide. Symptoms such as itchiness; redness; raised lesions; flaky, dandruff-like scales; a burning sensation; and temporary hair loss can make the person with psoriasis extremely self-conscious and possibly even depressed.
As bad as the appearance of scalp psoriasis can seem, the unpredictability of the condition can be even worse. As a disorder of the immune system, it often goes into remission. Such an event, however, can't be planned -- nor can an outbreak. Another challenge of scalp psoriasis is addressing the many variations of severity. One outbreak might lead to a hardly noticeable patch while another one might cover the entire scalp and even extend to the forehead, back of the neck and the area behind the ears.
There is good news, however. If you suffer from scalp psoriasis, you don't have to hang your head in shame or spend weeks covering your scalp with wigs and hats. There are effective treatments -- both medical, over-the-counter and home -- for this condition. To find out what they are and if they'll work for you, check out the following pages.
Understand Your Outbreak
Before you seek a treatment for your scalp psoriasis, it's best to understand what type of outbreak you're experiencing. Psoriasis is usually categorized as mild, moderate or severe. To determine how severe yours is, consider how much of your scalp (or body) is covered by the outbreak.
As a general rule of thumb, a moderate psoriasis outbreak tends to cover between 3 percent and 10 percent of the body. To visualize this, look at the size of one of your palms; it's approximately 1 percent of your body. Now, imagine an area three to 10 times that size. If your outbreak is smaller than that visual standard, you probably have mild psoriasis; if it's larger, you can consider your case to be severe.
A more straightforward way of evaluating the severity of your condition is to consider the impact it has on your life. If you find your scalp psoriasis symptoms to be particularly bothersome and limiting, then you can likely label your outbreak as severe.
Either way, you will want to be sure to share the details of your scalp psoriasis with your doctor so that he or she can provide the best treatment to target your category of outbreak.
Find out more about such treatments on the next page.
It makes sense that a treatment for a skin condition is one that would be put on the skin. In fact, one of the most frequently used remedies for scalp psoriasis is a topical medication known as anthralin. It's applied to the scalp, left on for a short period and then washed out.
While anthralin is widely used, it does come with some side effects, which include skin irritation and staining. To reduce such complications, you can select a formula that comes with a smaller concentration of the medication.
Other types of topical medication for scalp psoriasis include derivatives of vitamins A and D; corticosteroids; and products containing urea, lactic acid and phenol. These treatments are typically available as gels, foams or creams, and come in varying strengths.
If you'd like to try a home remedy you can apply topically, consider heated olive oil. It can soften psoriasis scales while moisturizing the scalp and hair. The key is to let the treatment remain on your scalp a few hours while your head remains covered by a towel.
You might have seen the next treatment advertised on television. Keep reading to learn more.
Prescription Pills and Injections
If your psoriasis is present on areas of the body other than (or in addition to) the scalp, your doctor might prescribe a prescription medication. There are a variety of treatments he or she might recommend. Sometimes, drugs such as cyclosporine, methoterexate, injectible corticosteroids, oral retinoids or oral vitamin D derivatives are used individually or in combination.
For severe cases of psoriasis, a class of drugs known as biologics might be prescribed. These medications, rather than directly targeting symptoms, work by blocking communication between the cells in your immune system. In doing so, they ultimately reduce inflammation. Biologics commonly prescribed for scalp psoriasis include alefacept, efalizumab, etanercept, infliximab and ustekinumab. Such medications are highly effective but also potentially dangerous. Because biologics affect the immune system, side effects can include an increased risk for developing serious infections or cancer.
On the next page, we'll take a look at treatments that don't require a prescription.
If you're experiencing a milder form of scalp psoriasis, you might want to explore the treatment options available at your local drug store. There are a number of potential remedies to consider.
Salicylic acid is an ingredient in many medicated shampoos and cleansers. And although it can soften scales, making them easier to remove, it can also make hair more susceptible to temporary loss and breakage.
Another popular treatment for scalp psoriasis is tar, which is often found in specially formulated shampoos. Tar is effective, but it does have a tendency to produce a strong odor and stain bedding, linens, clothing and white or gray hair. One way to combat the smell of a tar shampoo is to follow up a wash with a non-medicated conditioner.
One more treatment to go. Keep reading to find out what it is.
Phototherapy might sound complicated, but it's really quite simple. It involves exposing your skin to ultraviolet (UV) light. It's a treatment you can do on your own or have a medical professional perform.
Do-it-yourself phototherapy is as simple as exposing your skin to natural sunlight. However, for the best way to do so without also putting yourself at greater risk for sun damage or skin cancer, you should ask your doctor for guidelines. Another option for treating yourself at home is a hand-held UV comb. If you'd like a more thorough treatment, however, you can have a doctor perform phototherapy on you with an excimer laser.
There's no one-size-fits-all treatment for scalp psoriasis. Talk to your doctor to see which remedies are likely to work best for you. If you undergo a therapy that's too harsh or causes side effects worse than the disease itself, you should consider trying another treatment. You should also be aware that no psoriasis treatment works right away. It can sometimes take up to eight weeks or more to get your symptoms under control.
Keep reading for lots more information.
Related HowStuffWorks Articles
- American Academy of Dermatology. "Understanding Scalp Psoriasis May Head Off Hair Loss." 8/8/07 (Accessed 9/26/09) http://www.skincarephysicians.com/psoriasisnet/scalp_psoriasis.html
- American Academy of Dermatology. "What is Scalp Psoriasis?" 9/9/08 (Accessed 9/25/09) http://www.skincarephysicians.com/psoriasisnet/scalp_psoriasis_overview.htm
- Hitti, Miranda. "FDA Oks New Psoriasis Drug Stelara." WebMD 9/25/09 (Accessed 9/30/09) http://www.webmd.com/skin-problems-and-treatments/psoriasis/news/20090925/fda-oks-new-psoriasis-drug-stelara
- Mayo Clinic. "Psoriasis." 4/10/09 (Accessed 9/27/09) http://www.mayoclinic.com/health/psoriasis/DS00193
- Mayo Clinic. "Scalp Psoriasis vs. Seborrheic Dermatitis: What's the Difference?" 10/19/07 (Accessed 9/25/09) http://www.mayoclinic.com/health/scalp-psoriasis/AN01177
- National Psoriasis Foundation. "Psoriatic Arthritis." (Accessed 9/30/09) http://www.psoriasis.org/netcommunity/learn02
- National Psoriasis Foundation. "Scalp Psoriasis." (Accessed 0/29/09) http://www.psoriasis.org/netcommunity/sublearn03_loc_scalp
- National Psoriasis Foundation. "About Psoriasis." (Accessed 9/29/09) http://www.psoriasis.org/netcommunity/learn01
- National Psoriasis Foundation. "Treating Psoriasis. Specific Location: Scalp." (Accessed9/29/09) http://www.psoriasis.org/netcommunity/sublearn03_loc_scalp