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How Flaky Can You Get With Scalp Psoriasis?

    How Flaky Can You Get With Scalp Psoriasis?

    It is normal for people to scratch their heads and to see dandruff fall out from time to time, but how do you know if it is already a sign of scalp psoriasis? Here is all that you need to know about the said skin disease.

    Scalp Psoriasis, Defined

    As the name suggests, scalp psoriasis is a common type of psoriasis that forms plaques or scales in the scalp area. It is a “noncontagious, chronic inflammatory” skin disorder, which resembles flaky dandruff that can also be seen in the forehead, hairline, ear area, and even in the nape of the neck.

    According to Merola, Li, Li, Cho, and Qureshi (2016), most people who are living with psoriasis have this particular kind, at about around 45-56%.

    The hair holds the silvery-white scales in place that develops and builds up easily, which later on results in a thicker plaque that are hard to treat. They may disappear and re-appear once again depending on several triggers and factors. Scalp psoriasis can either take place alone or combined with other types in different parts of the body.

    There are some severe cases in which people may experience temporary localized hair loss, but it does not cause a person to go bald.

    Scalp psoriasis can also be a sign or indicator that a person has psoriatic arthritis. Some people may not have it, while others may have it both.

    Causes of Scalp Psoriasis

    Just like any other type of psoriasis, scalp psoriasis shows up when a person’s immune system weakens. It is through the immune system that the skin cells are able to develop and regenerate in days, rather than in weeks. The excess skin cells eventually pile up and end up making the person feel the itch on the scalp and notice it to be reddish in color.

    Stress may also play a factor in the occurrence and appearance of psoriasis.

    Symptoms of Scalp Psoriasis

    Most individuals experience both flakiness and itchiness with other symptoms that include:

    • Reddish scalp patches
    • Dandruff-like flakes and silvery-white scales (powdery texture)
    • Dryness of scalp
    • Itching (which can go from mild to intense)
    • Bleeding from scratching
    • Burning sensation or soreness
    • Temporary hair loss

    Treatment and Management for Scalp Psoriasis

    The National Institute for Health and Care Excellence (NICE) released a guideline on how to treat scalp psoriasis.

    A topical treatment may be administered for adults, young people, and even children with scalp psoriasis following these considerations:

    1. For starters, a doctor may prescribe a powerful corticosteroid once a day for four weeks. If you have difficulties incorporating corticosteroids in your regimen, the dermatologist may recommend vitamin D preparation as an alternative.
    2. If it doesn’t work out for you after four weeks, the doctor may provide a new corticosteroid formulation like shampoo or mousse. There are also other scalp treatments such as an emollient or oil that can help with treating the scales before you proceed with a more potent kind.
    3. If it still continues to persist, your dermatologist may consider combining two different product applications, a more potent corticosteroid and a vitamin D preparation, for another four weeks.
    4. When all else fails, reapplication of the potent corticosteroid or coal tar preparation may be considered. Your dermatologist may also refer you to a specialist for other available treatments that would suit you.

    NICE also shared a list of topical treatments that may help in treating scalp psoriasis:

    • Topical steroids (corticosteroids)
    • Vitamin D analogs
    • Tar products
    • Medicated shampoos
    • Emollients/Oils

    A dermatologist may also offer different treatments and ways of management such as:

    • Dithranol
    • Antimicrobial treatment
    • Ultraviolet light
    • Salicylic acid
    • Scale softeners
    • Oral or injected medications

    Key Takeaways

    Whatever type of psoriasis you may have, the treatment for it is specific to it, depending on your triggers and even your way of living. Your dermatologist may opt to try several different topical creams to see what works best for you. The need for proper diagnosis, management, and plenty of support cannot be understated, as psoriasis is often a lifelong condition.

    Learn more about Psoriasis here.

    Hello Health Group does not provide medical advice, diagnosis or treatment.


    Scalp Psoriasis, https://www.mountsinai.org/care/dermatology/services/psoriasis/scalp, Accessed October 7, 2021

    Scalp Psoriasis, https://www.uclahealth.org/dermatology/scalp-psoriasis, Accessed October 7, 2021

    Scalp Psoriasis, https://www.papaa.org/learn-about-psoriasis-and-psoriatic-arthritis/further-resources/scalp-psoriasis/, Accessed October 7, 2021

    Scalp Psoriasis, https://dermnetnz.org/topics/scalp-psoriasis, Accessed October 7, 2021

    Scalp Psoriasis, https://www.psoriasis.org/scalp/, Accessed October 7, 2021

    Scalp Psoriasis: Symptoms, https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-symptoms, Accessed October 7, 2021

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    Written by Fiel Tugade Updated Aug 18
    Medically reviewed by Martha Juco, MD
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