Psoriasis is a chronic autoimmune condition that causes the formation of thick, reddened, or silvery patches of skin. There are several different types of psoriasis, like psoriatic arthritis or erythrodermic psoriasis. Regardless of the type, psoriasis can affect anywhere on the body, including the scalp.

No matter where it is on the body, psoriasis can range from mild to severe. Even if scalp psoriasis seems like nothing more than a mild inconvenience, it’s essential to see a doctor if you experience persistent symptoms. Psoriasis is an indication of inflammation, which can leave you open to developing further illnesses.

What is Scalp Psoriasis?

In psoriasis, something mistakenly causes the body’s immune system to attack healthy skin cells. This overactive immune response causes skin cells to grow too quickly, leading dead skin cells to accumulate in scales and patches on the skin’s surface. It’s unclear what triggers this overactive immune response, but it is thought to be partially hereditary.

When psoriasis occurs on the scalp, it is known as scalp psoriasis. People with psoriasis on the scalp may have red or silver scaly patches on the scalp that are itchy and uncomfortable. Mild cases may be mistaken for dandruff or a dry scalp, while severe cases can cause immense discomfort and even temporary hair loss.

Scalp psoriasis can occur at any age, but it most commonly develops in teens and young adults. The American Academy of Dermatology estimates that most cases begin between 20 and 30 years old, while the National Psoriasis Foundation estimates most start between 15 and 25 years old. It often occurs in people with other psoriasis forms, such as plaque psoriasis.

Scalp Psoriasis vs. Dandruff or Seborrheic Dermatitis

Many skin conditions can cause flakes, itching, and redness of the scalp. Two of the most common are dandruff and seborrheic dermatitis, also known as seborrheic eczema. Both conditions can be easily confused with mild scalp psoriasis but do not share the same symptoms.

  • Cause: Scalp psoriasis is caused by an autoimmune condition. Dandruff can be caused by dry or oily skin, a reaction to hair products, or overgrowth of yeast on the scalp. Seborrheic eczema is an inflammation of the scalp, potentially due to a reaction with a common yeast.
  • Redness: While scalp psoriasis and seborrheic eczema often present with redness and inflammation, dandruff typically does not.
  • Flake size: Scalp psoriasis tends to cause larger, thicker flakes than dandruff and seborrheic dermatitis. 
  • Location on body: Scalp psoriasis can spread beyond the scalp to the face or neck. Dandruff and seborrheic dermatitis are usually confined to the scalp.
  • Treatment: Dandruff can usually be treated with over-the-counter products. Seborrheic eczema and scalp psoriasis often require medical treatment. 

 

The Early Signs of Scalp Psoriasis

It’s difficult to identify early signs and symptoms of scalp psoriasis because it shares symptoms like itchiness, flaking, and redness with conditions like dandruff or seborrheic eczema. If you’re concerned about symptoms on your scalp, see a dermatologist for an accurate diagnosis.

Dry, Flaky Scalp

Scalp psoriasis can cause the skin on your scalp to dry out, peel, and flake. It may be mild, with just slight flaking, or severe, with large flakes and sore, red skin.  

Itching

Itchiness is a common symptom of many scalp conditions, including scalp psoriasis. In some cases, it may be temporary and easily resolved. However, chronic itchiness can be extremely frustrating and interfere with sleep, work, and daily activities. 

Formation of a Rash

Scalp psoriasis can lead to the development of a rash on the scalp, which can be extremely itchy and uncomfortable. However, a scalp rash can also be caused by other conditions, like an allergic reaction (contact dermatitis).

Red, Scaly Bumpy Patches

One telltale sign of scalp psoriasis is scaly, red, and bumpy patches on the scalp. The affected areas can be extremely itchy and painful; in severe cases, the scale can build up to the point where it resembles plaque.

Silvery-White Scales

Scalp psoriasis is a chronic condition that can cause silvery-white scales to form on the scalp. The scales are usually itchy and may be painful. 

Burning or Soreness

Scalp psoriasis can cause the scalp to burn or feel sore. It may feel like your head is on fire, and even the slightest touch can cause immense pain. 

Hair Loss

Scratching or removing scales or patches from the scalp can remove hair alongside it. While the hair will grow back on its own, someone with scalp psoriasis may be extremely self-conscious or embarrassed about the resulting bald patches.

Treatment Options for Scalp Psoriasis

In addition to causing physical discomfort, even mild scalp psoriasis symptoms can lead to embarrassment and low self-esteem. While there is no cure for the condition, the good news is that several over-the-counter and prescription treatments can help manage and improve symptoms.

Over-the-Counter Psoriasis Shampoos

While many treatments for psoriasis and scalp psoriasis must be prescribed by a medical professional, some psoriasis shampoos are available without a prescription and can be effective for treating mild cases of scalp psoriasis. The National Psoriasis Foundation recommends shampoos with salicylic acid and coal or wood tar to break down excess skin cells and reduce the rate of further growth.

Topical Medications

Medicated shampoos, creams, and lotions can help control scalp psoriasis symptoms. These medications are applied to the scalp to reduce inflammation and itchiness. Some are available without a prescription, while others must be prescribed by a medical professional.

In moderate cases, your doctor or dermatologist may prescribe certain types of topical corticosteroids. Like over-the-counter topical medications, they are applied to the scalp to reduce inflammation and itching and help slow skin cell growth.

Light Therapy (Phototherapy)

In some cases, your doctor or dermatologist may recommend treating scalp psoriasis with light therapy, also known as phototherapy. The scalp is exposed to ultraviolet (UV) light with light therapy, which can help slow skin cell growth and reduce scalp psoriasis symptoms. 

Oral Medications

In severe cases of psoriasis, your doctor or dermatologist may prescribe an oral medication to reduce inflammation and excess production of skin cells. You may be prescribed acitretin, cyclosporine, or methotrexate. Some medications are also used off-label for this purpose, but they can have severe undesirable side effects.

Lifestyle Adjustments

Some people find that their scalp psoriasis is triggered by environmental factors, like foods, hair styling treatments, or stress. In these cases, it can help to do things like:

  • Reduce or eliminate foods from the diet
  • Stop drinking alcohol
  • Change shampoos
  • Avoid or limit the use of styling products and heat tools (e.g., curling irons and hair dryers)
  • Reduce stress and practice stress management techniques

 

See Your Doctor for Scalp Diagnosis and Treatment

If you are experiencing any symptoms of a scalp condition, whether psoriasis or something else, it is vital to see a doctor or dermatologist for an accurate diagnosis. Treatments for conditions like dandruff or seborrheic eczema are ineffective for scalp psoriasis and can lead to unnecessary discomfort.

With the right treatment plan, it is possible to manage scalp psoriasis and live much more comfortably.