Psoriasis - Specific locations: scalp

Specific locations: scalp

At least half of all the people who have psoriasis have it on their scalp.

Scalp psoriasis can be very mild, with slight, fine scaling. It can also be very severe with thick, crusted plaques covering the entire scalp. Psoriasis can extend beyond the hairline onto the forehead, the back of the neck and around the ears.

Other skin disorders, such as seborrheic dermatitis, may look similar to psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis appears yellowish and greasy.

Treating scalp psoriasis

Treatments are often combined and rotated because a person’s psoriasis may become less responsive to medications after repeated use. Systemic treatments are not commonly used just for scalp psoriasis but may be used if psoriasis is present elsewhere on the body and/or the psoriasis is moderate to severe.

Mild scalp psoriasis

Tar products and salicylic acid are generally sufficient for treating very mild scalp psoriasis.

Many coal tar and non-coal tar medicated shampoos for treating scalp lesions are on the market. Remember, medicated shampoos are designed for the scalp, not the hair.

Sometimes doctors inject scalp lesions with steroid medications. This is done only when the scalp psoriasis is mild and involves a few areas. Steroid injections are given sparingly because the medication can be absorbed into the system.

Moderate to severe scalp psoriasis

If you have a more severe case of scalp psoriasis, you may need to try different treatment plans before you find the one that works for you. If crusting of the scalp along with scaling occurs and/or the lymph nodes in your neck are enlarged, indicating a yeast infection, your doctor may prescribe antimicrobial treatment.

Common topical treatments for scalp psoriasis include:

• Anthralin
• Dovonex 
• Taclonex 
• Tazorac 

 Common systemic medication treatments for psoriasis include:

• Methotrexate
• Oral retinoids
• Cyclosporine
• Biologics

Ultraviolet light

Hair blocks ultraviolet (UV) light treatments from reaching the scalp. However, better results can be achieved with conventional UV units if you part your hair in many rows, if you have very thin hair or if you shave your head. Hand-held devices called UV combs are available to deliver a higher intensity of UV light. Natural sunlight may also help if the hair is very thin or the head is shaved.

Scalp itch

Itching is often a problem for those with scalp psoriasis. Over-the-counter tar shampoos and shampoos containing menthol can help reduce itching. Topical steroids and oral antihistamines are also effective for reducing scalp itch.

Search the online treatment guide for more treatment information.