Mild scalp psoriasis appears as fine scaling, while severe scalp psoriasis is noted by thick, crusted plaques covering the large portions of the scalp. Psoriasis can extend beyond the hairline to the forehead, 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 looks yellowish and greasy.
Treating scalp psoriasis
Unfortunately, scalp psoriasis can be difficult to treat. It can take time to find a treatment that is a good fit because everyone responds differently to treatments. The good news is that there are many treatment options available. Treatments are often combined and rotated due to concerns about side effects or because treatments have become after repeated use.
Systemic treatments are not often used for scalp psoriasis alone but may be used if psoriasis is present elsewhere on the body or if psoriasis is unresponsive to other treatment options.
Safely softening and removing plaques can make it easier for topical treatments to penetrate the top layers of skin. Soaking the scalp in warm (not hot) water or applying oils, lotions, creams or ointments to a damp scalp can help soften plaques. You can then comb the scalp gently in light circular motions by holding the comb almost flat against the scalp to remove softened plaques.
Mild scalp psoriasis
There are many coal tar and non-coal tar medicated shampoos for treating lesions associated with scalp psoriasis. Keep in mind that medicated shampoos are designed for the scalp, not the hair.
Doctors may inject scalp lesions with steroid medications if the psoriasis is mild and involves only a few areas. Steroid injections are given sparingly because the body can absorb the medication.
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 right one that works for you. If you experience crusting of the scalp and scaling or enlarged lymph nodes in the neck (indicating a yeast infection), your doctor may prescribe antimicrobial treatment.Common topical treatments for scalp psoriasis include:
Itching is very common if you have scalp psoriasis. Over-the-counter tar shampoos and shampoos containing menthol can help reduce itching. Topical steroids are also effective for treating an itchy scalp. Read more about managing itch »
Scalp psoriasis and hair loss
Hair loss is a common problem experienced by those with scalp psoriasis. Often this hair loss is the result of damage to the hair shaft or hair follicles and not a result of the psoriasis itself. This damage can occur from rubbing, scratching or excessive combing, and from chemicals or ingredients in treatments and products.
Getting your scalp psoriasis under control with the appropriate treatment is the first step to healthy hair growth. Hair loss related to psoriasis and psoriasis treatments is almost always temporary. Normal hair growth will usually return once your psoriasis is effectively managed and irritants from rubbing, scratching, and treatments have been reduced or stopped. It is only in very rare cases that the hair follicles may be damaged and the hair may no longer grow.
Learn more about managing scalp psoriasis:
Last updated by the National Psoriasis Foundation