Scalp Psoriasis

45 to 56 percent of people living with psoriasis have scalp psoriasis.

It can affect the scalp, hairline, forehead, back of the neck, and skin around the ears.

(Merola, Li, Li, Cho, & Qureshi, 2016)

Did You Know?

Symptoms may include fine scaling that looks like dandruff or appear as thick, crusted plaques that cover the entire scalp. Other skin disorders, such as seborrheic dermatitis, may resemble psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis looks yellowish and greasy. Scalp psoriasis is common in patients of color, but treating it can be particularly tough due to the hair type.

Photo courtesy of Amit Garg, M.D.

 
Scalp psoriasis image, courtesy of Amit Garg, M.D,

Scalp Psoriasis May Indicate PsA

Scalp psoriasis may be an indicator of psoriatic arthritis (PsA), as many people have both. If you think you have scalp psoriasis, see a dermatologist to diagnose scalp psoriasis and visit a rheumatologist to screen for psoriatic arthritis.

Psoriasis on the scalp is considered a high-impact site, which can have an increased negative impact on quality of life, regardless of the total area affected by psoriasis.

Scalp Psoriasis Treatments

No matter how severe your scalp psoriasis is, there are options for treating the itching and flakes – from over-the-counter shampoos and topicals to light therapy, oral treatments, and biologics.

The 4 Types of Scalp Psoriasis Treatments 

  1. Over-the-counter products
  2. Topicals
  3. Phototherapy
  4. Systemics

Scalp psoriasis can be difficult to treat. It may take time to find a treatment that works well 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 stopped working after repeated use.

Photo courtesy of Amit Garg, M.D.

 
Scalp psoriasis image, skin of color, courtesy of Amit Garg, M.D.

Over-the-Counter Products

Over-the-counter (OTC) scalp psoriasis products may help manage symptoms if you have mild scalp psoriasis. The two active ingredients that you should look for in OTC products are salicylic acid and tar (either coal or pine wood tar).

  • Salicylic acid works to soften plaques and scales and remove scales from the skin.
  • Tar made from coal or pine wood works to slow skin cell growth and reduce inflammation, itching, and scaling.

If you are looking for OTC products to try, check out NPF's Seal of Recognition program. These products have been created or are intended to be non-irritating and safe for people with psoriasis

Do You Know Your OTC Products?

Take this quiz to find out if you know what to look for in an over-the-counter product.

Test my knowledge

Topicals

Topical treatments include medicated psoriasis shampoos, topical steroids, and tars as well as prescription topicals. Because the hair is in the way, treating the scalp with topical treatments is not always easy. Talk with your dermatologist about how you normally care for your scalp including how frequently you wash your hair. These conversations are important in making the right treatment decision for you.

Phototherapy

Phototherapy for psoriasis uses ultraviolet (UV) light to slow skin cell growth. Handheld phototherapy units with built-in combs are available to help UV rays reach the scalp.

Systemics

Oral psoriasis treatments and biologics are often prescribed if you have psoriasis on areas beyond the scalp or if your scalp psoriasis has not responded well to other treatments.

Image of psoriasis shampoos

Psoriasis Shampoos Your Scalp Will Love

You deserve a product that keeps the itching and flaking at bay.

Discover products
Tami and Ayesha

Losing Your Hair and Confidence

Two women share how their mental well-being was hit hard by alopecia from scalp psoriasis. 

Read their story
A graphic of a person scratching their head.

Scalp Psoriasis or Dandruff?

Plenty of people have confused one for the other, so we broke down some key differences.

Read more

Scalp Psoriasis Quick Guide

You have options when it comes to treatment. Learn more about scalp psoriasis, treatment options, and tips for hair care.

Get your free copy

Last updated on 2/23/2024 by the National Psoriasis Foundation.

References

Merola, J. F., Li, T., Li, W. Q., Cho, E., & Qureshi, A. A. (2016). Prevalence of psoriasis phenotypes among men and women in the USA. Clin Exp Dermatol, 41(5), 486-489. doi:10.1111/ced.12805

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