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.
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.
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.
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.
Over-the-counter (OTC) 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 wood tar).
- Salicylic acid works to soften plaques and scales and remove scales from the skin.
- Tar made from coal or 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.
Topical treatments include medicated shampoos, topical steroids and tars as well as prescription topicals. Because the hair is in the way, treating the scalp with a topical treatment 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 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.