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.
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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.
Photo courtesy of Amit Garg, M.D.
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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 pine wood tar).
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.
Take this quiz to find out if you know what to look for in an over-the-counter product.
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 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 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.
Oral 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.
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Last updated on 10/28/2022 by the National Psoriasis Foundation.
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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