Scalp Psoriasis

Types of Psoriasis

There are five types of psoriasis: plaque, inverse, guttate, pustular, and erythrodermic. It is possible to have more than one type of psoriasis at one time and more than one type in a lifetime. Treatments may vary depending on the type and location of the psoriasis.

Symptoms

Symptoms of scalp psoriasis may include fine scaling that looks like dandruff or appears as thick, crusted plaques that cover the entire scalp. [2] Plaques may look red, purple, or brown depending on your skin color. [3] Scalp psoriasis is common in people with skin of color, but treating it can be particularly tough due to the hair type. In rare cases, severe scalp psoriasis can cause temporary hair loss (alopecia). [4]

Other skin conditions, such as seborrheic dermatitis, may resemble psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis looks yellowish and greasy.

Causes & Triggers

The cause of psoriasis is not fully understood. Psoriasis plaques occur because the overactive immune system speeds up skin cell growth. Normal skin cells completely grow and shed (fall off) in a month. With psoriasis, skin cells do this in only three or four days. Instead of shedding, the skin cells pile up on the surface of the skin.

Inflammation caused by psoriasis can impact other organs and tissues in the body. People with psoriasis may also experience related health conditions. One in three people with psoriasis may also develop psoriatic arthritis. Scalp psoriasis may be an indicator of 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.

Scalp psoriasis can be triggered by the same factors as other types of psoriasis. Common psoriasis triggers include:

• Stress
• Certain medications
• Smoking tobacco
• Alcohol
• Injuries or trauma to the skin
• Illness, such as infections
• Changes in weather
• Diet

Learn more about triggers and flares by downloading your free Flare Guide and Symptom Tracker.

Diagnosis

A health care provider will take several factors into consideration when making a diagnosis for psoriasis, including:

• The appearance of the skin. Different types of psoriasis have different appearances.
• The location of psoriasis. Certain types of psoriasis are more common in certain locations.
• Itch of the skin. This is a common symptom of psoriasis.
• A skin biopsy (the removal of a small piece of skin to be looked at under a microscope) may be needed if the diagnosis is not clear from visual inspection. The biopsy may also be done to determine if it is psoriasis or another skin condition. However, most often, psoriasis can be identified by examining the skin and does not usually require a skin biopsy.

Treatment & Management

Although there is no cure, there are more effective psoriasis treatments today than ever before. Treating psoriasis can help improve symptoms as well as lower the risk of developing psoriasis comorbidities such as psoriatic arthritis, heart disease, obesity, diabetes, and depression.

Scalp psoriasis can be difficult to treat. It may take time to find a treatment that works well because everyone responds differently to treatments. Treatments are often combined and rotated due to concerns about side effects or because treatments have stopped working after repeated use.

Treatments for psoriasis include:

• Topicals, including over-the-counter topicals, topical steroids, and topical non-steroids
• Phototherapy
• Systemics, including oral, biologic, and biosimilar treatments