How to Treat Scalp Psoriasis

By

Gina Garippo

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Scalp Psoriasis

More than half of people with psoriasis experience outbreaks on their head. If you’re tired of trying to control scalp itch or hide embarrassing lesions along your hairline, take heart. Treatment for scalp psoriasis really does work.



What Treatment Is Best for Me?

Psoriasis on the scalp is basically the same as psoriasis on other areas of the body. Treatment of scalp psoriasis varies depending on the severity of the problem. Some people only have occasional light scaling. Others have crusted plaques that can cover the entire scalp.

There are many treatment options for psoriasis, and they all come with risks and benefits. Ultimately, whether you treat with topical creams, light therapy, or medications, you and your doctor will decide the best treatment path together.

Medical Reviewer: William C. Lloyd, MD, FACS Last Review Date: Apr 13, 2016

2018 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

If you have scalp psoriasis, your doctor can tailor treatment to your specific needs. A few treatment options that may be recommended include:

Coal Tar. Tar derived from coal has been used for years in many over-the-counter medicated shampoos like T/Gel and T/Sal. It works to slow the fast growth of skin cells, reducing the itching and scaling of the condition. Look for one with menthol, which can help reduce itching. After applying, leave the product in your hair the full recommended time. These shampoos are easy to use and are most effective for people who have light scaling on their scalp.

Salicylic Acid. People with heavy scaling on the scalp may benefit from using an over-the-counter salicylic acid ointment before applying other topical lotions or shampoos. The acid helps remove the scales, which can block the effectiveness of other treatments.

Corticosteroids. Corticosteroids are available in prescription shampoos such as Clobex shampoo and oils like Derma-Smoothe/FS, as well as lotions, foams, and creams. They provide good results for scalp psoriasis and tend to work quickly. Results can be seen in three to four weeks. Just be sure to use corticosteroids exactly as directed by your doctor. Taking them for too long or taking more than prescribed can lead to negative side effects.  

Vitamin D Analogs. Vitamin D analogs, available by prescription, are effective on the scalp. However, it can take up to eight weeks to see significant results. One of the most popular vitamin D analogs for the scalp is calcipotriene, commonly found in the ointment Dovonex. Oftentimes, doctors prescribe corticosteroids and vitamin D simultaneously. One popular combination ointment is Taclonex.

Topical Retinoid. Tazorotene, a prescription retinoid drug derived from vitamin A, is also commonly used on scalp psoriasis. It decreases inflammation, which can lead to psoriasis flares. Tazorotene is found in gel form and sold under the brand name Tazorac. (Note: As with any medication, talk with your doctor before using tazorotene. It may not be suitable for women who are pregnant or intend to get pregnant.)

Systemic Treatments. If your scalp psoriasis is severe and hasn’t responded well to topical treatments, you may be prescribed a systemic medication (medication taken by mouth or injection) to help control the problem. This is especially true if you have psoriasis on other areas of your body. Some common drugs include methotrexate, cyclosporine, oral retinoids, and biologic medications.

How Do I Apply Topical Treatments?

Although there are many effective solutions for scalp psoriasis, some can be a little tricky to apply. It can be difficult to see where you’re working, and your hair can sometimes get in the way. These strategies may help:

  • Before applying treatment, gently comb out any loose scales.

  • Part the hair in small sections to apply the treatment directly to exposed skin.

  • If possible, ask a friend or loved one to help you.

Whatever treatment option you choose, make sure you always follow the instructions on the product. Ask your doctor or pharmacist if you have any questions.

What About Styling My Hair?

Just because you have psoriasis on your scalp doesn’t mean that you can’t look good and feel your best. Boost your confidence with a great haircut or style. Then try these hair tips:

  • Go ahead and color or perm your hair if you want. For most people, it doesn’t irritate scalp skin. Just try it first on a small section of hair.

  • Be careful not to use hot styling tools for too long on your hair. They can dry out your scalp. Whenever possible, let your hair air dry for a fun and low-maintenance style. Then, use a little hairspray. It usually doesn’t irritate psoriasis.

  • Have the style you want? You can wash your hair with a shampoo that treats psoriasis, but follow up with a regular conditioner. It can reduce the medicated smell and keep your scalp soft.

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PHYSICIAN CONTRIBUTOR psoriasis-on-elbow

Expert Answers to Psoriasis Treatment FAQs

Dr. David Harvey, a dermatologist and surgeon, answers some common psoriasis questions.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: May 3, 2016

© 2018 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. “Continuing Education. Patient Education in Psoriasis.” S Ryan. World of Irish Nursing & Midwifery. October 2009, vol. 9, pp. 45-46.;
  2. American Osteopathic College of Dermatology (http://www.aocd.org/skin/dermatologic_diseases/psoriasis.html);
  3. National Psoriasis Foundation (http://www.psoriasis.org/page.aspx?pid=411);
  4. National Psoriasis Foundation (http://www.psoriasis.org/page.aspx?pid=414);
  5. National Psoriasis Foundation (http://www.psoriasis.org/page.aspx?pid=442);
  6. Psoriasis Association (http://www.psoriasis-association.org.uk/scalp.html);
  7. National Psoriasis Foundation (http://www.www.psoriasis.org/document.doc?id=155);

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