Psoriasis isa chronic skin condition that affects approximately 125 million people worldwide (about 2-3% of the global population). Its most recognizable symptom is the development of red, raised, and scaly patches of skin, commonly known as plaques. These can appear on various parts of the body, such as the knees, elbows, and scalp. (1)

Scalp psoriasis can often be confused with other conditions like dandruff or seborrheic dermatitis due to their similar appearances. This article will outline the distinct symptoms of scalp psoriasis and explain how it differs from other conditions.

ScalpPsoriasis: Symptoms and Appearance

Nearly half of psoriasis patients experience scalp psoriasis at some point. These symptoms typically include: (2)

• Red patches on the scalp.
• Thick, shiny white or silver scales.
• Itching, ranging from mild to severe.
• Intense scalp dryness that may result in cracking and bleeding.
• A burning sensation on the scalp.
• Temporary hair loss, but hair usually grows back after skin clears.

Dandruf for scalp psoriasis? Simple ways to tell them apart

To distinguish between scalp psoriasis and dandruff, it is important to recognize their key differences, as highlighted in the table below: (3)

Struggling with scalp psoriasis or dandruff? Our dermatologists at Dr. Soliman Fakeeh Hospital provide advanced treatments to soothe your scalp and revitalize your hair. Schedule your appointment today!

ScalpPsoriasis Treatment: Steps to Take

There's no cure for psoriasis, but you can take a number of steps to alleviate itssymptoms.

A crucial initial step involves the careful removal of thick psoriasis scales, to allow the topical treatments to penetrate the skin more effectively. Here’s an over view of the recommended steps for treating scalp psoriasis: (4)(5)

Step 1: Soften the scales

To effectively remove psoriasis scales, it is vital to first soften them with oils such as coconut, olive, or almond oil. Warm the oil slightly before applying it to the scalp. Once applied, cover your hair with a towel or shower cap and leave it overnight for the best results.

For stubborn scales, consider incorporating products that contain salicylic acid to improver em oval efficiency.

Step 2: Gently remove the scales

Begin by delicately detaching the scales from the scalp with a fine-toothed comb. It is important to handle this process with care, as aggressive removal can worsen psoriasis and increase the risk of hair loss.

Step 3: Washing hair with a psoriasis shampoo

• Corticosteroidshampoos: Such asClobetasol, are commonly prescribed and can effectively alleviate psoriasissymptoms. For optimal results, use such shampoos daily for four weeks. It'salso safe to use it once or twice a week to maintain results.
• Coaltar shampoos: For relieffrom itching, coal tar shampoo can be an effective option for managingpsoriasis. Some products combine corticosteroids with coal tar for enhancedefficacy. Nevertheless, be aware that coal tar shampoo may discolorlight-colored hair or stain clothing if it comes into contact with the fabric. 

Usage instructions: Apply the shampoo gently to the scalp, avoiding vigorous scrubbing. Allow it to remain for 5-10 minutes before rinsing thoroughly. 

Step 4: Applying topical treatments

Your scalp is now prepared to apply medication. Physicians often recommend one or more of the following options:

• TopicalCorticosteroids: Thesetreatments reduce redness, itching, and scaling, and are available in cream,gel, or lotion forms. It is crucial to apply corticosteroids only to affectedareas as directed by your doctor; overuse can lead to skin thinning and otheradverse effects.
• CalcipotriolCream: Thissynthetic vitamin D derivative is most effective when applied before bedtimeand covered with a shower cap to enhance absorption. In severe cases, acombination of calcipotriol and corticosteroid, such as Daivobet ointment orgel, may be recommended for better results.
• Tazarotene: Applied as a thin layer to psoriasis patchesbefore bedtime and rinsed off in the morning. An example of this medication isEVITAR gel.

Managing severe symptoms

In instances of severe scalp psoriasis, physicians may suggest: oral medications, steroid scalp injections administered directly to the affected area(s), or light therapy.

While all mentioned treatments are effective, responses can vary widely depending on the patient's specific condition. Consequently, individuals with scalp psoriasis should prioritize regular consultations with their physician. This practice allows for close monitoring of treatment efficacy and the timely management of potential side effects.

References

1. Psoriasis and Psoriatic Arthritis Alliance - Scalp Psoriasis
2. American Academy of Dermatology Association - Scalp psoriasis: Symptoms
3. National Psoriasis Foundation - Scalp Psoriasis vs Dandruff
4. American Academy of Dermatology Association - Scalp psoriasis: Shampoos, scale softeners, and other treatments
5. Irish Skin Foundation - TREATMENTS FOR SCALP PSORIASIS