Scalp psoriasis

What is psoriasis?
Psoriasis is a common skin condition affecting 2-3% of the population of the United Kingdom and Ireland.

What does it look like?
Psoriasis appears as raised red patched of skin covered with silvery scales. It is very simply a speeding up of the usual replacement processes of the skin. This process is the same wherever psoriasis occurs on the body.

How does scalp psoriasis feel?
There is thick scales and redness that may also be obvious around the scalp margins, on the forehead, neck and behind the ears. Many patients experience severe itching and a feeling of tightness and some report soreness.

When should I go to the doctor?
For those with scalp patches that flare from time to time it is possible to manage at home. Shampoo treatments are improving all the time and can be bought over the counter. Your pharmacist should be able to advise.
However, if your scalp is covered with thick scale or it does not clear up do consult your GP who may arrange a referral to a Dermatologist. There is a range of treatments that can be prescribed including coal tar, dithranol, salicylic acid, steroid creams and ointments as well as Vitamin D based treatments.

Applying the treatment
The method of applying in the treatment is most important. It involves parting the hair in sections and rubbing the treatment along the exposed areas. It is best to do this in order, working your way around the hair. You may need someone to help you in order to see the top of your head properly. You will find that some treatments need to be left on and some need to be washed out after a set period of time. Do follow the instructions that come with the product or the advice of your healthcare professional.

Can I brush and comb?
Providing care is taken to avoid scratching the scalp, combing and brushing to remove scaling is not only good but also necessary.

What about perms and other hair treatments?
Scalp psoriasis should not stop you having any cosmetic procedures. Having a perm or colouring the hair can have a positive effect on your self-esteem. Hair dyes are gentler than they used to be but it would be best to seek advice from a hairdresser who should have up to date information about possible options, rather than colour or treat your hair at home. It is a good idea to make sure there are no scratches on the scalp when the hair is treated as the chemicals concerned can cause irritation on the broken skin.

I am embarrassed to go to the hairdresser
A good hairdresser should be able to help you manage your hair and scalp. Telephone in advance and speak to a stylist to explain the situation or try to find a hairdresser who will visit you at home.

My hair is coming out!
Some people with severe psoriasis suffer temporary thinning of the hair. This can be very distressing but the hair will grow again once the flare-up has subsided.

Does it go away?
Psoriasis tends to come and go and it can and does go away. Some people may be lucky enough not to have a further flare up. Others may experience long periods of remission. It is unusual for anyone to suffer extensive scalp psoriasis for a long time provided they seek medical help and use treatments as directed.

Helpful hints
· Brush and comb hair gently and regularly
· Buy some pillow case protectors or keep a supply of old pillow cases for times when you are using treatments
· Give all treatments a good chance to work – weeks rather than days
· Always read the instructions carefully on all treatments
· Tell your GP or Dermatologist if any treatment is causing you problems or discomfort
· Try different hairstyles to cover any psoriasis on the hairline
· Wearing light coloured clothes on the top half of your body will help to disguise falling scales
· Keep up to date with new treatments – the office has details.