Psoriasis is a condition of the skin that can happen in various parts of the body including the scalp. It is a chronic inflammatory disorder characterized by raised reddish scaly lesions over the involved region. It can vary from mild disease with few lesions to severe disease involving the entire body. One of the common areas affected is the scalp. Scalp psoriasis can occur alone or with involvement of other areas of the body.
The first and most important thing to understand about scalp psoriasis is that it is not contagious – as a matter of fact, there are studies that show that this condition is caused due to issues related with the immune system. The immune system is overactive and releases various signals that causes the skin cells to grow very fast resulting in the development of psoriatic patches. However, genetic factors also play a role and studies have shown that scalp psoriasis run in families.
There are certain symptoms that could help you detect scalp psoriasis, and these include:
• Scaly patches that are bumpy to touch and red in colour
• Scales that are silvery white in colour
• Flaking that is quite similar to dandruff
• Dryness on scalp that is often accompanied by itching
• Isolated patches are seen in psoriasis unlike diffuse scaling which is seen in dandruff
• Sometimes the reddish lesions extend onto the forehead and back of neck
Usually hair loss is not seen in scalp psoriasis but sometimes, there tend to be some itching and picking at the bumps. The stress that is caused to the hair follicles is what leads to the hair loss. However, in most cases, the hair loss is not permanent and the hair does grow back, once the scalp psoriasis has been taken care of.
Scalp psoriasis is usually confused with seborrhoeic dermatitis but a trained trichology physician can easily pick up the diagnosis. Careful evaluation of rest of the body is done to look for any other areas of involvement.
The treatment for scalp psoriasis involves topical medications and medicated shampoos.
Scalp lotions containing steroids and salicylic acid are the first line of treatment of scalp psoriasis. Shampoos containing steroid, salicylic acid or coal tar either alone or in combination are given as adjuvants to be used thrice a week. Regular use of emollients is also advised to reduce dryness. If there is involvement of other areas of the body, oral medicines can be considered depending on the extent of involvement.
Some of the other medications that can be tried are:
• Topical retinoids like Tazarotene,
• Topical immunomodulators like tacrolimus
• Topical vit D analogues like Calcipotriene