What is Psoriasis?

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.

What are the Symptoms of Psoriasis?

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.

Medications used to Treat Psoriasis: Some of the other medications that can be tried are:
• Topical retinoids like Tazarotene,
• Topical immunomodulators like tacrolimus
• Topical vit D analogues like Calcipotriene

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While all of us pay a lot of attention to our hair, we do tend to neglect our scalp, which is actually just as important. For many people, the start of their hair loss lies in their ignoring the health of their scalp. There are several conditions that can affect the scalp, and is the case with all illnesses, understanding the root cause is the first step for proper diagnosis.

There are numerous conditions that can affect the scalp and some of them might start in infancy! Some of the most common conditions include:

attention to scalpSeborrheic dermatitis: This is a condition, that in the mildest form, is dandruff. The severe versions could lead to excessive production of oil and even reddening of the scalp. In this condition, your scalp will feel very greasy and this could lead to acne or even psoriasis. The condition is most commonly seen in people who already have oily skin.

Cradle cap: Like dandruff, this is yet another version of seborrheic dermatitis, but this condition is seen most commonly in infants, especially those below six months of age. The condition typically presents itself with greasy scalp and crusts or scales, which are slightly yellowish in colour. However, this is not a very serious infection and does not even require any medication as well. Parents could try running a little oil on the scalp, as this will loosen the crust, and then the same can be washed off with baby shampoo. Medicated shampoos could also be utilised, under directions from a doctor.

Head lice: There are very few children who have not dealt with hair lice and it generally affects the ages between three and eleven. Lice can spread quite easily and children are most susceptible to the same at school, summer camps or any place where there are several other children in close proximity. These small insects thrive on blood and the eggs are laid quite close to the scalp. While lice do not lead to any serious infections, they can cause severe itching and are generally frowned upon by school authorities. There are several medicated shampoos available and most of them can be purchased over the counter.

Dandruff: Perhaps the most common of scalp conditions is dandruff and it can be detected by the presence of white flakes on the scalp. These flakes are caused due to the excessive build-up of dead skin and the shedding of the same. There is no actual known cause of dandruff, but it is generally considered that it is caused due to certain types of fungus. Dandruff is not contagious and does not cause any serious problems; however, it can cause severe itching and the flakes can fall on dark clothes, leading to embarrassing situations.

The condition can be taken care of by washing hair and scalp on a regular basis with shampoos that contain either of these:

  • Selenium sulfide
  • Zinc pyrithione
  • Salicylic acid
  • Ketoconazole
  • Coal tar

Most of these medicated shampoos are available over the counter or a doctor could prescribe a stronger combination for persons suffering from severe dandruff.


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