Common scalp conditions: Scalp Psoriasis

What is Scalp Psoriasis?

Psoriasis occurs when the immune system causes skin cells to be produced and replaced more quickly than usual. This leads to a build-up of skin cells on the surface, resulting in the characteristic thickened, scaly patches associated with psoriasis. It can affect the entire scalp or appear in smaller areas. It may also extend beyond the hairline onto the forehead, neck or behind the ears.

What are the symptoms of Scalp Psoriasis? 

Common signs and symptoms of Scalp Psoriasis include:

• Red or inflamed areas of skin
• Thick, flaky or silvery-white scales
• Itching or irritation
• Dry or sore areas of the scalp
• Scaling that extends beyond the hairline
• Increased sensitivity or discomfort

Scratching or picking at the scales can irritate the scalp further and may cause bleeding. In some cases, inflammation and scratching can also contribute to temporary hair shedding.

What are the causes of Scalp Psoriasis?

Scalp psoriasis is linked to an overactive immune response rather than poor scalp hygiene. A number of factors may trigger or worsen a flare, and these can vary from person to person.

Potential triggers include stress, skin injury or irritation, certain infections and some medications. Identifying individual triggers can be helpful when managing recurring symptoms.

How can you treat Scalp Psoriasis?

Treatment for Scalp Psoriasis depends on the severity of the condition and how it is affecting the individual. Medical treatment commonly involves topical preparations applied directly to the scalp. NICE recommends a potent topical corticosteroid as an initial treatment for Scalp Psoriasis, with alternative or additional treatments considered if symptoms are not adequately controlled. Treatments may include different formulations, scale-removing preparations, vitamin D-based treatments or combination therapies, depending on individual circumstances.

For persistent, extensive or difficult-to-control Psoriasis, referral to a dermatologist or specialist healthcare professional may be appropriate. Psoriasis can also affect areas such as the nails and joints, and people with psoriasis should be assessed for symptoms that could indicate psoriatic arthritis.

If you are experiencing persistent scalp scaling, redness, itching or inflammation, professional assessment from a Trichologist can help determine whether scalp psoriasis may be contributing to your symptoms and whether medical referral is appropriate.