The major symptoms of scalp psoriasis are thick and scaly patches of skin, redness, inflammation, itching, burning, and dandruff. It can range from mild (small, red bumps) to severe (thick plaques.) Psoriasis of the scalp can extend below the hairline, causing red, itchy plaques on the forehead and the back of the neck.
There are specialized shampoos to help treat scalp psoriasis. The most common ingredients in over-the-counter shampoos for scalp psoriasis are coal tar and salicylic acid. These shampoos can relieve itching and slow skin cell growth and often work well for mild cases of scalp psoriasis. Readily available over-the-counter shampoos for scalp psoriasis include Denorex, Zetar, Neutrogena T/Gel, and D-Psoria.
If over-the-counter shampoos aren’t working, there are prescription strength shampoos and topical treatments. The most common ingredients in these include calcitriol, tazarotene and calcipotriol.
Shampoos and other topical treatments work best if the plaques are removed before treatment to better allow the medication to penetrate the skin. You should protect your ears when applying shampoos and topical treatments. Put a small amount of petroleum jelly on a cotton ball and insert in your ears to protect your ear canal.
When applying shampoos and topical treatments, gently part your hair and apply inside the part. Try not to rub the shampoo onto your head as this can irritate your scalp and cause the psoriasis to worsen. Always apply a moisturizing conditioner after shampooing.
There are also lifestyle changes you can make to help relieve the major symptoms.
Keep hair short and well groomed. The longer your hair is, the more difficult it is to treat scalp psoriasis.
Remove the plaques by applying a softener that contains salicylic acid and gently remove the excess skin with a brush or fine tooth comb. Try not to scratch or pick as this can irritate your scalp and cause a flare or cause your hair to temporarily fall out.
Keep your scalp moist and hydrated. Apply aloe vera, coconut oil, or a lotion recommended by your dermatologist while your scalp is damp. You might find that wearing a shower cap after applying moisturizers improves their effectiveness; however, you should discuss this with your doctor first.
Limit the use of hot styling tools, such as a hair dryer or curling iron, as these can dry out your scalp and worsen your psoriasis.
If your psoriasis is prone to flaking and causes dandruff, try wearing light colored tops and scarves to help hide the flakes. It can take several months after you begin treatment to see an improvement in dandruff.
For itching, try shampoos with menthol, over-the-counter oral antihistamines, or use cool packs on areas that are most bothersome. Your doctor can also prescribe medication to control the itchiness.
If you experience discomfort, pain or tenderness, contact your dermatologist. Scalp psoriasis can sometimes become infected. Signs of infection include tenderness, crusting and swollen lymph nodes. You should call your doctor immediately if you experience these symptoms.