My doctor says I have scalp psoriasis. How do I treat it?

Answer From Lawrence E. Gibson, M.D.

Scalp psoriasis, which involves red, itchy areas with silvery-white scales that often extend beyond the hairline, can be tricky to treat. Scratching can worsen the condition and your hair can prevent medication from reaching your scalp.

To improve the look and feel of your scalp:

  • Apply scale softener. A scale softener containing salicylic acid can help loosen scales on your scalp and allow medication to work better. Apply the scale softener directly to your scalp. Don't pick at your scalp scales. This can cause hair loss and trigger a scalp psoriasis flare.
  • Use medicated shampoo. Over-the-counter medicated shampoos can be effective at treating scalp psoriasis. Choose one that contains coal tar or salicylic acid to ease itchiness and remove scales. Be gentle when washing your scalp to avoid irritation.
  • Don't scratch. Scratching your scalp can make your psoriasis worse, as well as cause bleeding and hair loss. Shampoos containing coal tar or menthol can help reduce itching. If itchiness continues, your doctor might recommend that you take an oral antihistamine medication to provide relief.
  • Try topical medications. Your doctor might recommend the topical treatments anthralin, calcipotriene (Dovonex), tazarotene (Tazorac, Avage) or a combination of betamethasone and calcipotriene (Taclonex). Side effects vary. Anthralin stains anything it comes into contact with and calcipotriene, tazarotene, and betamethasone and calcipotriene can cause skin irritation. Follow your doctor's directions for when and how long to use the medication.

If your scalp psoriasis is severe, you might need a medication that affects your entire body (systemic). Light therapy also might be helpful. Talk to your doctor to see what treatment might work best for you.

Jan. 03, 2019 See more Expert Answers

See also

  1. 5 signs a psoriasis support group is right for you
  2. 6 ways to manage itchy skin when you have psoriasis
  3. Arthritis
  4. Arthritis pain: Do's and don'ts
  5. Can arthritis pain medications be harmful?
  6. Can psoriasis make it hard to sleep?
  7. Dry skin
  8. Ease stress to reduce your psoriasis flares
  9. Exercising with arthritis
  10. Ground flaxseed
  11. Gluten sensitivity and psoriasis: What's the connection?
  12. How to heal cracked heels
  13. How to heal cracked skin at thumb tip
  14. Is the Mediterranean diet good for psoriasis?
  15. Living better with psoriasis
  16. Psoriasis-related health risks
  17. Mayo Clinic Minute: Fingernails are clues to your health
  18. Mayo Clinic Minute: Moisturizer tips from a dermatologist
  19. Photodynamic therapy
  20. Prednisone risks, benefits
  21. Pregnancy and breast-feeding with psoriasis
  22. Psoriasis
  23. Psoriasis and clinical trials
  24. Psoriasis and intimacy
  25. Psoriasis and your self-esteem
  26. Identifying psoriasis triggers
  27. Psoriasis: Get the most out of your treatment
  28. Psoriasis: How can I protect my skin during a workout?
  29. Psoriasis treatment options
  30. Psoriasis: What if I get psoriatic arthritis, too?
  31. Psoriasis: What to share with your doctor
  32. Relaxation techniques
  33. Scalp psoriasis vs. seborrheic dermatitis
  34. Skin biopsy
  35. Skin care tips
  36. Skip flavored lip balm
  37. How to trim thickened toenails
  38. Slide show: 5 ways to thrive with psoriasis through the holidays
  39. Slide show: Caring for your skin when you have psoriasis
  40. Hand exercises for people with arthritis
  41. Joint protection
  42. Types of psoriasis
  43. Common skin rashes
  44. Time your lotions right
  45. Ward off dry skin
  46. Water exercise
  47. Alternative psoriasis treatments
  48. What are the risks of vaccinations for people living with psoriasis?
  49. White patch on skin: A cause for concern?