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

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