Scalp psoriasis causes red, inflamed patches covered with silvery scales, leading to itching, irritation, and discomfort. While there’s no cure, various effective treatments—ranging from OTC shampoos to prescription medications—can help manage symptoms and improve quality of life.
What is Scalp Psoriasis?
Scalp psoriasis is a type of psoriasis that primarily affects the scalp, though it can also extend to the forehead, back of the neck, and behind the ears. It is caused by an overactive immune system that speeds up skin cell growth, resulting in patches of thick, scaly skin. Triggers such as stress, infections, cold weather, or certain medications can worsen the condition.
Over-the-Counter (OTC) Treatments
Many mild to moderate cases of scalp psoriasis can be treated effectively with over-the-counter (OTC) shampoos, creams, and ointments. Some of the most commonly recommended OTC treatments include:
- Salicylic Acid
Salicylic acid is a keratolytic agent that helps break down the scales associated with scalp psoriasis, making it easier to remove dead skin. It is often found in medicated shampoos and topical treatments. By softening the plaques, salicylic acid allows other medications to penetrate the skin more effectively. However, overuse can lead to irritation, so it’s essential to follow the directions carefully. - Coal Tar
Coal tar is another common ingredient in scalp psoriasis treatments. It slows the rapid growth of skin cells and reduces inflammation, itching, and scaling. Coal tar shampoos and creams are widely available and can be an effective option for mild to moderate cases of scalp psoriasis. The downside is that coal tar can have a strong odor and may stain clothing or bedding. - Zinc Pyrithione
Found in many dandruff shampoos, zinc pyrithione has antifungal and antibacterial properties that can help reduce inflammation and itching. While it is not as strong as some prescription medications, it is a good option for those with mild scalp psoriasis or as a supplementary treatment.
Prescription Treatments
For more severe cases of scalp psoriasis or when OTC treatments don’t provide enough relief, prescription medications may be necessary. Some of the most effective options include:
- Topical Corticosteroids
These are the go-to prescription treatment for scalp psoriasis. Corticosteroids help reduce inflammation and slow down the rapid growth of skin cells. They are available in various strengths, from mild to potent, and come in forms like shampoos, gels, and foams designed for scalp application. While effective, prolonged use of corticosteroids can lead to thinning of the skin, so they are generally recommended for short-term use. - Vitamin D Analogues
Topical treatments like calcipotriene (Dovonex) and calcitriol (Vectical) are synthetic forms of vitamin D. They work by slowing skin cell production and reducing inflammation. Often, these are used in combination with corticosteroids to enhance their effectiveness. - Tazarotene (Tazorac)
Tazarotene is a topical retinoid (a form of vitamin A) that helps reduce scaling, redness, and inflammation. While it can be effective, it may cause irritation or dryness, especially if used in combination with other strong medications. - Biologics
For severe cases of scalp psoriasis that don’t respond to topical treatments, biologic medications such as adalimumab (Humira), etanercept (Enbrel), and secukinumab (Cosentyx) may be prescribed. These are injected or infused medications that target specific parts of the immune system to reduce inflammation and prevent flare-ups. Biologics are often reserved for patients with extensive psoriasis affecting other parts of the body in addition to the scalp. - Oral Systemic Treatments
In some cases, oral medications like methotrexate, cyclosporine, or acitretin may be used to treat severe psoriasis. These medications work by suppressing the immune system and slowing down skin cell turnover. However, they come with significant side effects and are generally reserved for more serious cases.
Learn More About Treatments for Scalp Psoriasis
Scalp psoriasis can be challenging to manage, but there are a variety of effective treatments available. OTC options like salicylic acid, coal tar, and zinc pyrithione can provide relief for mild cases, while prescription treatments such as corticosteroids, vitamin D analogues, and biologics are often necessary for more severe or resistant cases. The key to managing scalp psoriasis is working with a healthcare provider to find the right combination of treatments that work for your specific condition. With the right approach, you can significantly reduce symptoms and improve your quality of life.