Psoriasis is a chronic autoimmune condition that causes red, scaly, thick, and flaky skin. Psoriasis of the scalp occurs in about half of all people who have psoriasis.
All forms of psoriasis, including scalp psoriasis, are caused by an overactive immune system, but the reason for this immune system overactivity is not known.
Factors that can increase a person’s chances of developing scalp psoriasis include:
- Family history
- Use of certain medicines, including blood pressure medications, lithium, and antimalarial drugs
- Certain types of infections, such as strep
- Obesity
- Smoking
Triggers for scalp psoriasis flares include:
- Stress
- Skin injury, including scratches, scrapes, cuts, bug bites, sunburns, and vaccinations
- Illness, such as ear infection, bronchitis, tonsillitis, or respiratory infection
- Exposure to secondhand smoke
- Excess alcohol consumption
- Allergies
- Certain foods
- Weather, especially cold and dry weather
- Environmental factors
What Are Symptoms of Scalp Psoriasis?
Symptoms of scalp psoriasis may affect all or part of the scalp and include:
- Fine scaling that looks like dandruff
- Appears powdery with a silvery sheen
- Thick, crusted plaques that cover the entire scalp
- Red and bumpy areas
- Dry scalp
- Cracked skin that itches or bleeds
- Burning or soreness
- Localized hair loss
- Emotional effects
- Embarrassment
- Depression
- Anxiety
- Psoriatic arthritis
- May also occur in some patients
- Causes stiff, swollen, painful joints
How Is Psoriasis of the Scalp Treated?
Scalp psoriasis can be difficult to treat. The goal of treatment for scalp psoriasis is to relieve symptoms.
Treatments to help get rid of psoriasis on the scalp include:
- Topical treatments, such as creams and ointments
- Over-the-counter (OTC) topical treatments: The National Psoriasis Foundation (NPF) has a Seal of Recognition program that recognizes over-the-counter products intended to be non-irritating and safe for people with psoriasis
- Look for products such as shampoos that contain:
- Salicylic acid to help soften plaques and scales and remove scales from the skin
- Coal tar or wood tar, to help slow skin cell growth and reduce inflammation, itching, and scaling
- Scale lifters (keratolytics) with active ingredients such as salicylic acid, urea, lactic acid, or phenol to help loosen and remove scale, and allow medications to reach the psoriasis plaques
- Aloe vera, jojoba, zinc pyrithione, and capsaicin to soothe, moisturize, remove scale, or relieve itching
- Anti-itch treatments such as calamine, hydrocortisone, camphor, benzocaine, diphenhydramine hydrochloride, and menthol (may increase irritation and dryness)
- Coverings such as plastic wrap, cellophane, waterproof dressing, cotton socks, or a nylon suit may be applied over topical treatments to help increase effectiveness
- Prescription topical treatments
- Anthralin
- Calcipotriene (Dovonex)
- Calcipotriene and betamethasone (Taclonex)
- Calcitriol (Vectical)
- Steroids
- Tazarotene (Tazorec)
- Phototherapy (light therapy)
- Ultraviolet light B (UVB): broad band and narrow band
- Psoralen + UVA (PUVA)
- Systemic treatments
- Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen (Advil, Motrin) for inflammation
- Biologics and biosimilars
- Tumor necrosis factor-alpha (TNF-alpha) inhibitors
- Interleukin 12 and 23 (IL-12, IL-23) inhibitors
- Interleukin 17 (IL-17) inhibitors
- T-cell inhibitors
- Interleukin 23 (IL-23) inhibitors
- Disease-modifying antirheumatic drugs (DMARDs)
- Traditional oral systemics
- Acitretin (Soriatane)
- Cyclosporine
- Methotrexate
- Off-label systemics, including hydroxyurea (Hydrea), isotretinoin, mycophenolate mofetil, sulfasalazine, and 6-Thioguanine
Health Solutions From Our Sponsors
From 
Healthy Resources
Featured Centers
Health Solutions From Our Sponsors
References
https://www.uptodate.com/contents/psoriasis-the-basics?search=psoriasis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.psoriasis.org/
https://www.psoriasis.org/scalp/
https://www.psoriasis.org/
https://www.psoriasis.org/scalp/