What Is Scalp Psoriasis Look Like – If your scalp is itchy and your shoulders are itchy, is it just dandruff – or could it be scalp psoriasis? It’s true that both conditions can cause annoying white flakes, but dandruff and scalp psoriasis stem from different causes and require different treatments. Dermatologist Mona Gohara, MD, associate clinical professor of dermatology at Yale School of Medicine, is here to sort out all the differences.
Dandruff is a very common scalp condition characterized by dry flakes of skin that cling to a person’s hair or clothing. According to the American Academy of Dermatology (AAD), it generally does not require medical treatment, but it can be itchy and uncomfortable, as well as embarrassing for those who have to deal with it. Here are the reasons:
What Is Scalp Psoriasis Look Like
• A yeast imbalance. “We have a type of yeast in our bodies called Malassezia that is part of our normal microbiome,” Dr. Gohara says. “Dandruff, or seborrhea, is caused by its overgrowth.”
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• Oily scalp. Dandruff may be associated with increased oil production on the scalp, as evidenced by greasy hair or an oily scalp.
• An excessively dry scalp. “Dandruff can also be the result of a very dry scalp,” Dr. Gohara says. “Also, flaking can occur from using too many products on the hair or not washing the products properly — but it’s not the same as dandruff.”
“Psoriasis of the scalp is a completely different animal than dandruff,” Dr. Gohara says. Psoriasis can appear anywhere on the body, they point out, and according to the National Psoriasis Foundation (NPF), 45 to 56% of people with psoriasis have it on their scalp. It can be very itchy, sometimes burning or painful. Here is more information about the cause of scalp psoriasis:
• “Psoriasis is the result of excessive proliferation of the epidermis, the top layer of our skin, resulting in thick, scaly plaques,” Dr. Gohara says.
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Excessive proliferation is caused by immune dysfunction around the skin cells, Dr. Gohara explains. According to the Journal of Psoriasis and Psoriatic Arthritis, psoriasis is called an “immune-mediated” disease — that is, an immune system disorder that causes inflammation from an unknown cause. An overactive immune system reactivates the growth of skin cells, causing them to accumulate and form plaques instead of shedding.
• “Typically, in psoriasis of the scalp, the plaques are usually very dry, not oily or greasy. “There’s a red or pink color — or for darker skin, dark red or purple,” says Dr. Gohara.
• “Psoriasis of the scalp can greatly interfere with one’s lifestyle,” Dr. Gohara says. “It’s very obvious — everybody knows if you have it. If you have a heart problem, people don’t see it, but they see scalp psoriasis breaking out.
“The color — that red, pink or purple color — is very different from scalp psoriasis,” Dr. Gohara says. As well as dry and thick plaques, silver in color. Psoriasis of the scalp can spread beyond the hairline and behind the ears. A dermatologist can help you determine what your condition is.
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Dandruff is not related to systemic problems in the body, Dr. Gohara points out. Psoriasis is associated with arthritis in the small joints or lower back, psoriatic arthritis, as well as heart problems related to inflammation.
According to the AAD, there are specific over-the-counter shampoos designed to treat dandruff. They contain a variety of ingredients, including salicylic acid (found in Neutrogena’s T/Sal), zinc pyrithione (Head & Shoulders), coal tar (also found in Neutrogena’s T/Gel), and selenium sulfide (Selson Blue). There is also an OTC anti-yeast shampoo (Nizoral) used to treat dandruff, Dr. Gohara says. Prescription options are also available through your dermatologist.
Dr. Gohara adds.
According to the NPF, scalp psoriasis is difficult to treat because the plaques cover the hair. Doctors usually start with the basics in treating it, Dr. Gohara says, often with a prescription topical inflammatory medication, a form of steroid.
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If a person has a mild case of scalp psoriasis, there are OTC psoriasis products to try first, says the NPF; Look for products that contain salicylic acid or coal tar. Shampoos targeted to help psoriasis can help: “Salicylic acid shampoos cut through the overgrowth of the top layer of scalp skin,” Dr. Gohara says. Other shampoos containing coal tar can also be tried.
Phototherapy, which uses ultraviolet light to slow cell growth, is also used to treat psoriasis. “As dermatologists, we always tell people to avoid UV light, but it’s a very effective anti-inflammatory,” Dr. Gohara says. For scalp psoriasis, a doctor may use a hand-held phototherapy device with a comb to specifically target that area, according to the NPF.
If a person’s psoriasis is moderate to severe and not limited to the scalp — or if their scalp psoriasis has not responded to other treatments — oral systemic medications that target molecules in immune cells are available, the NPF says. “Biologics are also available to treat psoriasis,” Dr. Gohara says. “These are a game changer — they specifically target the problem in the immune system.” These drugs and biologics have side effects, and your dermatologist can help you explain and help you decide if they are a good option for you.
“One thing people need to be aware of is that stress can make psoriasis worse because stress increases the hormone cortisol, which increases inflammation,” Dr. Gohara says. So it makes sense to focus on whatever you can do to reduce your stress, whether it’s taking yoga classes, practicing mindfulness, finding time to relax and read, or reaping the benefits of a daily reflective walk.
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Another concern among people with scalp psoriasis is whether it is safe to dye their hair. “I would never tell anyone to avoid coloring their hair, but it’s true that psoriasis tends to show up in areas of the body that are stressed or traumatized,” Dr. Gohara says. “Hair dye, styling products and chemicals can all wreak havoc on one’s skin. Yes, people with scalp psoriasis can get a flare-up from coloring their hair. It’s a good idea to have a conversation with your stylist about using gentler formulas.
Lisa (she/her) is the executive director of the Hearst Health Newsroom
, she specializes in producing investigative health reports and other stories that help people live their healthier lives. She has won several editing awards including the National Magazine Award.
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Kim Shares Her Makeup-Free “Psoriasis Face” LeAnn Rimes Opens Up About Having Psoriasis My Mom Had Psoriasis Now I Do More Women Come Out About Their Rare Skin Conditions Scalp Psoriasis is a type of skin disease that causes lesions on the scalp. Although many treatments are available, it cannot be completely cured and may recur after treatment.
Psoriasis is a common skin disease that causes well-demarcated lesions with sharp edges covered with scales. Lesions are round, oval or geographic in shape. The scalp is the most common part of the body affected by psoriasis. Psoriasis affects many other parts of the body, such as the elbows, knees, gluteal folds, nails, and joints.
Our skin is constantly producing new cells and shedding the top layer of old cells. In psoriasis, more cells are produced than shed. This causes a superficial scaly appearance in areas of thickened skin.
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Like other types of psoriasis, scalp psoriasis appears to be an autoimmune response with a genetic basis. It is often manifested in the presence of certain factors such as emotional factors, pregnancy, stress, antimalarial drugs, use of certain drugs including lithium, NSAIDs, blood pressure drugs, beta blockers and ACE inhibitors.
Seborrheic dermatitis, or dandruff, is a common condition that causes confusion in diagnosis due to its similar appearance. On closer inspection, the scales appear greasy in seborrheic dermatitis, while in psoriasis they are silvery and dry.
Scalp psoriasis is treated with topical or systemic medications. Combinations of different treatments are often used, depending on the extent of the condition. Many of these drugs cannot be used in pregnant patients.
Topical formulations such as oils, lotions, solutions, creams, and shampoos are available for application to wounds. These should be used only as prescribed by the doctor. These may include:
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Biological agents acting on the inflammatory process of psoriasis. They
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