Scalp Psoriasis

Quick Guide

It can be tough to manage scalp psoriasis. Psoriasis plaques on your

scalp may be itchy, flaky and difficult to treat. But living with scalp pso-
riasis doesn’t mean you can’t enjoy your hair and manage scale build up.
There are ways to make living with scalp psoriasis easier.
 Over 60 percent of people living with psoriasis have scalp psoriasis. Scalp psoriasis
can affect the hairline, the forehead, the back of the neck and the skin around the
ears. Symptoms may be fine scaling that looks like dandruff, or appear as thick,
crusted plaques that cover the entire scalp. Plaques can have a red, purple or silver
color. In rare cases, scalp psoriasis may affect hair growth.

Scalp psoriasis can have a major impact on a person’s quality of life. People living
with scalp psoriasis often talk about feeling embarrassed or self-conscious about
their visible plaques, fine scaling or hair loss. Scalp psoriasis can affect rela-
tionships and interactions with other people as scalp psoriasis sometimes brings
unwanted stares and comments. In addition, scalp psoriasis may cause intense itch
which may make it difficult to focus or sleep.

Although there is no cure for scalp psoriasis, there are many treatments that can
manage scalp psoriasis symptoms. It is important to talk with a dermatologist who
can help to find the right treatment for you.

Over-the-counter
products
Over-the-counter (OTC) products may help
manage symptoms for people with mild
scalp psoriasis. These products come in
many forms ­– shampoos, conditioners,
soaps, foams and creams. The two active
ingredients that you should look for in OTC
products are salicylic acid and tar.
• Salicylic acid works to soften
plaques and scales and remove
scales from the skin.
• Tar made from wood or coal works
to slow skin cell growth and reduce
inflammation, itching and scaling.
Tips for dealing with itch
• Try not to scratch or pick at a psoriasis lesion.
As you’re shopping
for OTC products,
you may notice
that some have the
National Psoriasis
Foundation (NPF)
seal. These products
are part of NPF’s
Seal of Recognition program which
highlights products that have been
created or are intended to be non-­
irritating and safe for people with
psoriatic disease. Many of these
products contain salicylic acid
and coal tar. Visit NPF’s Seal of
Recognition website for a list of prod-
ucts at psoriasis.org/seal.

• Use conditioner after you shampoo to keep the scalp moisturized.

• Shampoos, lotions and creams that include menthol as an active

ingredient can be helpful in soothing itch.

• Press a wet towel or cold pack against the itchy spot.

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 Topical treatments
If you are not seeing an improvement in your scalp psoriasis with OTC products, your
dermatologist may recommend that you use one or a combination of topical treatments:
• Medicated shampoos that include tar, salicylic acid, selenium,
topical corticosteroid (also called steroids), zinc or ketoconazole

• Topical steroids

• Topical tars

• Prescription topicals, including Dovonex (calcipotriene),

Tazorac (tazarotene) and Dithranol

Because the hair is in the way, treating the scalp with topical treatment is not easy. For
the treatment to be effective, it is important to use the treatment well. Often, using one
treatment well results in more improvement than poor use of a more complicated treat-
ment regimen. Be honest with your dermatologist about how often you use treatments.

Next steps
If your scalp psoriasis is not getting better after using topical treatments well, then your
dermatologist may recommend phototherapy, biologics or oral treatments.

Phototherapy (also called light therapy) uses ultraviolet (UV) light to slow skin cell
growth. Treatment can be given in a health care provider’s office or at home with a pre-
scription and instructions from your provider. Handheld phototherapy units with built-in
combs are available to help UV rays reach the scalp.

Biologics or oral treatments are often prescribed when a person has psoriasis on more
than the scalp or if other treatments haven’t worked to treat the scalp psoriasis. In April
2020, the US Food and Drug Administration approved Otezla to treat scalp psoriasis. Talk
to your dermatologist to see if Otezla is right for you. If your treatment plan is not
working or not meeting your treatment goals, speak with your dermatologist about other
treatment options.

Caring for your hair

Getting a haircut may bring up feelings of embarrassment, anxiety and dread for some-
one living with scalp psoriasis. However, there are ways to lessen those feelings.

The first step is to find a hairdresser or barber who makes you feel comfortable. Some
hairdressers know about scalp psoriasis or have cut hair for other people living with
scalp psoriasis. You may ask if any hairdresser has experience with scalp psoriasis when
you set up an appointment.
Be open about what scalp psoriasis is for you and what it is not – contagious or an infec-
tion. Also, you can ask your hairdresser to comb your hair gently and to avoid scratching
the scalp.

It may take going to a few different hairdressers to find a person who makes you feel
comfortable, but the search may be well worth it.

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 If you use heated tools and chemicals to style your hair, consider that these may irritate
your scalp psoriasis. Try to limit the use of heated tools to dry and style your hair. Instead
try air drying your hair or using a heated tool at a low heat. Also, avoid dyes and chemi-
cals that make your scalp burn, irritated or dry.

What to wear
We believe that you should feel comfortable in whatever you wear whether that shows or
hides your scalp psoriasis. Here are some tips on what to wear with scalp psoriasis:
• Wear white or light-colored clothing to hide scalp flakes.

• Wear a top with a colorful print to distract from your plaques.

• Avoid knit and sweater materials which may hold onto flakes.

• Accessorize with a scarf to hide any plaques on your neck.

• Wear a hat to cover up your plaques on your scalp or hairline.

Connect with others

There are others out there who are living with scalp psoriasis just like you. They may
know the embarrassment you feel, the struggle to find the right treatment and the relief
you feel when your scalp psoriasis is managed. It may help to share your experiences and
encourage each other. Contact the Patient Navigation Center to be connected to others
living with scalp psoriasis.

Work with your Patient Navigator

NPF’s Patient Navigation Center provides free and personalized assistance to
anyone impacted by psoriatic disease, including families and caregivers.

You can reach our navigators by phone, text, email and instant chat
Monday-Friday, 7:30 am - 4:30 pm PST.

Phone: 1-800-723-9166 (option 1) | Text: 503-410-7766

Email: education@psoriasis.org | Chat: psoriasis.org/navigationcenter

National Psoriasis Foundation education materials are medically reviewed and are not intended to replace the counsel of a
physician. The Foundation does not endorse any medications, products or treatments for psoriasis or psoriatic ar thritis and
advises you to consult a physician before initiating any treatment.
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