Psoriasis on the scalp: causes & what helps

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What does psoriasis look like? Pictures of psoriasis

What is Scalp Psoriasis?

Psoriasis on the scalp (psoriasis capitis) is a common form of psoriasis. Psoriasis is a chronic autoimmune disease and causes accelerated and therefore excessive production of skin cells. The skin disease causes thick, white-silvery and itchy scales to form

• on the scalp,
• often also at the hairline on the face
• as well as in the neck.

The visible dandruff formation often puts a lot of strain on those affected.

There is no cure for psoriasis, but the symptoms can be easily treated. Furthermore, lifestyle changes and self-care can help relieve symptoms and improve quality of life.

What are the causes of psoriasis on the head?

The causes of the development of psoriasis have not yet been conclusively clarified. It is believed that a complex interaction of genetic, immunological and environmental factors can promote psoriasis. It has been proven that the predisposition to psoriasis can be inherited. The probability of inheritance is significantly higher if both parents have the genetic predisposition.

The immune system plays a crucial role. When the disease breaks out, the immune system reacts overactively and triggers inflammatory reactions in the skin. The body mistakenly fights itself, which is why psoriasis is considered an autoimmune disease.

If there is a genetic predisposition, various environmental factors can trigger this overreaction of the immune system. This includes:

• Skin injuries
• Infectious diseases
• certain medications, such as beta blockers for high blood pressure
• hormonal changes, for example during pregnancy
• Stress, psychological strain
• Smoking or alcohol
• pro-inflammatory diet
• strong sunlight

Anti-inflammatory foods: The best 15 for your diet

Treatment: What helps against psoriasis on the scalp?

Psoriasis cannot be cured, but the disease is easily treatable. Nevertheless, the treatment of psoriasis capitis can be challenging and lead to a long duration of therapy. The hair makes it difficult to apply the medication and to remove the skin flakes.

The aim of the therapy is to relieve the inflammation on the scalp and stop the excessive dandruff formation.

As a rule, the treatment is carried out in the following steps:

• Remove dandruff: In order to treat the scalp, the first step is to loosen and remove the scales. For this purpose, special preparations such as shampoo, tincture, oil or foam are used, which have a dandruff-relieving effect. They contain active ingredients such as salicylic acid, urea or tar. The respective product is applied to the scalp, massaged in if necessary or left to act overnight and then rinsed out.

• external treatment: Preparations are then used that relieve inflammation and reduce the growth of excess skin cells. This is achieved with shampoos or solutions that contain so-called vitamin D3 analogues. If itching is particularly severe, a short-term treatment with cortisone can be carried out beforehand. Creams or ointments are used for this, which are preferably applied in the evening and rinsed out the next morning.

• Light therapy: Phototherapy may be recommended for severe psoriasis. With the help of UV light, inflammation is inhibited and cell division is slowed down. The plaques are either irradiated directly with UV or treated with a so-called light comb. With the latter, it is important to ensure proper use in order to minimize the risk of skin cancer.

• systemic treatments: In some cases, a doctor may also prescribe systemic medications with active ingredients such as methotrexate, ciclosporin, fumaric acid esters or biologics as tablets, infusions or injections. They are intended to regulate the immune system and control inflammation on the scalp. These medications are mostly used in severe cases of psoriasis.

Psoriasis on the scalp: What those affected can do

Even if the therapy works well, the medicinal product usually has to continue to be used. If there is no further attack, this can be used at greater intervals, for example once a week. In addition, self-care and certain measures can help those affected to live well with psoriasis on the scalp.

The following tips, among others, have proven to be effective:

• gentle scalp care: Use mild, hypoallergenic shampoos to wash your hair. When doing this, avoid excessive rubbing to minimize irritation. Frequent hair washing is also unfavorable because it dries out the skin and therefore further irritates it.

• no hairdryer heat: Blow drying with high heat irritates the scalp. Only use low temperatures for styling.

• Stress management: Learn stress relief techniques such as meditation, yoga, or breathing exercises, as stress can be a known trigger for flare-ups.

• healthy eating: A balanced, plant-based diet can help boost the immune system and reduce inflammation in the body. Avoid possible triggers such as alcohol.

• Avoid smoking: Smoking can cause flare-ups and make them worse. Therefore, it is advisable to avoid or quit smoking.

• regular check-ups: Visit a dermatologist’s office for regular check-ups to monitor the progress of psoriasis.

• Contact with other affected people: Exchanging ideas with other people who also suffer from psoriasis can be supportive and offer helpful tips and advice.

• Psoriasis training: Some clinics offer training programs in which those affected get to know their illness better and learn how to deal with it. The courses provide information on skin care, nutrition and psychology.

Symptoms of psoriasis capitis

Typical signs of psoriasis on the scalp are:

• Defined, red spots on the scalp, hairline, forehead or neck

• thick, white-silvery skin flakes, also called plaque

• Skin thickenings

• severe itching

• inflamed areas of skin, accompanied by redness, burning or pain

In some cases, restricted hair growth may also occur, which is often confused with hair loss. The reason for this is the thickened skin and the formation of plaque in the inflamed areas. The hair can no longer break through this layer as it grows and leads to bald spots on the scalp.

The disease typically progresses in episodes. This means that periods with particularly severe symptoms alternate with phases in which the psoriasis hardly causes any problems on the scalp. A flare-up can be triggered by various stimuli, such as stress, certain medications or injuries to the skin.

This is how psoriasis on the scalp is diagnosed

Scalp psoriasis can easily be confused with dry skin or other skin conditions such as seborrheic eczema. Anyone who suffers from dandruff in their hair and an itchy scalp should have this checked at a dermatologist’s office.

In addition to a detailed anamnesis, the dermatologist examines the affected areas on the scalp with a dermatoscope. With this special magnifying glass, fine details such as patterns of scaling and signs of inflammation can be better seen. This examination is often enough to make a diagnosis.

In individual cases, a biopsy may also be necessary to confirm the diagnosis. To do this, a small tissue sample is taken from the affected area of ​​the scalp and examined under a microscope.

Additional examination for psoriatic arthritis

If those affected also experience joint pain or restricted movement of the joints, psoriatic arthritis is suspected – psoriasis with inflammation of the joints.

In this case, the joints are examined using imaging techniques such as ultrasound or X-rays to confirm the diagnosis and determine the degree of inflammation.

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