Scalp psoriasis causes, symptoms and cure: This one is a real head-scratcher

Psoriasis is a chronic skin disease with unpredictable relapses characterised by plaques and papules (raised skin tissue less than 1 cm), often crowned by silver scales (Image: Canva)

Do you enter a room looking like you just came from a wintery Hallmark movie, with snowflakes on your hair, but in the middle of June? You cannot stop scratching your head and have to deal with that constant, irritating itchiness!

Stop, and take note. You could be suffering from Scalp Psoriasis, a dermatological disease that can cause much harm if you don't take care of it in time.

Psoriasis is a chronic skin disease with unpredictable relapses characterised by plaques and papules (raised skin tissue less than 1 cm), often crowned by silver scales. The variants of psoriasis may include Guttate Psoriasis (drop-like lesions), Rupioid Psoriasis (limpet/shellfish-like scales), Penile Psoriasis (in both circumscribed and un-circumscribed males), and Scalp Psoriasis, among others.

Scalp Psoriasis: Recognising the condition

Scalp psoriasis mostly affects adults than children. In its worst form, the scales on the scalp can be massive, spilling on to the forehead, even on the nape of the neck. It either presents as diffused patches or spreads on the entire scalp. It is believed that skin colour is responsible for the varied appearance of scales in different individuals. Dark red or salmon-coloured scales are observed in lighter skin tones, whereas in people of colour, red, brown, or purple scales are predominant. Warmth in the affected area, tenderness, and lymph node swelling may occur if left untreated.

Causes of Scalp Psoriasis 

It takes weeks for new cells to form on the scalp. However, scalp psoriasis can accelerate cell division, making shedding older cells taxing. This build-up on the scalp surface results in scaly patches, characteristic of scalp psoriasis. Burns, cuts, lacerations, infections like pharyngitis, and elevated stress levels can flare the symptoms and worsen existing condition. A few drugs like lithium and antimalarials also take the blame.

It is, however, a non-infectious disease, meaning it cannot spread from one person to another. Its generation may be attributed to a dysfunction of the immune system. A familial predisposition to such dysfunction is likely. Scales formed on the scalp may be inconspicuous but can progress to a severe form resulting in crusting sores.

In its worst form, the scales on the scalp can be massive, spilling on to the forehead, even on the nape of the neck (Image: Canva)

Signs and symptoms

Symptoms of scalp psoriasis entail scaly and bumpy patches. Dandruff-like flaking is also commonly observed along with a dry and itchy scalp. Persistent scratching of the scalp can disturb the circadian and steer one towards skin infections and hair loss. Loss of your thick mane can also be due to harsh chemicals used for treatment and stress.

Differential diagnoses

Seborrheic dermatitis: Commonly known as dandruff, it can be confused with scalp psoriasis. Small and greasy flakes are seen in dandruff, often accompanied by discolouration of the skin. The sites affected include the eyebrows, the axilla (underarm), the trunk, and the scalp.

Ringworm: If present on the scalp, it is referred to as Tinea capitis. It may also cause scaling and pustulation. However, it can be differentiated from scaly psoriasis by the presence of an annular or ring-like lesion spreading centrifugally.

Sebopsoriasis: A condition that is an admixture of the symptoms of both psoriasis and seborrheic dermatitis. Typically seen on the face and scalp, it presents as red (or yellow) greasy scales.

Visiting the dermatologist and following up regularly can prevent the disease from becoming unbearable.

A wide range of medicated shampoos are available in the market for scalp psoriasis (Image: Canva)

Prevention and cure  

You can prevent scalp psoriasis flare-ups by keeping the skin moist by using a humidifier. Avoiding dry and cold weather is preferable, as it may worsen existing symptoms. Stress management by practising yoga or breathing exercises can relieve anxiety and have an indirect effect on this disease. Medication like lithium and quinidine should be abstained from if one is susceptible to developing scalp psoriasis.

A wide range of medicated shampoos are available in the market for scalp psoriasis. However, a few home remedies can provide symptomatic relief like reducing flaking and redness. Customarily used as a preservative, apple cider vinegar can be used to mitigate itchiness. Culinary additions like turmeric and omega-3-fatty acids can help contest inflammation. Spending some time in the sun and applying aloe vera gel over the affected areas may alleviate symptoms.

Visiting the dermatologist and following up regularly is recommended. Sticking to a personalised treatment regimen can help the disease from becoming unbearable.