Scalp Psoriasis – Information, Treatment And Options

What is Scalp Psoriasis

Psoriasis is a benign non-infectious skin disease of undetermined cause. Its name comes from the Greek word psora which means itch. There are five types of psoriasis: guttate, pustular, erythrodermic, inverse, and plaque.

By far the most common is Psoriasis vulgaris or common plaque psoriasis. This type affects over 90% of psoriasis patients. Studies have shown that for a very small percentage of women with plaque psoriasis the symptoms slightly decrease during pregnancy. Although the disease can manifest at any time, the first symptoms most often appear in those between 15 and 30 years of age.

The most prevalent signs of this type of psoriasis are areas of dry skin that are reddish or rosy colored and covered with silver or silver-gray scales that are raised and thick. They may occur anywhere on the body, but are most often found on the elbows, knees, and trunk. When they occur as scalp psoriasis there are large patches of flaky skin on the scalp and extreme dandruff. Psoriasis can also cause inflammation of the joints. Psoriatic arthritis affects up to 30% of those with psoriasis and they often require treatment by a rheumatologist.

Though less common, psoriasis can affect any part of the body and is occasionally seen even on the palms of the hand and the soles of the feet. Psoriasis also affects both the finger and toe nails. This is known as Psoriasis ungulum and causes grooves along the nail plates, loss of nail surface, and yellow spots resembling drops of oil.

In severe cases there is loss of the nail itself and it is often mistaken for onychomycosis. In males, psoriasis can sometimes cause scaly patches on the genitals as well. The severity of the disease is usually rated as mild when it affects less than 3% of the body and moderate between 3-10%. Over 10% is considered severe.

Understanding Scalp Psoriasis

Despite great progress made in medicine, psoriasis is a disease that is still not fully understood.

There are currently two schools of thought regarding the cause of psoriasis. One theory is that psoriasis is an immune-mediated disorder where the body’s immune system mistakes healthy skin for diseased tissue. This triggers an inflammatory response which leads to over production of skin cells. The other theory holds that psoriasis is caused by a disorder that results in excessive growth and reproduction of skin cells.

There is anecdotal evidence for the immune disorder origin in that patients with compromised immune systems, either by chemotherapy or HIV often present with psoriasis. Psoriasis is a life long condition. Symptoms may disappear for a few weeks to even years, but it always remains in the body and can flare again at any time.

Although the exact cause of psoriasis is not known, research has shown that here is a strong genetic predisposition to the disease. The probability of developing psoriasis is 50% if both parents have the disease and 15% if one parent is affected. The odds are 7% if a sibling is affected. Ongoing research on the human genome seems to implicate two specific genes IL12B and IL23R as high psoriasis-risk genes.

Although there is still no definitive known cause, there are some contributing factors that seem to be associated with psoriasis outbreaks. These include infections, sunburn, stress, certain medications, and changes in seasons or climate. It has also been shown that excessive smoking and alcohol consumption tend to make the condition harder to treat. Psoriasis also occurs more often in those with dry skin and an outbreak is more likely after a break in the skin such as a cut or scratch.

Psoriasis is often confused with atopic dermatitis and a definitive diagnosis is best made by a dermatologist. Diagnosis is most often made based on the appearance of the skin. There is no blood test or any other procedure that will show positive for psoriasis.

During the visual examination a biopsy or scraping may be done to rule out other potential conditions. After the scraping, pinpoint bleeding from the skin below known as Auspitz’s sign is another indication that the condition is psoriasis.

Treating Scalp Psoriasis

There is no cure for psoriasis, but there are many different treatment options. At home care includes oatmeal baths to soothe the skin and help to loosen scales, over the counter dandruff shampoo, and moisturizers.

Exposure to sunlight may also help, but a sunburn can trigger an outbreak. There are also prescription creams, ointments, and shampoos as well as medications in both pill and injection form. Most medications target the immune response, but some are anti-inflammatory drugs such as corticosteroids. If areas have become infected, antibiotics are prescribed as well. Although psoriasis is a chronic disease proper treatment and support can minimize its impact on general health and well being.