Understanding Scalp Psoriasis May Head Off Hair Loss
When psoriasis develops on the scalp, hair loss sometimes follows.
What surprises most people is that the root cause of this hair loss
is not the psoriasis. Understanding why hair loss occurs and how to
manage scalp psoriasis can help.
Root Causes of
When psoriasis develops on the scalp and hair loss results, the root
cause is generally one or more of the following:
removed too forcefully. When scalp psoriasis is severe, very
thick scales tend to develop. Forcefully removing these scales
often loosens the hair as well as the scales.
scratching. Psoriasis can be incredibly itchy, but
frequently scratching the scalp can pull on the hair. Repetitive
pulling can lead to a type of hair loss called traction
treatment too harsh. Sometimes the psoriasis treatment
causes the hair loss. Certain medications used to treat scalp
psoriasis such as salicylic acid can temporarily damage the hair
and lead to hair loss. Also, any treatment that is too vigorous
or frequently used can break the hairs and cause hair loss. In
most cases, hair grows back when the treatment stops.
Having psoriasis can be stressful. For some people, stress leads
to hair loss. Research shows that stress can cause too many
hairs to enter the resting (telogen) phase of the hair growth
cycle. Hair stays in the resting phase for about 3 months. At
the end of this phase, the body sheds all of the hair in the
resting phase. When too much hair goes into the resting phase at
one time, the body sheds large amounts of hair at once.
Tips for Controlling Scalp Psoriasis
While it may seem nearly impossible to control the causes of hair
loss associated with scalp psoriasis, effectively managing scalp
psoriasis can diminish hair loss. Here are tips that dermatologists
often give their patients struggling to control scalp psoriasis:
with gentle combing and brushing. Loosening and removing
scale is an essential part of treating scalp psoriasis. The key
is to do it gently. Picking at the scale can aggravate the skin
and cause psoriasis to flare. Over time, the picking also can
cause traction alopecia, a type of hair loss.
scalp not the hair. When applying a topical psoriasis
medication, including medicated shampoos, be sure the treatment
reaches the scalp and does not sit in the hair.
treatment seems too harsh, talk with a dermatologist. Skin
on the scalp is thick, so treatment for scalp psoriasis may be
stronger than the medication applied to other areas. If the
medication causes concern, talk with a dermatologist. There are
a number of treatments for scalp psoriasis. Rotating treatments
can help as can switching to another treatment.
seems to stop hair loss, consult a dermatologist. There are
many causes of hair loss. The cause of a patientís hair loss may
have nothing to do with psoriasis or its treatment. Hereditary
thinning or balding, which is the most common cause of hair
loss, affects millions. A dermatologist can help determine the
root cause of hair loss and recommend treatment options.
alternating shampoos. Using a medicated shampoo one day and
a non-medicated shampoo the next can help avoid over-drying of
the scalp and hair. Be sure to discuss this strategy with a
dermatologist before trying it.
conditioner after every shampoo. Applying a conditioner
after every shampoo can help keep the scalp moist. A
non-medicated conditioner also may help reduce the odor left
behind by some tar shampoos.
Let hair air
dry. Skin affected by psoriasis is extremely dry.
Blow-drying can increase the dryness and exacerbate hair loss.
Limiting use of blow dryers and styling products helps to reduce
styling options with a dermatologist first. While hair
colors, perms, straightening, and hair sprays can boost
self-esteem, they also can irritate scalp psoriasis. Sometimes
the chemicals damage already fragile hair, leading to hair loss.
Before using any of these hair-care products, either test the
product on a small area or ask a dermatologist when such a
product can be used.
fingernails short. For many, scratching is inevitable. Short
nails can prevent one from scratching the scalp so hard that it
Wear a hat or a
scarf or shave the head bald. Until the hair grows back, these
strategies can relieve some of the uneasiness that sometimes
accompanies noticeable hair loss.
psoriasis support group. The psychological impact of hair loss,
even when temporary, can be dramatic. Sharing common experiences
can help ease feelings of loneliness and frustration. To find or
start a support group, visit the National Psoriasis Foundationís
Web page about
On the Bright
While hair loss can leave patients feeling devastated, knowing a few
key facts about scalp psoriasis may alleviate some anxiety. The
first fact: Once scalp psoriasis clears, most patients find that
their hair loss was temporary. Secondly, when a patient consults a
dermatologist, it is rare for anyone to suffer from severe scalp
psoriasis for a long time when the treatment is used as directed.
All content solely
developed by the American Academy of Dermatology
For an overview, visit
the AAD pamphlet
Psoriasis and Psoriatic Arthritis.
About 50% of people who
have psoriasis will develop psoriasis on their scalp at