Scalp

Psoriasis

It is not just dandruff. Although scalp psoriasis may flake like dandruff,
the symptoms and treatments are different. Learn tips to managing and
feeling confident with scalp psoriasis.

1
Scalp psoriasis
Between 45 – 56% of people living with psoriasis have scalp psoriasis.1 Symptoms can appear on the hairline, forehead,
back of the neck and skin around the ears. Scalp psoriasis can have fine scales that look like dandruff or appear as thick,
crusted plaques that cover the entire scalp.2 Plaques may look red, purple or brown depending on your skin color.3 In rare
cases, scalp psoriasis can cause temporary hair loss.4

Treating scalp psoriasis

Although scalp psoriasis can be difficult to treat, there are effective treatments available.2 Treatments include topical,
phototherapy, oral systemic and biologic treatments. Your health care provider will recommend a treatment based on
your disease severity, health history and reaction to other treatments. You can learn more about each type of treatment at
psoriasis.org/treatment-and-care.

Over-the-counter (OTC) products may help manage symptoms for people with scalp psoriasis. These products come
in many forms—shampoos, conditioners, soaps, foams and creams. Two active ingredients, salicylic acid and coal tar,
are approved by the U.S. Food and Drug Administration (FDA) for the treatment of psoriasis and can be found in OTC
products.

As you are shopping for OTC products, you may notice that some have the National Psoriasis
Foundation (NPF) seal on the product. The NPF Seal of Recognition highlights and recognizes
OTC products that have been created or intended to be non-irritating and safe for those living with
psoriatic disease, as well as for those with severe sensitive skin or joint mobility limitations. For a list
of products, visit psoriasis.org/seal-of-recognition. These products are not promoted or endorsed
by the NPF but have met standards for the Seal of Recognition program.

While you may only see plaques on your scalp, remember that psoriasis is an immune-mediated
disease related to systemic inflammation. That means your body and its systems can be impacted
by inflammation that may not be visible. While OTC shampoos may help relieve symptoms of scalp
psoriasis, they may not address the more impactful inflammation-related symptoms. To lower your
risk of the comorbidities of psoriatic disease, which include heart disease and type 2 diabetes, you
should work with your health care provider to find a treatment plan that addresses scalp psoriasis,
as well as reduces systemic inflammation.

Living with scalp psoriasis

Haircuts
Do you ever feel embarrassed or anxious when you get a haircut? Have you ever had a hairdresser or barber
comment about your scalp psoriasis before? Here are a few tips to make your haircut experience more
comfortable:

1. If you know other people in your area living with scalp psoriasis, ask if they have any
recommendations for a hairdresser or barber to see.

2. When you set up the appointment ask if the hairdresser or barber has any experience with scalp
psoriasis.

3. If your hairdresser or barber asks, be open about what scalp psoriasis is. Let them know that it is not
contagious or an infection.

4. Ask your hairdresser or barber to comb your hair gently to avoid scratching the scalp.

2
Hair styles
Heated tools and chemicals used to style hair may irritate scalp psoriasis. Try to limit the use of heated tools by
air drying your hair or using a heated tool at a low heat. Also, avoid dyes and chemicals that can make your scalp
burn or cause irritation or dryness.4

Itch
Scalp psoriasis can be very itchy.2 Here are tips to help manage itch:

• Avoid scratching and picking at scalp psoriasis. Although this may be easier said than done,
scratching may only provide short-term relief and cause the skin to itch more. Scratching the skin
can trigger the Koebner [KEB-ner] phenomenon which is when skin injuries trigger a psoriasis flare.
Scratching may cause the skin to break, flake and bleed which can increase the level of inflammation
and possible risk of infection.

• Keep your fingernails trimmed so if you do scratch, they do not scratch your scalp too hard and cause
any bleeding on your scalp.

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

• Look for shampoos and conditioners with menthol (as an active ingredient) which may help in
soothing itch.

• Press a wet towel or cold pack against the itch.

• Ask your health care provider about treatments that can help manage the itch.

Hair loss
Some people with scalp psoriasis may have temporary hair loss. Hair tends to grow back in that area once
psoriasis plaques heal. If your hair loss does not stop once your scalp psoriasis goes away, talk with your health
care provider. There may be other reasons for hair loss.4

Emotional impacts
Scalp psoriasis can negatively impact a person’s quality of life—70% of people with scalp psoriasis report
challenges with their daily life.2 Scalp psoriasis may influence how people style their hair, which clothes they
wear or if they wear hats or grow out hair to hide the plaques. People with scalp psoriasis may feel ashamed,
embarrassed or self-conscious about their scalp psoriasis and flakes.2 Talk with your health care provider if
scalp psoriasis is impacting your quality of life, mental health or relationships with others. Your provider may
suggest a different treatment plan or other ways to help improve your symptoms.

What to wear
You should feel comfortable in whatever you wear whether that shows or hides your scalp psoriasis. Here are tips
on what to wear when you have scalp psoriasis:

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

• Wear white or light-colored clothing to hide scalp flakes.

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

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

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

3
 You can listen to more fashion tips in an episode of Psound Bytes® with Alisha Bridges
called, “Look Your Best and Be in Fashion with Psoriasis.” Listen now at psoriasis.org/
watch-and-listen/look-your-best-and-be-in-fashion-with-psoriasis. TM

References
1. Merola JF, Li T, Li WQ, Cho E, Qureshi AA. Prevalence of psoriasis phenotypes among men and women in the USA. Clin Exp Dermatol.
2016;41(5):486-489. doi:10.1111/ced.12805

2. Aldredge, Lakshi M.; Higham, Robert C. Manifestations and Management of Difficult-to-Treat Psoriasis, Journal of the Dermatology Nurses’
Association: 7/8 2018 - Volume 10 - Issue 4 - p 189-197 doi: 10.1097/JDN.0000000000000418

3. Kaufman BP, Alexis AF. Psoriasis in Skin of Color: Insights into the Epidemiology, Clinical Presentation, Genetics, Quality-of-Life Impact, and
Treatment of Psoriasis in Non-White Racial/Ethnic Groups [published correction appears in Am J Clin Dermatol. 2018 Feb 16;:]. Am J Clin Dermatol.
2018;19(3):405-423. doi:10.1007/s40257-017-0332-7

4. Scalp Psoriasis: 10 Ways to Reduce Hair Loss. American Academy of Dermatology. https://www.aad.org/public/diseases/psoriasis/treatment/
genitals/scalp-hair-loss. Accessed August 4, 2021.

Work with a Patient Navigator

The NPF Patient Navigation Center (PNC) provides assistance to anyone impacted by psoriatic
disease, including families and caregivers. Information provided by the PNC is for educational use
only and does not replace medical care or advice.
You can reach our navigators by phone, text, email and chat Monday-Friday 7:30 am - 4:30 pm PST.
Call: 1-800-723-9166 (option 1) | Text: 503-410-7766
Email: [email protected] | Chat: psoriasis.org/navigationcenter

The National Psoriasis Foundation (NPF) is a 501(c)(3) organization governed by a Board of Directors and advised on medical issues by
the Medical Board and the Scientific Advisory Committee. National Psoriasis Foundation education materials are reviewed by the NPF
Research Team and by lead Medical/Scientific advisors as appropriate and are not intended to replace the counsel of a health care
provider. The Foundation does not endorse any medications, products or treatments for psoriasis or psoriatic arthritis and advises you
to consult with a health care provider before initiating any treatment.

Updated January 2022

© 2022 National Psoriasis Foundation