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At least half of all people who have psoriasis have it on their scalp, according to the National Psoriasis Foundation (NPF). It can range from small patches of fine scaling to crusted plaques covering the entire head, and even extending beyond the hairline onto the forehead, the back of the neck and around the ears. The good news? There is a wide variety of treatments that can help minimize scalp psoriasis. Mark Lebwohl, M.D, chairman of the department of dermatology at Mount Sinai School of Medicine in New York City and chairman of the NPF’s medical board, explains what’s available.
Q: What are some good nonprescription methods for treating scalp psoriasis?
A: First off, wash your hair every day. This helps to eliminate the scale and, obviously, makes your locks look better. If your psoriasis is mild, you can try an over-the-counter shampoo that contains coal tar and/or salicylic acid. Salicylic acid can be drying, though, so I always recommend using a conditioner as well. One of the oldest tricks for treating scalp psoriasis is to heat up a little olive oil, massage it into your scalp and put a shower cap over it. Leave it on overnight, and then wash the oil out in the morning. It will hydrate your scalp and help loosen some of the scale.
Q: What are some options for people with moderate or severe scalp psoriasis?
A: There are some new prescription products on the market that are not only effective, but also have gotten easier to apply to the scalp. Topical cortisone medications such as clobetasol propionate can be prescribed in shampoo form or as a spray, lotion (Clobex) or foam (Olux). There’s also a suspension called Taclonex Scalp, which combines betamethasone dipropionate and calcipotriene, a synthetic form of vitamin D, which can be helpful for moderate to more severe scalp psoriasis. Beyond that, there are number of things your doctor can do in the office.
Q. What are some of those?
A: They include ultraviolet light therapy and laser therapy. In fact, treatments done with the excimer laser (which uses ultraviolet light) have been shown to be effective on the scalp, even when other treatments don’t work. There’s also a new comb made of optic fibers that delivers very effective narrowband UVB light to affected areas. Because there is such a wide variety of treatments available for psoriasis, if one doesn’t work for you, keep looking. Chances are you’ll be able to find something that will improve your condition.