Can Scalp Psoriasis Lead to Hair Loss? We Asked a Dermatologist

By: Sophie O'Kelly | Jun 29, 2021

There's nothing worse than an itchy scalp. And there are many reasons why your scalp might suddenly prompt you to scratch it — from dandruff to an allergic reaction.

However, if your itchy, dry scalp persists and you've started to notice red, scaly patches around the forehead, the back of your neck or even in your ears, you could be dealing with a case of scalp psoriasis. What's even more frustrating is that, in some cases, scalp psoriasis can also cause hair loss. Thankfully, there are ways to help clear scalp psoriasis and its symptoms.

To help you get to the root of this tricky skin complaint and control flare-ups, VEGAMOUR has unpacked the research. Plus, learn more about the best scalp products for you.

What Is Scalp Psoriasis?

According to the American Academy of Dermatology, psoriasis can crop up anywhere on the body. When it appears on the head, it's typically referred to as scalp psoriasis. Board-certified dermatologist Susan Bard, M.D. explained, "Psoriasis is an autoimmune disease that can affect the skin, nails and joints. It is often hereditary and can be triggered by a variety of environmental factors. It leads to inflammation and subsequent scaly plaques that often affect the scalp."

The skin's outer layer constantly generates new skin cells to replace the old ones. When someone is living with psoriasis, this process is sped up and happens over a number of days rather than weeks. A healthy skin cell rejuvenation process usually takes between three and four weeks, but if scalp psoriasis is in play, it can take just three days.

Scalp psoriasis is a surprisingly common skin condition that's also an autoimmune disease. The National Psoriasis Foundation estimates that 125 million people worldwide have psoriasis, which is around 2%-3% of the entire population. But just because it's common doesn't mean it's easy to deal with. Anyone struggling with scalp psoriasis and especially severe scalp psoriasis can quickly become depressed and self-conscious because an affected area can become pretty visible.

It's essential that you visit a dermatologist to diagnose scalp psoriasis and guide you through treatment options, including potential topical medications.

Read: Top Causes of Hair Loss

When and How Does Scalp Psoriasis Occur?

Psoriasis, including that of scalp, can pop up at any age, but it predominantly occurs in those under 20 or over 60. In general, psoriasis tends to plague a person's body in fits and starts. It runs a chronic course, and then with treatment and time, it can start to dissipate, which offers some relief.

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What Does Scalp Psoriasis Look Like?

With scalp psoriasis, too much skin cell growth can typically lead to chronic inflammation across the whole scalp. The excess cells can form psoriatic plaques, which often have a reddish-silver appearance that can flake, itch, crack and even bleed. Not fun at all! Sometimes the patches are sore and irritating, and sometimes, they're not. Mild scalp psoriasis can, at times, go almost unnoticed. However, severe scalp psoriasis can last for a long time and be very noticeable.

During a psoriasis flare-up, the swollen edges of the thick plaques are usually well defined. And if the white, silvery scale gets knocked off, that's when bleeding can occur. To protect the sensitive, thickened skin, it's crucial you take care when brushing or combing the hair. It's also essential you use a shampoo and conditioner that are appropriate for your scalp's condition.

Learn: Why a Healthy Scalp Is So Important

What Causes Scalp Psoriasis?

There are a few reasons why someone can suffer from plaque psoriasis, but the leading cause seems to be a weakened immune system. It can also come down to genetics. If one or more of your parents has scalp psoriasis, you have an increased chance of developing it, too.

Someone with the condition may be producing more T cells and neutrophils, a type of white blood cell. If too many T cells are produced, they can start attacking the healthy cells by mistake, which can lead to inflammation.

The risk of scalp psoriasis is also believed to be triggered by the following:

Smoking can weaken your immune system, further increasing your risk of developing scalp psoriasis, and it can exacerbate an existing condition.
Stress is unendingly bad for the body. High and toxic stress levels can trigger psoriasis and other skin conditions.
Obesity and excess body weight have been found to interfere with some oral medications and prescription topicals used to treat psoriasis.
Bacterial or viral infections can mean your immune system is compromised, which could also increase your risk of developing scalp psoriasis.

Also: Everything You Should Know About Stress and Hair Loss

How Does Psoriasis Lead to Hair Loss?

As well as being visibly noticeable, psoriasis can be unbearably itchy. The itching can get so bad it can interfere with sleep and your everyday interactions. And that's not all. Too much scratching can cause temporary hair loss over time as the hair follicles become damaged. The aim is to avoid scratching — even though it's really difficult. "When the scale is shed, it tends to pull the hair out with it," said Bard. "While the inflammation doesn't specifically affect the hair follicle, inflammation of the scalp can have a detrimental effect on hair growth and can lead to shedding."

Though psoriasis scales are upsetting to live with, you might also suffer from hair loss if you try to forcibly remove scales. The American Academy of Dermatology Association suggests avoiding scratching and picking at the scales to lessen the chance of aggravating the skin. They also recommended keeping fingernails short and filed down to reduce hair loss and limit the damage caused when scratching is the only option.

It's important to note that psoriatic alopecia — also known as hair loss due to psoriasis — can affect the entire scalp, and some data suggests that those living with psoriasis are also potentially at risk of developing alopecia areata (another autoimmune disease that attacks the hair follicles) over time. This is why, if you're living with severe psoriasis, you must check in with a dermatologist or health care professional to arrange an educated treatment plan.

Read: What Is Alopecia Areata? One Type of Hair Loss Explained

How Can You Combat Scalp Psoriasis and Thinning Hair?

Once you've had a formal scalp psoriasis diagnosis, you can start your treatment plan and get to work clearing up the irritating issue. It is worth remembering that there is currently no cure for the condition, so it's all about managing flare-ups when they happen.

Depending on the severity of your scalp psoriasis, to help slow skin cell growth, your dermatologist could recommend topical steroids, topical therapies or even steroid injections if the legions just won't disappear. Always seek professional help from a dermatologist for you scalp psoriasis. They can help make recommendations and you can ask them about any products you'd like to use.

Learn: Smelly Scalp? Here's What You Can Do

Shampoo and Conditioner

The first line of defense against scalp psoriasis is usually a good medicated shampoo. Look out for formulas that contain selenium, coal tar or salicylic acid, which works to soften the plaques and help loosen the scales from the skin. Once your scalp psoriasis flare-up has dissipated, continue shampooing regularly with medicated shampoos to make topical treatments easier to apply.

That said, medicated shampoos can be rough on your hair so a moisturizing shampoo and conditioner is a must-have to keep your strands soft when you aren't experiencing flare ups. On those days consider using a gentle, moisturizing conditioner, like GRO+ Advanced Replenishing Conditioner, which is formulated without irritating sulfates, silicones or parabens, and boosts the skin's natural moisture levels — especially if you're using also a medicated shampoo. The mung bean in the formula helps strengthen weak hair, and cannabidiol can help soothe the scalp (yes, this conditioner can be applied to your roots!) and improve the effectiveness of other ingredients.

For best results when you're struggling with psoriasis, always check with a dermatologist or trichologist before introducing a new scalp or hair treatment into your routine.

Topical Treatments

Frustratingly, hair can make the scalp inaccessible for topical treatments. The treatments are often gooey and sticky, which can lead to you wanting to wash your hair more — because who wants to walk around with icky, sticky-looking hair! Unfortunately, the more you wash your hair, the more the scalp can dry out and make the itching issue worse. If you're struggling to apply a topical treatment, talk it through with a professional.

Detoxifying Your Scalp

Once your psoriasis has cleared up, you could treat your scalp to a total detox with the GRO Scalp Detoxifying Serum. This silky, smooth formula takes a comprehensive approach to scalp health, incorporating a blend of proprietary phyto-actives, vegan proteins and minerals designed to boost your hair's wellness. The Zinc PCA in the formula works to absorb excess oils, which can help reduce scalp irritation and support the skin's natural moisturizing factor. The wild-harvested baobab and marula oils provide antioxidant support in the form of Omega 6 and 9 fatty acids, which further moisturize, protect and balance out the skin.

What Else Is There to Know About Scalp Psoriasis?

Scalp psoriasis can really disrupt someone's life and overall well-being. While you might think it's solely a condition that affects the skin, in some cases, psoriatic arthritis can occur — especially if the psoriasis is left untreated. According to the National Psoriasis Foundation, out of the 8 million people with psoriasis, approximately one-third of them will develop psoriatic arthritis, affecting the joints and the tendons. Having psoriasis doesn't guarantee a psoriatic arthritis diagnosis, but, unfortunately, the risk is higher. If you're concerned, visit a rheumatologist to screen for the condition and catch it early if you can.

Keeping the scalp soothed and calm is integral to a healthy head of hair. Whether you're dealing with scalp psoriasis or not, steering clear of astringent chemicals and highly perfumed products is the way forward. Invest in a hair wellness system that takes a gentle, natural and effective approach to maintain your mane and keep your crowning glory glossy and happy.