A.Vogel Talks Scalp Psoriasis

Scalp psoriasis affects approximately 50% of psoriasis sufferers and can spread to other parts of the body


Felicity Mann
Skin Health Advisor
@AVogelUK
Ask Felicity

An introduction to scalp psoriasis

It is often reported that as many as 50% of psoriasis sufferers find that their condition spreads to their scalp, sometimes lingering as far down as the nape of their neck, appearing on their forehead and behind their ears.1 

This can then cause some difficulty, as the plaques that manifest during an outbreak of scalp psoriasis, can be thicker as the hair follicles prevent the excess skin from being shed, making the affliction trickier to treat.

In cases of scalp psoriasis, the symptoms can be quite severe and the itchiness can be infuriating. Often the condition is mistaken for seborrhoeic eczema , despite the differences in appearance. However, not all cases of scalp psoriasis are serious and in some especially mild episodes, the symptoms are hardly noticeable. 

Nevertheless, it is important to learn more about the condition if you are at risk, so that you can arm yourself with ways of tackling the disease and beating your unpleasant psoriasis symptoms.

1https://www.psoriasis.org/about-psoriasis/specific-locations/scalp

The causes of scalp psoriasis

Scalp psoriasis, as an extension of common psoriasis, shares many of the overall triggers and causes found in most other variants of the condition. Genetics, lifestyle habits and environmental factors will all play an important role in increasing your susceptibility to the diseases, however it is still worthwhile learning as much as you possibly can about any potential causes, as it can help you to eliminate any risk factors from your daily routine, reducing your chances of experiencing a flare-up in your symptoms.

  • Genetics: Unfortunately, your genes are often the primary factor motivating your psoriasis outbreak. Your genetics are responsible for so many reactions in your body that they can even influence how your immune cells respond in different situations. Approximately 10% of the population carry the genetic markers that can instigate an episode of psoriasis, leaving many psoriasis sufferers feeling disillusioned about their chances of beating the illness. However, there is still plenty that you can do to strengthen your immune system and reduce your psoriasis symptoms – your genetics are in not an excuse to suffer with your symptoms and surrender to the condition
  • Immune system: Psoriasis is often caused by the immune system initiating an autoimmune response, attacking its own immune cells with waves of inflammatory chemicals. This can cause your skin cells to rapidly reproduce without first shedding the dead skin cells. This can cause an excessive amount of skin to develop on your epidermis, leading to common psoriasis symptoms such as dry, damaged skin, swelling and itchiness. The factors influencing this autoimmune response can vary; it can be caused by anything from your genetic make-up to lifestyle habits like your diet and smoking. Keeping the immune system strong and healthy is very important during an outbreak of psoriasis, particularly if there are secondary issues affecting your immune function
  • Liver function: It might not seem like an obvious trigger to consider, but your liver function is vital when it comes to reducing your chances of experiencing an outbreak of scalp psoriasis. This makes sense when you think about it though – your liver works tirelessly to filter the toxins in your body and to separate waste products from nutrients. If your liver function is compromised, these essential tasks will not be performed and other organs, such as the skin, may have to take over the task of expelling toxins from the body. The skin will do this by allowing any impurities to be perspired through your skin, which can sometimes cause a negative reaction when these pollutants interact with your skin cells.2 This can stimulate an autoimmune response from your immune system as it will detect that there are pathogens already in your system and will do its best to purge your body of any potential irritants, attacking its own cells in the process.
  • Poor nutrition: Poor nutrition can have an unfortunate effect on your immune system and liver health, thereby enabling your psoriasis symptoms. If you are malnourished, your body is being deprived of the essential nutrients that it requires to function and, if you are overly fond of refined sugars, caffeine and alcohol, you may risk weakening your immune system as these products all contain inflammatory chemicals. Eventually, your immune system will struggle to cope with the demands of your diet and it will become fatigued, more prone to over-reacting in certain situations and more susceptible to viral infections. Your skin can also suffer tremendously due to your diet, becoming dryer and more prone to blemishes as your liver function starts to decline and toxins are excreted through the epidermis
  • Stress: Stress can be very disrupting for the immune system for a number of reasons. When you experience stress, it can stimulate your sympathetic nervous system, fooling your body into believing that you are in a life or death situation. Of course this is rarely the case in this day and age, but nevertheless, your ‘fight or flight’ reflex will be triggered, signalling to your body that you are about to engage in vigorous physical exercise. Your immune system will produce inflammatory chemicals like adrenalin and histamine, in order to dilate the blood vessels so that nutrient can be redirected to your major organs. Your digestion will be affected as well, as your body will not be interested retaining any extra ‘baggage’ during this time, causing you to sometimes experience bouts of either diarrhoea or constipation. The chemicals in your system can also upset your skin cells, occasionally stimulating an autoimmune response from your immune system, which may even inspire an outburst of psoriasis
  • Hormones: A study by the Department of Dermatology at, Teikyo University emphasised the connection between psoriasis and your levels of hormones, underlining that your hormones can trigger a number of immune responses in the skin.3 This may explain why sufferers of psoriasis notice that their symptoms start to flare-up when they experience a hormonal change, such as puberty or menopause. This is not just coincidental as female sex hormones like oestrogen can sometimes contribute to an outbreak of the skin condition. It is speculated that oestrogen’s influence originates from the inflammatory effect it can have on the immune system, with lowered levels of oestrogen sometimes inspiring an episode of psoriasis, explaining why the condition is so prevalent during menopause and why some women actually find that their symptoms are more bearable during pregnancy. However, further research is still required in this area before it will be possible to pinpoint the exact relationship between your skin and your hormones
  • Irritants: It is usually accepted that if you suffer from psoriasis, you may also suffer from sensitive and easily irritated skin. There are plenty of potential aggravators that you expose your skin to every day, from UV radiation to the type of shampoo you use. It’s important to be aware of any chemicals or environmental factors that can dry out or damage your skin as the immune system will attempt to heal any perceived harm to your skin cells, inspiring an inflammatory response. Even lifestyle choices like smoking should be treated with caution as the noxious chemicals from cigarettes, whilst being overall terrible for your body, can irritate your skin. It’s estimate that smoking almost doubles your risk of developing psoriasis or experiencing a flare-up, so it may be worthwhile considering ditching this habit if you want to improve the health of your skin.

2https://www.dermaharmony.com/detoxification/liverandpsoriasis.aspx

3http://www.jdsjournal.com/article/S0923-1811(04)00256-7/abstract

The symptoms of scalp psoriasis

The symptoms of scalp psoriasis can be unpleasant to experience and sometimes they can have negative repercussions for your psychological wellbeing.

Nevertheless, it is important to learn more about the various side-effects so that you are aware of what is normal and able to prepare treatments to tackle any pain or discomfort.

  • Dry skin: The dense layer of skin that develops on your epidermis is usually extremely dry and prone to flaking, however in episodes of scalp psoriasis, your hair follicles prevent any excess skin from being shed, often resulting in thicker plaques and more intense itchiness. Your skin can erupt into silvery scales and quite often inflammation and the associated tenderness can make the affected area feel sore.
  • Thicker plaques: In typical cases of psoriasis, plaques can appear as flaking, pale scales across a bed of red and inflamed skin, however in scalp psoriasis the development of these plaques can be affected by your hair follicles. In severe cases, your skin plaques can start to crust across the scalp, appearing greasier and more yellowish in colour, which is why it is occasionally confused with seborrhoeic eczema
  • Blistering: Blistering is another unusual symptom of scalp psoriasis, normally brought about by forceful rubbing or scratching of the scalp. If you develop blisters it is important not to irritate them in any way, and especially not to squeeze them. If your blister bursts and you notice that it is emitting blood rather than pus or fluid, you should speak to your doctor and remember not to peel away the dead skin
  • Discolouration: Beneath the excess skin, you may notice a great deal of redness and inflammation. When inflammatory chemicals are released into your body, they can sometimes affect the pigmentation of your skin by dilating the blood vessels. This can cause your skin to appear very red and irritated but this discolouration should diminish as the symptoms of your condition start to clear
  • Itchiness: Itchiness can be a real problem with scalp psoriasis. Not only does itchiness add further damage to the skin and place you at risk of developing a bacterial infection, the symptom can also stimulate hair loss in an episode of psoriasis. If the skin around your hair follicles has lost its strength and became brittle, it will be more prone to breaking. When you scratch your scalp, you are tearing the skin away from your head - sometimes you can also end up removing a clump of your own hair as well
  • Hair loss: It’s a common misconception that psoriasis can cause your hair to fall out – it might trigger the symptoms that do have this effect, but it is not usually the root cause. Instead secondary symptoms such as stress and itchiness are normally responsible, although sometimes the conventional medication that you take can also play an influential role. Luckily, most people find that their hair does grow back once their psoriasis flare-up has calmed down
  • Stress: Stress is a common experience with most skin conditions but it can be particularly brutal in psoriasis, especially since the symptoms are so visible and hair loss is a possibility. You should focus on keeping yourself calm and finding productive ways of treating your illness rather than linger on any feelings of doubt or apprehension. Stress is brilliant at mobilising inflammatory hormones and will only make your episode of psoriasis even more uncomfortable and unpleasant to experience
  • Sleep deprivation: If you are suffering from psychological stress or intense itchiness, then your sleep is bound to be affected. Sleep, however, is important for many different bodily functions and sleep deprivation can place further pressure on the immune system and add to your anxiety. This can form a vicious cycle as the more fatigued you feel, the more likely you are to be overwhelmed by other emotional and physical symptoms, thereby disrupting your sleep and repeating the pattern.

Home remedies

Scalp psoriasis can be a debilitating and disheartening condition to suffer from but you shouldn’t despair and immediately assume that there are no natural solutions for your affliction. There are plenty of home remedies and self-help steps you can take to reduce your symptoms and achieve a better quality of life.

  • Relax: One of the most valuable things you can do to ease your psoriasis symptoms is to take a deep breath and relax. Stress can make it difficult to think objectively but it really is important that you try to soothe any anxieties or apprehensions that you may have. This may seem easier said than done, especially if you are suffering from a demoralising symptom like hair loss, but the best thing you can do is to simply be nice to yourself. Take some time out of the day to splurge on the sofa or enjoy a brisk walk in the sunshine. You could even try taking up yoga as this has been shown to lower your stress levels and make you feel more relaxed, even in situations where you may feel under pressure or ill at ease. Meditation is another good practice that may be able to help you as it teaches proper breathing techniques that will enable you to slow down your heart rate, reducing any stressful symptoms you may be experiencing
  • Good nutrition: Eating more of the right nutrients can have a very positive effect on your immune system, so it might be worthwhile cooking more meals that involve essential vitamins, such as vitamins A, B and C. These anti-oxidants can help to support your skin and aid your digestion and they are commonly found in most green leafy vegetables, wholemeals and fruit. You could even get blitzing in the kitchen and check out some our smoothie recipes – all of these are bursting with minerals like potassium, zinc and magnesium whilst also contain high levels of anti-oxidants. If you feel the urge to reach for some coffee first thing in the morning, it might also be an idea to switch from a caffeinated beverage, to our natural coffee substitute, Bambu, or you could even try having a cup of herbal tea instead. Herbal teas have been known to boost your immune system, with Golden Rod tea even being beneficial as a detoxing agent, helping to cleanse your liver. Also keep in mind that you should be drinking plenty of plain water throughout the day as this will keep your skin hydrated and prevent any issues with your kidneys and digestion
  • Avoid irritants: The harsh chemicals in your perfumes or moisturisers can be tough on your skin so it might be an idea to consider some fragrance-free alternatives. Salt of the Earth deodorants are unscented and contain no abrasive chemicals or additives that might upset your psoriasis symptoms, while Salcura zeoderm moisturiser can be used to ease dry or chapped skin. If you are lucky enough to enjoy some sunny weather, remember to apply sunscreen or wrap up if you are in the midst of winter. These steps may seem simple but they can go a long way towards keeping your skin safe from any potential aggravators
  • Coconut oil: An old one but a good one, coconut oil has been used in the treatment of many types of skin conditions for decades, and has a variety of beneficial qualities that can help to ease your symptoms. Unlike most other oils, coconut oil does not clog up your skin pores, but is instead absorbed as it contains similar fatty acids to those found on your skin.4 It can also encourage your anti-inflammatory hormones, reducing swelling and calming the growth of extra skin cells. Coconut oil is also excellent for the immune system, protecting your skin against free radicals and bacterial infections. Make sure that you purchase a raw, organic version of the substance, such as those available at Your Health Food Store
  • Turmeric: Turmeric might be more famous for its culinary uses, but this spice definitely packs a punch against skin conditions like psoriasis. This is because it contains a powerful compound known as curcumin, which can inhibit the production of inflammatory chemicals such as histamine, reducing swelling and itchiness. You either apply the spice topically to your skin (just be careful not to wear any expensive clothes!) by diluting with a little water until it forms a past. Or alternatively, if you don’t fancy risking your wardrobe, you could try a turmeric supplement like Pukka Wholistic Turmeric Capsules
  • Pine bark extract: A study conducted by the Department of Biomedical Sciences at the Ch-Pe University in Pescara, found that Pyncogenol, a pine bark supplement, improved many of the symptoms of psoriasis.5 This could be due to the anti-oxidant qualities of the plant, which can strengthen skin cells and promote immune function, or because extracts of pine bark can also act as anti-inflammatory agents. If you are interested in this treatment, you could always try browsing Your Health Food Store’s range of pine bark supplements.

4http://www.smartpsoriasisdiet.com/how-to-use-coconut-oil-to-treat-psoriasis

5http://www.ncbi.nlm.nih.gov/pubmed/24637472

Herbal remedies

When it comes to psoriasis, there are plenty of herbal remedies aimed at easing the external irritation and strengthening your immune and liver function.

Please make sure you take these remedies as directed and speak to your doctor if you feel that your symptoms are still persisting despite your best efforts.

  • Neem shampoo: The word neem comes from the Sanskrit language and means, ‘the healer.6’ This is possibly due to its prevalence in Indian medicine, but the plant certainly does seem to have a variety of beneficial properties, especially when it comes to nourishing dry or damaged skin. A potent anti-bacterial agent that contains high amounts of fatty acids and vitamin E, neem can help to reduce inflammation and itchiness, protecting your skin against secondary infections and hydrating your dry, brittle skin cells. In cases of scalp psoriasis, it might be worth taking a look at Neem Shampoo, which can relieve an irritated, itchy scalp
  • Vitamin C: Vitamin C is renowned as an excellent vitamin for skin cells, promoting the production of collagen and preventing damage from nasty free radicals that may cause skin dryness. Unlike most other vitamins though, vitamin C cannot be naturally synthesised by your body and must be extracted from your diet, meaning that vitamin C deficiencies can be quite common. If you want to increase your intake of this essential nutrient, you could try taking a vitamin C supplement like Nature-C. Nature-C is a chewable vitamin C capsule that is made from natural fruit extracts and is suitable for anyone over the age of 6
  • Milk Thistle: Your liver is very important when it comes to expelling impurities from your body so it is vital that you support your liver function and takes steps to maintain its health. Milk Thistle Complex is excellent at cleansing the liver and protecting it from any potential harm. The tincture is made using extracts of dandelion and peppermint, which are rich in essential minerals and nutrients. However, the remedy may not be suitable to take if you are breastfeed or pregnant, or under the age of 18
  • AvenaCalm: Stress can be a prominent psychological symptom of scalp psoriasis, often exaggerating your physical symptoms and affecting your quality of life on a day to day basis. Conventional stress medicines might seem unappealing to you, due to their negative side-effects, however, taking a natural stress remedy like AvenaCalm, might take the edge off your anxiety. If you take AvenaCalm consistently, it can work to gradually soothe your sympathetic nervous system, enabling you to feel calmer and more in control of your condition. If you are desperate though and require immediate relief from your stress symptom, you could try Stress Relief Daytime, a fast-acting solution that contains extracts of Valerian and Hops. Please be aware though, that these treatments are only suitable for those over the age of 18 and should not be taken in addition to any other stress medications
  • Dormeasan®: Sleep deprivation can be extremely detriment for your stress levels and immune system, often making you feel perpetually fatigued and irritable. If you are looking to restore a natural sleep cycle, you could try a natural sleep remedy like Dormeasan®. Unlike conventional sleeping pills, dormeasan is a non-drowsy formula that should leave you feeling refreshed and energised the next day. It is made from natural extracts of Valerian and Hops and is suitable for anyone over the age of 18 but should not be taken if you plan on operating heavy machinery or are pregnant.

6http://www.psoriasisselfmanagement.com/natural-herbs-supplements/benefits-of-neem-for-psoriasis/

Conventional medicine

You should always consult your GP if you are suffering from a severe episode of psoriasis. There are a variety of conventional medicines available to treat the condition; however you should also be aware of the side-effects that each medication can trigger. This knowledge may help you if you find yourself suffering unduly because of the medicine you have been prescribed and may help you form a better idea about which medicine should work for you.

  • Medicated shampoos: If you suffer from scalp psoriasis then the first stage of treatment that will be recommended to you will be the use of a medicated shampoo. These shampoos will normally contain coal tar or salicylic acid in order to ease itching and remove any dead skin cells. However, some of these shampoos may trigger an adverse reaction from your skin, possibly intensifying your symptoms. They may also vary in effectiveness, depending on the severity of your psoriasis
  • Topical creams: Topical creams are often prescribed if over the counter medicines are not working effectively enough. They are generally aimed at reducing the production of excess skin and relieving any swelling or inflammation. Nevertheless, some of these creams may inspire a range of unfortunate side-effects that can worsen your episode of psoriasis or even trigger an outbreak of eczema
  • Systemic medication: Systemic medicines are generally either applied as an injection or in the form of a pill and are only used if other psoriasis treatments have failed. This particular form of treatment can be quite common in instances of scalp psoriasis as light therapy may not be suitable if you have weak or frail hair follicles. However, systemic medicines can have severe repercussions for other areas of your body, like your liver, so they should only be considered if your psoriasis symptoms have made your life unbearable
  • Anti-depressants: Anti-depressants are normally only prescribed if your doctor feels that your mental health is negatively impacted by your psoriasis symptoms. These drugs work to regulate your mood but can stimulate a range of side-effects that may even exaggerate your emotional distress. Each person can react differently depending on the type of anti-depressant they are prescribed so you may also have to try a few variants before you settle on one that works for you.

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