Treatment of scalp psoriasis is challenging, but there are many therapies that can help. Sometimes, the best treatments are arrived at by trial and error, so it is important to be patient when treating and awaiting results. The following are some common forms of treatment.
Anthralin: Anthralin can reduce the turnover of skin cells that cause the excessive buildup of scale, and reduce inflammation. As a result, it can be highly effective in treating scalp psoriasis. However, anthralin can be messy and cause staining of the skin, blond or gray hair, and clothing.
Anthralin can be applied directly to the skin for short periods (short contact anthralin therapy or SCAT) of 15-30 minutes. It should then be washed off to prevent irritation. Lower strengths of anthralin can be used and left on the skin for longer periods.
If your skin is tender and sore from psoriasis, anthralin might not be the best choice as it can cause irritation of the scalp.
Salicylic acid: Salicylic acid (keratolytic) is an ingredient in certain over-the-counter shampoos. It is helpful in removing excessive scales, which in turn allows for the penetration of other medications (such as steroids) into the site of inflammation. Salicylic acid can be mixed in low concentrations in mineral oil or provided in combination with a topical steroid (betamethasone dipropionate/salicylic acid) or combined with tar in a shampoo.
Shampoos: Shampoos that contain active ingredients such as tar, salicylic acid, zinc pyrithione, or selenium sulfide can be very helpful in reducing the scaling and thickness of scalp psoriasis. Recently, shampoos that contain steroids have been developed and can be quite helpful for patients.
Topical steroids: Steroid-containing scalp preparations can be very effective in reducing redness (inflammation) in psoriasis of the scalp. Steroids are usually prescribed either as a lotion, solution, or foam for hair-bearing areas (creams and ointments are difficult to apply to the hair-bearing scalp, often causing the hair to become matted). Alcohol-based lotions can cause stinging, so a water-based lotion can be substituted (amcinonide).
Topical vitamin D analogues (calcipotriol): Topical calcipotriol (Dovonex, Daivonex) scalp solution can be used alone or in combination with other topical treatments. Recently, a combination of topical steroids (betamethasone dipropionate) and calcipotriol (Xamiol) was approved for use in the treatment of scalp psoriasis. The combination of these agents was shown to be very effective, leading to excellent results in 56-83 percent of patients. To find out more, you can check out Psoriasis Scalp Treatment.