Psoriasis is an autoimmune disorder that presents as a chronic skin condition. According to Johns Hopkins Medicine, it’s characterized by “inflamed, red, raised areas that often develop into silvery scales,” and can show up anywhere you have skin. While it's most common in "high pressure" areas like your elbows and buttocks, it can also appear on your scalp.
Not only does scalp psoriasis come along with the itching and discomfort that's commonly associated with the condition, but it can also lead to another pesky side effect: Hair loss.
"The scalp is one of the most common areas of the body that psoriasis likes to target, affecting as much as 80 percent of psoriasis sufferers, and unfortunately it's one of the hardest areas to treat,” says Stanford University Resident Dermatologist James Kilgour, MD, founder of KilgourMD. The longer it persists, the more likely it is to affect the hair follicles and cause shedding.
Don't panic, though! Ahead, Dr. Kilgour and other dermatologists reveal how to approach the intersection of psoriasis and hair loss.
Can psoriasis cause hair loss?
Scalp psoriasis can cause hair loss, but it’s not a guarantee, nor is it permanent.
“Psoriasis can cause hair loss due to the build-up of thick, scaly plaques alongside mechanical trauma from scratching at the itch associated with them,” says Dr. Kilgour. “Psoriasis can also cause increased shedding of the hair, a condition known as telogen effluvium.”
Thankfully, once you've figured out how to manage your psoriasis, your hair should come back in full force. “Eventually, the hair will regrow back to normal provided you keep the psoriasis under control,” he says.
How to keep psoriasis under control
“The best way to prevent hair loss as a result of psoriasis is to treat the psoriasis itself, and reduce the itching and inflammation,” says board-certified dermatologist Dr. Tiffany Libby, MD. “There are a variety of treatments available for scalp psoriasis from topical to oral medications and biologic injections.”
Prescription medications, like corticosteroid-derived topical steroids, are generally the most effective form of treatment. According to The National Psoriasis Foundation, “Corticosteroids control inflammatory responses in the body, among other important functions, making them an ideal anti-inflammatory agent to reduce swelling and redness caused by plaques."
Considering corticosteroids generally require a prescription, Dr. Kilgour notes that the best course of action here is consulting a dermatologist. “Scalp psoriasis is notoriously difficult to treat, as many of the topicals that we use for psoriasis on the body do not penetrate well on the scalp,” he says
With that in mind, he points out that many derms lean toward biologics for scalp psoriasis treatment. “We are now in the era of biologics—medicines designed using synthetic antibodies that are highly targeted to treat the specific immunological pathways involved in skin disease,” he says. “These biologics can completely clear the skin, including the scalp, and are well tolerated.”
If you're looking to treat scalp psoriasis on your own (which can help, but likely won't give you the same results as prescription medications), anti-dandruff shampoo can help. “Scalp psoriasis can exist on a spectrum with dandruff, known together as sebopsoriasis,” says Dr. Kilgour. “An anti-dandruff shampoo can be an excellent addition to your treatment regimen and help prevent hair loss.”
Can scalp psoriasis cause hair loss? Yes. Will it be long-term? No—as long as you get the psoriasis under control.
“Typically when addressed early—meaning within the first three months of onset—the hair loss can be reversed,” says Quynh Giao Sartor, MD, a board-certified dermatologist based in Houston, Texas. She explains that because "long-standing inflammation from psoriasis can lead to permanent hair loss,” you'll want to deal with the underlying skin condition as quickly as possible.
Suffice it to say, if you’re living with severe scalp discomfort and are noticing increased shedding, it’s time to dial up your derm for the next best steps.
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