Scalp psoriasis – Clinical presentation, Treatment

• Psoriasis is an autoimmune skin condition in which inflammatory changes occur.  According to the National Psoriasis Foundation, Psoriasis affects about 2 to 3 percent of people worldwide. 
• Symptoms may vary from person to person. Usually symptoms may include raised and scaly skin patches, or plaques, that can vary in color depending on a person’s skin tone.
• Psoriasis is a chronic skin condition that may worsen at times and then improve. It’s an autoimmune condition caused by an overactive immune system that leads to rapid growth of skin cells.

There are different types of psoriasis. Psoriatic changes are mostly noticed on

• elbows
• knees
• back
• scalp

Psoriasis may affect the whole body or specific body parts  like the legs and trunk, or areas where skin touches skin, like under the  breasts or in the groin or armpits (called inverse psoriasis). Psoriasis can also affect the hands, feet, fingernails and joints.

What is scalp psoriasis?

When psoriasis affected the scalp region, it’s called scalp psoriasis. Scalp psoriasis is commonly seen among individuals with chronic plaque psoriasis. 

Causative factors include

• Exact reason of scalp psoriasis is not known yet but   specific genetic features might increase a risk of developing the condition. 
• Hereditary factors also play role in causing and so this condition runs in families.

Risk factors

• Use of or withdrawal from certain internal medications like corticosteroids
• Topical use of some creams
• Overexposure to UV light, for example, sunlight
• Some infections
• Stress

Clinical presentation of scalp psoriasis

• Scalp psoriasis causes rapid buildup of the skin cells, which results in scaly, thick itchy patches on the scalp and other areas of the body.
• In persons with lighter skin tones, pink or red colored patches appear with silvery white scales.
• Dark brown or purple patches appear on people with dark colored skin.
• It is difficult to treat plaque psoriasis on scalp because the usual topical steroid creams and ointments cannot penetrate the hair.
• Symptoms can also resemble like dandruff in some cases.

Symptoms and types of scalp psoriasis

Symptoms may vary from person to person and may be mild to severe and may include:

• Dryness of skin 
• Flaking or scaling of skin that resembles dandruff
• Itching, burning, or discomfort
• Raised reddish patches
• Silver-like scales
• Temporary hair loss or bleeding points may be noticed after scratching or removing the plaques on the scalp

These symptoms are noticed on both sides of the scalp, or they may affect most of the head. They may extend to the:

• Neck
• Ears
• Forehead
• Other parts of the face

Diagnosis & Treatment of scalp psoriasis

Diagnosis can be made by taking the complete history and by Physical examination. Certain investigations will help to confirm the diagnosis like blood investigations, skin biopsy. 

For treatment of scalp psoriasis topical corticosteroids or medicines are used in combinations.

Topical treatments

Topical medications for scalp psoriasis include:

• Corticosteroids (either topical or locally injected)
• Vitamin D derivatives such as calcipotriene
• Retinoids
• Coal tar shampoo
• Anthralin
• Salicylates

Due to present of hairs on the scalp topical medications for psoriasis are difficult to use. So, doctors usually recommend lotions, liquids, gels, foams, or sprays instead of thicker creams or ointments used on other parts of the body.

Systemic and biologic treatments

• When topical treatment is not effective then oral systemic medications and biologic infusions or injections should be used.
• These treatments effectively slow down the growth of skin cells or reduce inflammation.
• Biologic medications are helpful to block proteins in the immune system that may lead  to psoriasis, such as:

• Tumor necrosis factor-alpha (TNF-alpha)
• Interleukin 17-A
• Interleukins 12 and 23

Phototherapy treatments

In Phototherapy, ultraviolet light (UV) is used which heals patches of psoriasis on your scalp, especially when other treatments haven’t worked.

Self-care measurements 

• Consult doctor for proper treatment and skin care management. 
• Avoid scratching or picking of skin. Scalp psoriasis is different condition than common dandruff. There may be large and silvery scales. The scales must be removed carefully. Avoid scratch or pick them.
• Combing and brushing. Extra care should be taken while combing or brushing your hair, it can irritate your scalp. You can use a comb to gently remove scales. Proper cleaning should be done before each use to prevent infection, and consult with your doctor about any kind of adverse effects.

Complications of scalp psoriasis

Bleeding. Scalp psoriasis can cause itching and discomfort. Scratching or removing scales leads to bleeding.

Hair loss. Scalp psoriasis affects hair follicles, heavy scaling and excessive scratching leads to noticeable hair loss.  Use of many kind of scalp psoriasis treatments and stress can cause hair loss.

AYURVEDIC TREATMENT OF SCALP PSORIASIS

Chandigarh Ayurved centre provides effective Ayurvedic treatment for Scalp psoriasis. CAC provides a kit named ‘Psoriasis care kit’. This kit contains medications that are very effective to treat this kind of skin condition.

Psoriasis care kit

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Description of medications

1.Detox Premium Powder

The powder is very beneficial to cure any kind of body pain as it removes excess toxins from the body and balances the aggravated pitta and vata dosha. The ingredients help in reducing swelling, redness, shrinkage of tear lining in the anus, burning sensation, etc.

2.Blood Purifier Syrup

It is ayurvedic syrup that consists of various natural ingredients as the syrup purifies the blood by removing excess toxins it is very beneficial in maintaining proper circulation and improves the skin naturally.

3.Twak Tailam

Twak tailam is very effective for the skin as it deeply nourishes the tissues and improves the skin luster. The tailam supports skin health, helps in reducing uneven pigments, improves complexion, and helps in deep detoxification and blood purification without any side effects.

4.Skin care tablet

It helps to maintain the texture of your skin depending on the type of skin you have. Skin care is a blood purifying tablet. It cools and detoxifies the blood, increase blood circulation of the skin

5.Panchatikta Ghrita Guggulu

This tablet promotes detoxification and rejuvenation. Panchatikta Ghrita Guggulu tablet is a natural source of anti – oxidant. 

6.Neem soap

Neem (Azadirachta indica) is such a wonderful herb that is easily available and shows Anti-bacterial, Anti-inflammatory, Antioxidant, Anti-microbial, Antifungal, Antiseptic properties.

7.Trikatu Tablet

Trikatu Tablet helps to eliminate excess Kapha or mucous from the body, supports respiratory system, manages weight, helps to take out impurities or ama from the body, supports healthy detoxification, reduces swelling. It shows anti-inflammatory, analgesic, expectorant, antioxidant properties.