Psoriasis symptoms can show up anywhere on your body. Itchy or sore patches of raised, red, dry skin known as plaques can occur on the face, arms and hands, legs and feet, and the back. One of the most common types of psoriasis affects the scalp. According to the National Psoriasis Foundation (NPF), at least half of the 7.5 million Americans who have the disease have it on their scalp.
How you treat any type of psoriasis depends, to some degree, on how severe it is. The symptoms of scalp psoriasis can range from mild scales and flaking to moderate and severe plaques that cover the entire scalp and can cause the hair to thin in areas. Severe scalp psoriasis can go beyond your hairline, across the forehead to your neck and around the ears.
Depending on your symptom severity and how much of your skin is affected, your doctor may recommend a variety of treatment options. Fortunately, if one treatment doesn’t work or stops being effective, there are likely to be others that you can try.
“We have so many fantastic ways to clear psoriasis and to treat scalp psoriasis,” says Melodie Young, NP, RN, an advanced practice nurse focusing on gerontology and dermatology at Baylor Scott and White Modern Dermatology in Dallas.
For milder cases of scalp psoriasis, shampoos with ingredients such as coal tar extract and salicylic acid can be helpful. "Liquid or foam topical medications are easy to apply to the scalp," says Dina D. Strachan, MD, a dermatologist and assistant clinical professor of dermatology at NYU Langone Medical Center in New York City.
Severe flares may require the use of oral or injectable medication in conjunction with such topical treatments.
Dermatologists will sometimes treat mild scalp psoriasis with steroids, injecting scalp lesions with the medication. The steroids act to locally reduce the inflammation that causes this frustrating buildup of scaly skin cells.
Doctors don’t typically prescribe systemic medicines for scalp psoriasis alone, but if you have moderate-to-severe psoriasis on the scalp, you’re likely to have it elsewhere too. In that case, systemic medication can really help, says Colby Evans, MD, a dermatologist in Austin, Texas, and chairman of the board of trustees for the NPF.
Even though the symptoms of scalp psoriasis may appear to come and go, it’s important to remember that psoriasis is a chronic condition that will need to be treated and managed over time.
If you have flaking, itchiness, or redness caused by scalp psoriasis or another form of irritation, try one of these five easy, at-home treatments to control your symptoms. But always be careful to check with your doctor before trying any at-home treatments, to make sure they'll be safe and effective for you. And remember that the worst thing you can do is scratch an itchy scalp. That'll just worsen the psoriasis and raise the risk for infection if you create an open wound.
Olive Oil Soothes the Scalp, Loosens Flakes
Olive oil is good for your dietary health, but it also has many benefits when applied to the scalp and hair. An olive oil mask, for example, can help tame frizz and add shine. Olive oil also helps loosen flakes associated with psoriasis, says Soheil Simzar, MD, a clinical instructor of dermatology at the UCLA David Geffen School of Medicine in Los Angeles.
To get these benefits, massage 1 to 2 tablespoons of oil directly into the scalp. Depending on the severity of the plaques, you can leave the oil on anywhere from 10 minutes to overnight before washing it out. (Wear a shower cap to bed to keep the oil off your pillowcase.) Prior to rinsing, use a fine-toothed comb to gently remove the loosened scales.
Apple Cider Vinegar Can Relieve Psoriasis Itch
Thanks to its anti-bacterial properties, apple cider vinegar has the ability to ease the irritation of everything from bug bites to blisters. When it comes to your scalp, apple cider vinegar can help relieve the itch associated with psoriasis.
Try it by saturating your scalp with a mixture of 1 to 2 parts water and 1 part vinegar several times a week for 10 minutes — but don’t try this at-home treatment if you have cracked or bleeding skin.
Use a comb to gently remove scales once they’ve plumped up from the moisture, then shampoo and rinse as usual. You can also use the same apple cider vinegar rinse to remove dulling product buildup. Be sure to follow up with a deep conditioner to prevent your hair from drying out.
Oatmeal Helps Fight Inflammation
Oatmeal isn’t just a cholesterol-lowering breakfast option — it’s a major skin soother, too. An oatmeal bath is a popular at-home treatment option to help alleviate the pain of rashes caused by poison ivy, chickenpox, and sunburns. And when applied to the scalp daily, oatmeal can help with inflammation associated with psoriasis or dryness, says Jennifer Burns, ND, a naturopathic doctor and founder or the Bienetre Center in Phoenix.
For this easy at-home treatment, mix uncooked oatmeal with water to your desired consistency (you can even add some oil to the mix to help loosen scales). Smooth the paste onto your scalp and leave it in place for at least 10 minutes before rinsing.
Create Your Own Dead Sea Salt Treatment
A study published in February 2005 in the International Journal of Dermatology found that magnesium salts, the minerals found in the Dead Sea, help improve skin barrier function in people with inflammatory conditions such as psoriasis.
Here’s how to create your own salt scalp treatment: Combine Dead Sea salts (or Epsom salts) of a fine to slightly coarse grain with olive or coconut oil until you reach a paste-like consistency. Gently rub a small amount of the mixture into your scalp anywhere from once a week to once a day, depending on the severity of the plaques, then wash it off, Dr. Burns says.
Store any unused scrub in an airtight container. While the salt may dissolve over time, you can add more to bring it back to the thickness you like.
Tea Tree Oil Keeps the Scalp Infection-Free
Tea tree oil, an essential oil distilled from the leaves of a plant native to Australia, has anti-bacterial and anti-fungal properties that can help keep the scalp free of infection,which may result from frequent scratching.
If you have dandruff, psoriasis, or a dry, itchy scalp, mix 1 part tea tree oil to 10 parts olive oil and dab the affected areas with a cotton ball. Leave it on for five minutes before rinsing out.
"While there is no scientific evidence to support the use of tea tree oil for psoriasis, some people report it works,” says Stefan C. Weiss, MD, a dermatologist at the Weiss Skin Institute in Boca Raton, Florida. But Dr. Weiss cautions that it can cause an allergic reaction in others. If you're thinking of trying tea tree oil, test it first by applying a small dab on a healthy patch of skin on the inner arm before using it on your scalp.