Many people visit my practise for advice on itchy flaky scalp conditions, many consider they have scalp Psoriasis following a diagnosis from a GP or someone else in the family who has Psoriasis. True scalp Psoriasis is quite hard to treat. Some patients react with excellent results with very little scalp treatment, most of which is carried out at home. Others may take some time to see a noticeable improvement. Psoriasis is genetically linked and there will often be someone else in the close family who is also affected by the condition. It is not curable but may be controlled to a comfortable level. Scalp Psoriasis is harder to treat than body Psoriasis, largely due to patient compliance. Treatment creams may be applied to the body several times a day, whereas patients may be adverse to applying scalp treatments on a daily basis, particularly if they only wash their hair once or twice a week. Unfortunately shampoo alone is not enough to maintain scalp psoriasis largely due to its short contact time during shampooing.
Fortunately many patients who think they have scalp Psoriasis may have scalp conditions such as scalp eczema, dermatitis or just dandruff which all respond to scalp treatment very well in most cases and may need little or no maintenance once under control.
Trichological treatment for scalp conditions involves applying a scalp treatment cream containing moisturisers and a keratolytic to soften and loosen the scalp scale or crust. The cream is massaged into the scalp thoroughly then gently steamed for 10-20 minutes, the moist heat helps to soften the crust or scalp scale and aids penetration of the cream. It is emulsified with water and massaged again, rinsed off and shampooed. The softened scalp scale or crust can be gently lifted off. (We do not recommend you try to do this at home, picking off scalp scale which is not softened enough may result in bald patches). The scalp treatment is finished off with either a cooling moisturiser or anti-inflammatory lotion or gel.
Ideally this type of treatment should be carried out every two weeks to prevent build-up of scalp scale or crust. As the scalp begins to respond, clinic treatments can be less frequent until the condition reaches a point when clinic scalp treatments are not necessary at all. This is far more likely if the patient also treats their scalp at home with the recommended products at the suggested frequency.