Dermatology

Get Scalp Psoriasis Under Control

Get Scalp Psoriasis Under Control

Scalp itch can go beyond dandruff. Burning and severe flaking may not be relieved by OTC shampoos. These pharmaceutical and natural remedies might provide relief.

Pharmaceutical and Natural Remedies For Flakey Scalps

Sometimes scalp itch goes beyond typical dandruff. There may be burning and severe flaking that is not relieved by over-the-counter (OTC) medicated shampoos. If you have gone through bottles of Head & Shoulders, T-Gel, Selsun Blue, Denorex or Nizoral and still can’t find relief beyond a day or two, contact your dermatologist. Some powerful remedies lurk behind a doctor’s prescription pad.

Historically, cortisone has been the remedy for inflammation. Adverse effects associated with topical corticosteroids (i.e. liver damage) have shifted focus to:

  • Anti-fungal remedies: zinc pyrithione, selenium sulfide, propylene glycol, lithium succinate
  • Hydroxypyridones: ciclopirox
  • Azoles: bifonazole, fluconazole, itraconazole, ketoconazole*, miconazole, metronidazole
  • Allylamines: terbinafine

Many of these are active ingredients in the over-the-counter shampoos. For stubborn cases of scalp psoriasis, your doctor may prescribe oral medications, such as methotrexate (Trexall®) or cyclosporine, or combine stronger medications with medicated creams and ointments. [1] Ciclopriox (Loprox®) is currently available only with a prescription. Severe cases of scalp psoriasis may also be treated with phototherapy using the Excimer Laser or a UV light.

The FDA warns that serious liver damage and death outweigh benefits of Ketoconazole tablets (Nizoral, Janssen Pharmaceuticals). —FDA

Why Does My Scalp Itch So Much?

Psoriasis, clinically called atopic or seborrheic dermatitis, is a lifelong dermatology condition that causes thick, red patches of skin and silvery-white scales affecting approximately 2.2 percent of the population. Rapid skin cell proliferation forms patches on top of one another—forcing prematurely discarded skin cells to the surface. These psoriatic patches can be itchy, sore, and even burn. The condition can be either mild, moderate, or severe. Though it can’t be cured, it can be controlled.

💊 April 26, 2019—For treatment of plaque psoriasis in adults, the US Food and Drug Administration (FDA) has approved Duobrii lotion. It provides known benefits of a potent topical corticosteroid (halobetasol propionate, 0.01%) and a topical retinoid (tazarotene, 0.045%) with synergistic efficacy. —Medscape

Symptoms and appearance may resemble eczema and are therefore treated similarly. For distinction, eczema has been called by some dermatologists the itch that becomes a rash; skin manifestations are usually secondary to scratching. Whereas psoriasis is a manifested skin condition that also itches.

Get Scalp Psoriasis Under Control
Closeup flakey scalp

A dietary deficiency in essential fatty acids (EFAs) like omega-3 and omega-6 is common among psoriasis patients and vegetarians or vegans. Psoriasis, seborrheic dermatitis, and eczema have been linked to allergies, stress, and genetics.

A study of 319,000 13-14-year-olds from 107 centers in 51 countries and more than 181,000 six- to seven-year-olds from 64 centers in 31 countries links fast-food consumption to eczema and asthma. The authors suggest plausible explanations for the findings: fast food contains high levels of saturated and trans fatty acids, which are known to affect immunity, while fruit is rich in antioxidants and other beneficial compounds. [2]

What is The Cure for Scalp Psoriasis?

Ciclopriox clinical study: If OTC shampoos cannot keep flaking under control for more than three or four days, ciclopirox offers some promising results. One hundred and two patients were randomly selected to apply either ciclopirox olamine 1% shampoo or the vehicle shampoo to the scalp for 5 minutes, twice per week for 4 weeks.

By the end of the study, erythema (reddening), scaling, and pruritus (itching) had significantly improved or cleared in 93% of the ciclopirox shampoo-treated patients compared to 41% in the placebo group (P<0.00001). [3] According to GoodRx, Ciclopirox prescription prices range from $20–75.

What if you already have—or could purchase for under $20—a non-prescription remedy in your kitchen cabinet? Perhaps you prefer natural approaches or are awaiting a prescription refill in the mail. Do you require something more than a watered-down shampoo when your prescription is running low? Some options may temporarily decrease scalp psoriasis flare-ups.

Natural Remedies for Itchy Scalp

Get Scalp Psoriasis Under Control

Flaxseed oil: Rich in omega-3 essential fatty acids, flaxseed oil, applied topically, soothes dry skin and may provide the EFAs necessary to inhibit the compounds in the body that cause inflammation. [4,5] Flaxseed oil (an acquired taste) taken orally and topically may reduce the symptoms or eczema and psoriasis for some people.

You can drink flaxseed oil from a tablespoon, in capsules in juice, or protein shakes. The oil doesn’t retain its properties for more than about six months even when refrigerated. This might make it difficult to consume a large bottle before it goes bad.

Apple Cider Vinegar: There is no clinical support for the efficacy of vinegar in treating psoriasis. Anecdotal reports suggest apple cider vinegar provides symptom relief for many chronic sufferers. Apart from the elements that are good for detoxification and cleansing, others fight against bacteria that cause skin ailments. [6]

Some people have had success drinking the vinegar to attack psoriasis from within. You may consume a tablespoon of apple cider vinegar diluted with water 3:1 to reduce acidity twice a day. [7,8] Twenty minutes afterward, drink a full glass of water, and one hour later, as with all citrus juices, it is advisable to brush teeth to minimize tooth enamel erosion. (Brushing immediately after drinking citric acid has the reverse effect.)

Topical Treatment

Depending upon the severity of your condition, you might apply the diluted vinegar topically. Use once or twice per week until the condition is under control (or until your prescription arrives). Soak a cotton ball or cotton swab with vinegar and blot it on the affected areas. Or soak a compress in a mixture of vinegar and water and apply it directly to the skin. Leave it in for about 30 minutes before exfoliating with a fingernail brush, soft-bristle toothbrush (no longer used orally), silicone skin brush, or facecloth. Rinse with cool water.

Get Scalp Psoriasis Under Control

If the residual vinegar smell is too strong, use a mild shampoo like Johnson’s No More Tears or Neutrogena Anti-Residue shampoo. Washed skin requires moisturization to halt inflammation.

You can try using a tea tree oil conditioner to nourish hair and scalp but rinse thoroughly with cool water to prevent irritation. In place of a conditioner, you might pat dry and massage a teaspoon of flaxseed oil or aloe vera into the scalp. Some with eczema on other parts of their body, add flaxseed oil to bathwater.

Hello, I am 20 years old and have been suffering from severe Atopic dermatitis since I was an infant. [9] I’ve tried everything from steroid treatments to antibiotics and have had no semi-permanent relief from traditional medicine. I have recently been seeing a homeopathic doctor and have started to see great results.

The key to treating eczema is to treat the person as a whole by building up the immune system instead of suppressing it. I have had a recurring problem with eczema on my scalp and have found amazing relief in flaxseed oil. Flaxseed oil can be applied directly to the scalp and taken orally. When applied to the scalp, it provides immediate relief. I am eager to educate other eczema sufferers on the great benefits of this wonderful oil. Please post this letter for others to view. Thank you, Mallory.

Ease into topical use by treating a small non-facial area first—perhaps an inconspicuous spot behind an ear or on a temple. If there are no flare-ups, you may decide to treat a larger area of your face or scalp. The positive aspect of using a single-ingredient remedy is that you learn fairly quickly if it doesn’t agree with you.

Caution: Oil and vinegar are not cures for chronic skin conditions. Either might provide days or weeks of temporary relief. But everyone’s skin reacts differently. Some people might not tolerate citric acid. Flaxseed oil may be too oily for other people. Some adapt well to topical application while others can only take either component orally. When using natural topical remedies, monitor efficacy.

Psoriasis is a complex disorder with hereditary, dietary, emotional, and dermatological triggers. Consider any suggestions offered as an adjunct to professional care. Consult your primary doctor or dermatologist if your condition worsens or you do not see improvement within two weeks. [10] Looking to join an online support group? Visit patientslikeme.com.

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To support the writing of useful articles about dermatology, ClinicalPosters sells human anatomy charts, scientific posters, and other products online. You may sponsor specific articles or remit a small donation.

ClinicalPosters sells human anatomy charts, scientific posters, and other products online to offset expense of the writing useful articles about dermatology. Slide extra posters into DeuPair Frames without removing from the wall.

ClinicalPosters sells human anatomy charts, scientific posters, and other products online. You may remit a small donation.

You can support the writing of useful articles about dermatology by sponsoring specific articles or remitting a small donation. Visible content is optimized for device size.

* Oral prescriptions of Ketoconazole for skin infections should be discontinued. Ketoconazole tablets (Nizoral, Janssen Pharmaceuticals) have been prescribed to treat skin and nail fungal infections. The FDA now warns that serious liver damage and death outweigh the benefits. The warning does not affect topical solutions and shampoos.

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