Psoriasis of the scalp


Psoriasis, also known as psoriasis, is an inflammatory skin disease that can affect various parts of the human skin. Characteristics are mostly the reddish, flaky character of the skin. Psoriasis can appear in different forms. At the beginning there can only be small, reddish, scaly skin changes, but these can then spread over large parts of the body.

Most patients suffering from psoriasis suffer a lot from it, because the conspicuous areas of the skin, which can also often appear on the face, cannot be covered. The affected person is very often stigmatized. The disease progresses in episodes, whereby after the onset of the disease there is usually a basic attack on the skin. Stress and other previously unknown factors can lead to a relapsing increase in the fields of inflammation on the skin.

Causes of scalp psoriasis

Today we are sure that psoriasis is a so-called Autoimmune disease acts. The body's immune system does not recognize certain skin cells of its own and fights them. As a result, skin cells that are transported to the surface of the skin die off quickly. Normal skin regeneration, which can take several weeks, takes place in a patient with psoriasis within a few days, with the result that the exfoliated skin cells move very quickly to the skin surface and are deposited there. For this reason, the skin thickens very quickly and the skin flakes, which are very typical of psoriasis.

But why your own immune system the skin cells classified as foreign and this has not been resolved to this day. Another major cause of psoriasis is hereditary. The majority of psoriasis patients are believed to have inherited the condition through their close family members. Under these circumstances, one cannot influence the development of the disease. Approx. 2-3% of the population of Europe is affected by the disease. For many, however, the disease runs in weak bouts and low levels. A massive infestation occurs in only a small proportion, mostly affecting the patient's scalp and forehead. Other localizations are the arms, fingers and legs and parts of the back and trunk.


Diagnosing a psoriasis will be done based on a physical exam and some tests on the affected area of ​​the skin. There are some phenomena that are typical of psoriasis and mark it. That would be mentioned first Candle phenomenon. If you scratch over the thickened, conspicuous skin area with a wooden spatula, layers of skin peel off and leave the optical impression of grated candle wax. The more layers you scratch off in this way, the thinner the skin plate that has built up becomes.

At the bottom of this skin plate you will find a thin membrane, which is also very typical of psoriasis and is also called "the last skin" referred to as. If you scratch it too, small sections of this membrane open and punctiform bleeding occurs. This bleeding is the third characteristic of psoriasis and is called Auspitz phenomenon designated. With these three characteristics, which can be found with a simple examination of the skin, psoriasis has been proven.

Some additional laboratory tests, which are not part of a standardized initial diagnosis of psoriasis, can also be carried out. They would show some autoantibodies that are greatly increased and that corroborate the suspected diagnosis of psoriasis. Inflammation values ​​such as CRP or leukocytes can also be increased in the event of an acute flare-up of psoriasis.

Symptoms of psoriasis of the scalp

The first symptoms of psoriasis are reddish skin changes on the scalp. Usually only small areas are affected at first, but they can then increase in size as the disease progresses. The reddening of the scalp is also associated with moderate to severe itching. Those affected then usually begin to scratch the scalp, which is already peeling off the first layers of skin. The classic skin appearance of psoriasis of the scalp is a thickening of the skin, which is due to the rapid transport of skin cells to the skin surface.

In addition to reddening and itching, skin thickening occurs relatively quickly. This can lead to a skin plate on the scalp that is several millimeters thick. If the patient scratches due to the itching, layers of skin peel off and leave a candle-wax-shaped image on the skin. Also characteristic of psoriasis is an explosive spread of the reddening of the skin and the scaly skin areas. This can lead to a complete attack on the scalp, arms and / or back within a few days. If left untreated, these skin areas remain for several days to weeks.

Hair loss in psoriasis

Psoriasis that affects the scalp also has an impact on hair growth. The reason is that almost the entire scalp is covered with hair follicles. Inflammatory skin changes in the area of ​​the scalp always lead to the fact that the hair cells are impaired and their formation is restricted, with the result that the hair in the area affected by psoriasis falls out. In most cases, large, thick layers of skin then cover the scalp, which then becomes increasingly hairless. It can happen that either large areas on the scalp or several smaller areas become hairless.

The combination of hair loss and skin reddening leads to further stigmatization of the patient and also to psychological stress. As soon as the inflammatory skin areas on the scalp have healed, hair starts to grow again. It takes weeks for the new top hair to adapt to the hair on the healthy scalp, and so it can also happen that the hair grows completely unevenly on the head. An early loosening of the skin layers leads to a faster regeneration of the scalp and the hair follicles, which also leads to a faster regrowth of the hair.

Treatment of psoriasis

Since the curative treatment of the skin disease is not possible, the treatment strategies are always aimed at alleviating the symptoms. The measures that are initiated range from loosening the skin plates with certain lotions to inhibiting the immune system with medicinal products, which are intended to ensure that the immune system's reactions to the body's own skin cells are only weakened.

As a rule, creams and lotions are used to treat psoriasis. Bath additives are also used. To dissolve the skin plates, creams or hip baths with the active ingredient salicylic acid or urea are used. It is important that the dead skin cells that keep coming back are no longer able to build up a thick plate. The treatment should be carried out several times a day. The regularity guarantees that the skin no longer thickens unnaturally and can heal faster.

The excessive cell growth and inflammation of the skin is inhibited by the active ingredient dithranol. It is available in the form of lotions and creams and should be applied regularly to the affected skin layers. Substances that are derived from vitamin D also have this anti-inflammatory effect and also lead to a reduction in cell reproduction. This group includes substances such as calcipotriol and tacalcitol.

Cortisone preparations are also used in severe cases. Long-term treatment with cortisone should, however, be avoided. Phototherapy is also part of a treatment component for psoriasis. The special UV treatment should be carried out at regular intervals for a few minutes.

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Serious psoriasis should always be systemic, i.e. over a manageable time frame. treated with tablets. Medicines that are similar to vitamin A are used here. The substances, also known as retinoids, ensure that the skin regenerates faster and inflammation in the area of ​​the skin does not occur as strongly or, in the best case, is avoided entirely. So-called immunosuppressants in the form of tablets are used in severe cases.

These drugs, which should be taken especially during strong attacks, inhibit the work of the immune system and ensure that the reactions mediated by the immune system are easier. In this context, methotrexate or ciclospoprin A is used. Recently, so-called biologicals have also been used more and more frequently. These are mostly antibody-related drugs that fight against the excessive immune system. This impact group includes, among others infliximab or etanercept, which have a corresponding effect on the immune system.

Shampoo against psoriasis

Shampoos are also used, especially when the scalp is infected with psoriasis, which are primarily used to loosen the excess skin and inhibit the inflammatory reactions. Acetylsalicylic preparations in particular are available in the form of shampoos. Sometimes these preparations have a certain amount of urea added to them, which is supposed to accelerate the dandruff-releasing effect. The shampoo should be used once a day and soaked for a few minutes before being washed out again.

There are also shampoos that contain a certain amount of cortisone to reduce inflammatory skin reactions. Combined anti-inflammatory and skin solution is best. Corresponding shampoos are available in pharmacies and should be used for a limited time. Nourishing and moisturizing shampoos can also be used between different psoriasis attacks. You should ensure that relapses of psoriasis are reduced and the corresponding inflammatory reactions of the skin are less pronounced.

Home remedies for psoriasis

In addition to conventional medical drugs, there are also some home remedies that are intended to reduce psoriasis relapses or, in the best case, prevent them completely. The most effective measures are washing with chamomile water, which is supposed to reduce the inflammatory skin changes, and the application of aloe vera products, which are supposed to lead to the healing of the inflamed skin and to a reduction in recurrence.Baths with sea salt are also suitable as a preventive measure and also for treating acute attacks.

Other remedies for psoriasis

Various remedies are available for the treatment of psoriasis: Preparations such as Herbal Glo, a shampoo that can be used every day for a psoriasis attack and reduce the itching, are particularly suitable for the itchy scalp.

Psoriasis solutions

Numerous solutions are available for treating psoriasis. With its active ingredient, Squamasol ensures that the thickened skin is gently removed. The solution is applied to the scalp and massaged in 2-3 times a week. After 10 minutes it can be washed out again.

Transmission of psoriasis

Since psoriasis is a so-called Autoimmune disease acts, it is inheritable but not infectious. Even in the case of an acute episode, which leads to extensive reddening of the skin and severe scaling, transmission to a healthy person is impossible, even when close.

Psoriasis during pregnancy

Psoriasis rarely occurs for the first time in pregnant women. Most of the time, pregnant women have experienced and had to treat one or more attacks in earlier years. If a psoriasis attack occurs during pregnancy, an appropriate treatment strategy must be determined with the treating gynecologist and the dermatologist.

Greater caution is advised when taking medication during pregnancy. E.g. all medicines that are derived from vitamin A (retinoids) and that are often used against psoriasis are not permitted during pregnancy because they can damage the unborn child. Acetylsalicylic acid, which is mainly used to remove the flakes of skin, can also only be used to a limited extent.

Psoriasis prognosis

There is no cure for psoriasis. However, certain treatment strategies can lead to relapses becoming less frequent and less severe. Often, however, lifelong treatment is necessary in order to avoid outbreaks of the disease.