Topical treatments, such as shampoos, can help manage psoriasis on the scalp. Shampoos for psoriasis may include active ingredients like salicylic acid, coal tar, or clobetasol propionate.

Psoriasis is a long-term inflammatory condition that affects the skin and other parts of the body. Skin changes can affect the scalp. Topical treatments, such as shampoos, can help.

No single shampoo will be best for every individual with psoriasis, but knowing which options are available can help a person know what to look out for.

This article looks at the types of shampoos that can treat psoriasis and the differences between them. It also discusses when to see a doctor and what type of treatment they might suggest.

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Psoriasis shampoos are intended to treat the scalp, not to clean the hair. A person will usually need to use a regular shampoo to wash their hair after using a psoriasis shampoo.

These shampoos can work in different ways to reduce the number of flare-ups and relieve the symptoms of the condition. How they work depends on what ingredients they contain. Psoriasis shampoos will usually reduce inflammation and scalp scaling.

A doctor may recommend someone change the type of shampoo they use and other topical treatments regularly, as the shampoos may become less effective with frequent use.

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Different types of shampoo have different ingredients, and their effects will vary.

Examples of ingredientsTrusted Source commonly present in shampoos for scalp psoriasis include:

Salicylic acid

Salicylic acid is a medication that a person can apply directly to the affected skin. It helps treat scalp psoriasis by reducing the scaling on the scalp. The plaques will soften, and the scales become easier to remove.

However, the Psoriasis and Psoriatic Arthritis Alliance (PPAA) notes that some people who use salicylic acid in psoriasis shampoos find that it irritates their skin. High concentrations of salicylic acid may lead to irritation and temporary hair loss.

Coal tar

Coal tar shampoo is available in over-the-counter (OTC) preparations that come from coal and wood.

It may be helpful if scalp psoriasis causes itching.

Coal tar contains a compound that helps reduce the excessive development of skin cells. It can also help relieve itching and soreness, which are symptoms of psoriasis.

Clobetasol propionate

If scalp psoriasis does not respond to other shampoos or treatments, a doctor may prescribe a shampoo containing clobetasol propionate, a potent topical steroid.

A person can use a shampoo containing this medication every day for up to 4 weeks. Once the symptoms improve, they can use it once or twice a week to maintain the scalp condition.

After applying the shampoo to the scalp, it is best to leave it on for 5 to 10 minutes and then wash it off and reapply.

People with a sensitive scalp may only be able to apply psoriasis shampoos about twice a week.

According to the PPAA, a person should consider alternative options if the psoriasis shampoo does not improve symptoms after 8 weeks.

Sometimes, a person will need to apply a psoriasis shampoo every 2 to 3 weeks to help manage scalp psoriasis symptoms.

Scalp psoriasis can involveTrusted Source mild to severe scaling with crusted plaques on the scalp. This can be uncomfortable, leading to itching and sometimes pain. It may also extend to a person’s forehead, ears, and back of the neck.

At first, the flaking of dead skin cells can resemble dandruff. However, scalp psoriasis will have a scaly, silver appearance, according to the National Psoriasis Foundation.

Other symptoms may include:

  • bleeding, if a person scratches the scalp
  • a dry scalp, which may result in cracking and bleeding, or itching
  • soreness due to the skin scaling and as a result of itching
  • temporary hair loss due to repeated itching or severe scaling on the scalp
  • loss of sleep as a result of discomfort at night

Some people may feel embarrassed about the changes they see, and this can lead to depression and anxiety.

Although most people with scalp psoriasis know to avoid scratching their scalp when it itches, it can be hard not to. However, scratching an itchy scalp can worsen symptoms and cause the areas of psoriasis to grow or become infected.

Scalp psoriasis can be challenging to treat, and it is hard to know which treatments will be effective.

A person should speak to a doctor if:

  • they experience symptoms for the first time
  • symptoms are severe, including cracking or bleeding
  • OTC shampoos or medicated shampoos do not help

If there is cracking or bleeding, it can cause an infection. A doctor may recommend a systemic treatment in moderate to severe cases of scalp psoriasis that do not respond to other treatments.

People who are pregnant or nursing should also speak with their doctor and make a plan for treatment options during pregnancy because their usual treatment regimen may need some adjustments. This is because scalp psoriasis may worsen or flare during pregnancy. The PPAA also notes that some treatments are not suitable for those who are pregnant or nursing.

OTC scalp shampoos are not the only way to treat scalp psoriasis. Other options include treatments that a person can apply to the scalp and leave for a short time, sometimes overnight.

Examples include:

  • Topical steroids: A gel, lotion, or foam that contains steroid medication can reduce the itching and redness that people associate with scalp inflammation. Also, long-term steroid use can lead to unwanted side effects.
  • Coconut oil compounds: These combine coal tar, salicylic acid, and sulfur with coconut oil, which softens skin plaques, according to the PPAA. Coconut oil compounds work best when the person rubs them into the scalp, leaves them on overnight, and washes them off in the morning.
  • Dithranol: This is a plant-based treatment that people have used for more than a century to treat the condition. It may help treat psoriasis, but it can also stain the hair and skin. For this reason, it is less popular than some other options.

Other topical medications

Some creams, gels, lotions, or ointments work to slow down or normalize excessive cell reproduction and reduce inflammation.

Most people can manage mild symptoms of psoriasis with topical treatments.

Some of the more common medications include:

Light therapy

If symptoms do not improveTrusted Source with topical treatments, a doctor may recommend phototherapy, which involves using ultraviolet rays to treat the scalp.

Laser ultraviolet B (UVB) treatments may help treat scalp psoriasis, according to the National Psoriasis Foundation. A healthcare professional will target the laser precisely on a psoriasis lesion to focus the light. Lesions can withstand higher doses of UVB light than healthy skin. This treatment may have fewer side effects than many medications.

Systemic drugs

Systemic drugs work throughout the body.

They include:

These medications can help prevent inflammation and the buildup of skin cells.

Biologics

In moderate to severe cases, a doctor may prescribe a biologic drug. These newer drugs affect a specific part of the immune system and aim to treat the underlying cause of psoriasis.

Biologics can reduce the risk of flares and help manage symptoms.

Topical treatments for psoriasis, such as shampoos, can help relieve symptoms. However, there is no single best treatment option and no one shampoo that is best for everyone.

Psoriasis affects people in different ways. An individual may need to try a variety of options before finding one that works well or alternate between treatments if one becomes less effective.

Anyone with new or worsening symptoms of scalp psoriasis should ask their doctor about the options available.