Scalp Psoriasis

Overview: Psoriasis on the Scalp

Psoriasis is a chronic disease that is caused by an overactive immune system and is associated with inflammation throughout the body. Symptoms may resolve and recur throughout a person's life.

45 to 56 percent of people living with psoriasis have scalp psoriasis. [1] Scalp psoriasis can affect the scalp, hairline, forehead, back of the neck, and skin around the ears.

Psoriasis on the scalp is considered a high-impact site, which can have an increased negative impact on quality of life, regardless of the total area affected by psoriasis.

Showing scalp psoriasis along the hairline of a male.

Scalp psoriasis behind a female's ear, along her hairline.

A young person shows their scalp psoriasis

Symptoms

Symptoms of scalp psoriasis may include fine scaling that looks like dandruff or appear as thick, crusted plaques that cover the entire scalp. [2] Plaques may look red, purple, or brown depending on your skin color. [3] Scalp psoriasis is common in people with skin of color, but treating it can be particularly tough due to the hair type. In rare cases, severe scalp psoriasis can cause temporary hair loss. [4]

Other skin conditions, such as seborrheic dermatitis, may resemble psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis looks yellowish and greasy.

Causes and Triggers

The cause of psoriasis is not fully understood. Psoriasis plaques occur because the overactive immune system speeds up skin cell growth. Normal skin cells completely grow and shed (fall off) in a month. With psoriasis, skin cells do this in only three or four days. Instead of shedding, the skin cells pile up on the surface of the skin.

Inflammation caused by psoriasis can impact other organs and tissues in the body. People with psoriasis may also experience related health conditions. One in three people with psoriasis may also develop psoriatic arthritis. Scalp psoriasis may be an indicator of PsA, as many people have both. If you think you have scalp psoriasis, see a dermatologist to diagnose scalp psoriasis and visit a rheumatologist to screen for psoriatic arthritis.

Scalp psoriasis can be triggered by the same factors as other types of psoriasis. Common psoriasis triggers include:

Stress
Certain medications
Smoking tobacco
Alcohol
Injuries or trauma to the skin
Illness, such as infections
Changes in weather
Diet

Learn more about triggers and flares by downloading your free Flare Guide and Symptom Tracker.

Diagnosis

A health care provider will take several factors into consideration when making a diagnosis for psoriasis, including:

The appearance of the skin. Different types of psoriasis have different appearances.
The location of psoriasis. Certain types of psoriasis are more common in certain locations.
Itch of the skin. This is a common symptom of psoriasis.
A skin biopsy (the removal of a small piece of skin to be looked at under a microscope). A biopsy may also be done to determine if it is psoriasis or another skin condition.

Treatment & Management

Although there is no cure, there are more effective psoriasis treatments today than ever before. Treating psoriasis can help improve symptoms as well as lower the risk of developing psoriasis comorbidities such as psoriatic arthritis, heart disease, obesity, diabetes, and depression.

Scalp psoriasis can be difficult to treat. It may take time to find a treatment that works well because everyone responds differently to treatments. Treatments are often combined and rotated due to concerns about side effects or because treatments have stopped working after repeated use.

Treatments for psoriasis include:

Topicals, including over-the-counter topicals, topical steroids, and topical non-steroids
Phototherapy
Systemics, including oral, biologic, and biosimilar treatments

Over-the-Counter Products

Over-the-counter (OTC) products may help manage symptoms if you have mild scalp psoriasis. The two active ingredients that you should look for in OTC products are salicylic acid and tar (either coal or pine wood tar).

Salicylic acid works to soften plaques and scales and remove scales from the skin.
Tar made from coal or pine wood works to slow skin cell growth and reduce inflammation, itching, and scaling.

If you are looking for OTC products to try, check out NPF's Seal of Recognition program. These products have been created or are intended to be non-irritating and safe for people with psoriasis.

Topicals

Topical treatments include medicated psoriasis shampoos, topical steroids, and tars as well as prescription topicals. Because the hair is in the way, treating the scalp with topical treatments is not always easy. Talk with your dermatologist about how you normally care for your scalp, including how frequently you wash your hair. These conversations are important in making the right treatment decision for you.

Phototherapy

Phototherapy for psoriasis uses ultraviolet (UV) light to slow skin cell growth. Handheld phototherapy units with built-in combs are available to help UV rays reach the scalp.

Systemics

Oral psoriasis treatments, biologics, and biosimilars are often prescribed if you have psoriasis on areas beyond the scalp or if your scalp psoriasis has not responded well to other treatments.

Prevention

There is no known way to prevent the onset of psoriasis, however, there are many ways that you can manage your triggers to reduce flares.

Outlook/Prognosis

Psoriatic disease is lifelong, and symptoms may resolve and recur throughout the lifetime.

While there is no cure for psoriasis, treatments today are more effective than ever before and research into new treatments, as well as a cure, is ongoing. Treating psoriasis can help improve symptoms and may decrease the associated inflammation that can lead to psoriasis comorbidities such as psoriatic arthritis, heart disease, and depression.

Why treat psoriasis

Additional Resources

Psoriasis Shampoos Your Scalp Will Love

You deserve a product that keeps the itching and flaking at bay.

Discover products

Losing Your Hair and Confidence

Two women share how their mental well-being was hit hard by alopecia from scalp psoriasis.

Read their story

A graphic of a person scratching their head.

Scalp Psoriasis or Dandruff?

Plenty of people have confused one for the other, so we broke down some key differences.

Scalp Psoriasis Quick Guide

You have options when it comes to treatment. Learn more about scalp psoriasis, treatment options, and tips for hair care.

Get your free copy

Frequently Asked Questions

Are there medicated shampoos for scalp psoriasis?

The National Psoriasis Foundation's Seal of Recognition highlights and recognizes products that are non-irritating and safe for those living with psoriasis and includes medicated shampoos. Search the Seal of Recognition directory for shampoos and more.

Last updated on 4/18/2025 by the National Psoriasis Foundation.

References

Merola, J. F., Li, T., Li, W. Q., Cho, E., & Qureshi, A. A. (2016). Prevalence of psoriasis phenotypes among men and women in the USA. Clin Exp Dermatol, 41(5), 486-489. doi:10.1111/ced.12805
Aldredge, Lakshi M.; Higham, Robert C. Manifestations and Management of Difficult-to-Treat Psoriasis, Journal of the Dermatology Nurses’ Association: 7/8 2018 - Volume 10 - Issue 4 - p 189-197 doi:10.1097/JDN.0000000000000418
Kaufman BP, Alexis AF. Psoriasis in Skin of Color: Insights into the Epidemiology, Clinical Presentation, Genetics, Quality-of-Life Impact, and Treatment of Psoriasis in Non-White Racial/Ethnic Groups [published correction appears in Am J Clin Dermatol. 2018 Feb 16;:]. Am J Clin Dermatol. 2018;19(3):405-423. doi:10.1007/s40257-017-0332-7
Scalp Psoriasis: 10 Ways to Reduce Hair Loss. American Academy of Dermatology. https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-hair-loss. Accessed August 4, 2021.

Photos courtesy of Amit Garg, M.D.