Effective treatments for scalp psoriasis

Scalp psoriasis is characterized by dandruff on a very inflamed scalp. THE itching can be very debilitating, especially since it is important to resist the urge to scratch. The more you scratch, the more the scales persist. “Scalp is the most common location of psoriasis, along with the elbows, knees and/or lumbar region“, underlines the dermatologist Marc Perrussel. “Scalp psoriasis is very often associated with a comorbidity called psoriatic arthritis (affecting the scalp in 93% of cases)“, he adds.

What are the best prescription treatments?

Several treatments, local and/or systemic, can be prescribed by a specialist to treat scalp psoriasis. “In the presence of very debilitating psoriasis that is resistant to local treatments, one can resort to systemic treatments, associated or not with local treatments“, explains our expert.

► Local treatments: The topical corticosteroids in the form of a lotion or foam – or a galenic form adapted to the hairy region. THE topical corticosteroids combined with vitamin D analogues : “both will act in a complementary way and give a better result“, notes Marc Perrussel. “This association, in the form of an ointment or a gel, is very effective in the intensive treatment of an acute attack of psoriasis (one daily application for a maximum of 4 weeks). It can be used at a lower dose as a maintenance treatment (one application per week)“, developed Ameli.fr.

► Systemic treatments:

• Immunoregulatory treatments such as methotrexate, an anti-inflammatory and immunosuppressive agent
• The apremilast : This medication directly targets the enzyme that activates inflammatory cells, cytokines.
• Biotherapies : these are antibodies directed against the molecules which activate the keratinocytes, the cells of the skin. “These biologics are prescribed second-line in the absence of response to other treatments or in the event of a contraindication to the usual therapies. Their use is reserved for hospital specialists.notes Ameli.fr.

The management will depend on the severity of the psoriasis, the discomfort or even the suffering felt by the patient. “If you cannot improve your quality of life with local treatments, there are several systemic treatments available that allow gradual management, depending on the severity.“, continues the specialist.

What are the best shampoos?

There are several shampoos that have proven themselves in pharmacies. It is keratolytic products. “Their composition presents anti-inflammatory properties but at minimal doses. However, this may be sufficient for very mild psoriasis with little impact on quality of life.“, explains Marc Perrussel. On frizzy, dense hair and a very inflamed and scaly scalp, the action of local treatments will be very limited., he illustrates. Apart from treatment shampoos, it is important to use a mild, non-irritating shampoo. It is also recommended avoid washing in too hot water and drying your hair with a hair dryer, because heat is a source of irritation.

What are the best natural remedies?

Calendula oil, sweet almond oil are often promoted as natural treatments for psoriasis. “Baths based on starch, wheat or oil, or moisturizers can be helpful in cleaning lesions, calming inflammation, and stopping the itchiness of psoriasis“, details Ameli.fr. For our expert, if these products have keratolytic virtues – they take off and eliminate the keratin skin, “they will only have this effectively stripping effect but will not act on the inflammatory mechanism of the pathology“. So they can work but only on mild and very little disabling psoriasis.

What are the best homeopathy products?

According to our expert, no homeopathic treatment is effective against psoriasis of the scalp. “But if a patient is under homeopathic treatment in addition to the treatments that I have prescribed and this is in no way a contraindication, I see no objection. On the contrary, the placebo effect is often beneficial“, he concludes.

Thanks to Marc Perrussel, dermatologist.