Caring for the scalp
What areas of the scalp are most at risk?
The areas of the scalp which are most often affected by plaques are:
- above and behind the ears, and the earlobes;
- the nape of the neck, the forehead and the hairline
- at the parting of the hair
What are the symptoms of psoriasis of the scalp?
It is normal for the scalp to shed skin, but dandruff sometimes results when too many dead cells are shed. This is harmless and can be treated by using medicated shampoos. However, in psoriasis of the scalp, these white flakes are larger and more obvious. Be careful not to brush your hair too vigorously and frequently in an attempt to get rid of these flakes, as this can worsen inflammation and slow down healing.
What are the symptoms of psoriasis on the nape of the neck?
Plaques on the back of the head or behind the ears can often be very itchy, causing a great urge to scratch. Although scratching gives temporary relief and can be an outlet for stress, it actually makes the condition worse and it is better to find a long-term remedy. Don't be afraid to talk to your doctor about any stress or anxiety.
What are the symptoms of psoriasis on the earlobes?
The skin on the back of the earlobe tends to be delicate. Iit is less exposed to air and sunlight, and so has an increased tendency to be moist. This in turn means that it is vulnerable to colonisation by bacteria when it becomes inflamed. Remember to thoroughly wash and dry both sides of the earlobe.
What are the symptoms of psoriasis on the hairline and at the parting?
Combing or brushing the hair too much can increase inflammation at the hair root. In particular, this over-stimulates the areas along the hairline, at the parting and on the nape of the neck, leading to inflammation of the follicles.
How can I look after my hair if I have psoriasis of the scalp?
You should always wash and dry your hair gently, and try to avoid scratching or disturbing plaques. To help the scalp recover its natural balance, you can use an ordinary shampoo from time to time, alternating with a medicated shampoo recommended by your doctor. Remember to thoroughly dry behind the ears and both sides of the earlobes. Don't use the top heat settings on the hair dryer, and keep it 30 centimetres from your head. Avoid using rollers and curlers which pull the hair and dry the scalp.
Use a hairbrush with natural boar bristles rather than a plastic brush. Your doctor may also prescribe a tar-based shampoo, and will be able to best advise you on caring for your scalp.
I've lost hair because of scratching my scalp too hard. Is this permanent?
Psoriasis does not normally cause any damage to the hair follicle, so hair loss is not usually permanent. However, scratching lesions very occasionally leads to infection that may damage some follicles irrevocably. You should therefore talk to your doctor who can investigate for bacterial infection and prescribe a suitable treatment if necessary.
What kind of hairstyle is advisable?
It is best to avoid styles which place tension on the hair, such as back-combing or putting it up too tightly. Hair bands and scarves are not recommended. The scalp and ears should remain exposed to air and light.
If you have severe plaques on your scalp, a short haircut could be more comfortable and practical.
If you are suffering from a flare on the scalp, it is better to put off perming or dying your hair until the plaques have healed. You should advice your hairdresser to treat your scalp gently.
What can I do if my auditory canal is affected?
If your auditory canal is affected, use a cotton bud moistened in warm salty water to clean it, taking care not to force it too far into the ear, then dry it carefully. Consult a doctor if the canal becomes blocked.
What happens to the hair after psoriasis treatment?
Hair tends to become finer after psoriasis treatment, and it can also be difficult to get rid of tangles because of scale on the scalp.
What can I do if my scalp gets infected?
The scalp may become infected when the skin of the scalp or ears becomes cracked. A swab will confirm if a bacterial infection is present, in which case your doctor will prescribe an antibiotic.
You should treat your scalp very gently if plaques are present. It is best to avoid brushing and combing it too much, a recommendation which many patients find difficult to follow for aesthetic reasons. However, brushing and combing do not help get rid of scale and may in fact slow healing.
- You should not dry your hair at too hot temperature when using a hair dryer.