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Diseases of the scalp

Diseases of the scalp

There are several scalp diseases, which can cause itching of the scalp. One of them is scalp psoriasis.

Itchy scalp can become a serious problem and cause a lot of discomfort. A person, suffering from scalp problems, may also have dandruff that make it uncomfortable to wear dark clothing. Sometimes these problems can be a symptom of scalp psoriasis – a common skin disorder, which appears as raised reddish scaly skin patches on the hairy head skin.

What causes itchy scalp?

There are several diseases of the scalp that can make it itch. Some forms of dermatitis can cause itchiness. Head lice can also cause intense itching. Psoriasis on the scalp is also a quite common reason for itchy flaky scalp.

Psoriasis on the scalp

About fifty percent of all the patients suffering from psoriasis experience it on scalp. Hairy skin of the head is a very common area for psoriasis rash to appear. Usually plaque psoriasis is the one that manifests on scalp.

Psoriasis is a common, chronic, unpredictable, inflammatory proliferative skin disorder, which is caused by genetic, environmental and immune factors. It manifests by charesteristic rashes, causes great physical discomfort and social problems for the patient. Though psoriasis is not life threatening condition, it affects the life quality similarly to oncologic diseases and has a huge impact on patient well – being.

Psoriasis often causes dry, flaky, itchy scalp, and very rarely – hair loss. Even when it causes hair loss, the effect is temporal and the hair does grow back.

The treatment for scalp psoriasis can be divided to:

  • Reducing proliferation;
  • Anti-inflammatory.

Each patient’s treatment is individual. It depends on the stage of psoriasis, its clinical form, patient’s age, underlying diseases, spreading of the rash and previous treatment.

Psoriasis treatment is concluded using cascade principle. First cascade is topical medication. It is a first choice treatment.Topical medication includes:

  • Emollients;
  • Keratolytics (salicylic acid, lactic acid, urea);
  • Vitamin D 3 derives;
  • Dithranol (Cignolin, Anthralin);
  • Corticosteroids;
  • Coal tar products;
  • Local retinoids;
  • Local immunotherapy.


Topical treatment for psoriasis on scalp can be difficult to apply because of the hair. Anti – psoriatic dry scalp shampoos, which are often made of coal tar, can be difficult to use because of their odor – most of the patients find it irritating.

Second cascade treatment is phototherapy. It includes the use of UVB radiation combined with certain medication. Phototherapy also has its side effects: it can cause erythema, blisters and can even provoke skin cancer. Getting tanned in solariums is not a recommended therapy for scalp (or any other localization) psoriasis treatment.

Third cascade treatment is more effective, but it is also toxic and has many side effects. It includes systemic phototherapy and some medications, such as Methotrexate, Cyclosporine and Fumaric acid ester. When the patient goes through systemic phototherapy, he has to always wear sun glasses, because the eyes become more sensitive to sunlight.

Fourth and fifth cascade treatment includes medication that is even more toxic and more effective. Some antibiotics can be used as fourth cascade treatment.

Sixth cascade (the strongest treatment for scalp or any other kind of psoriasis) includes biological drugs. These drugs tend to act on psoriasis pathogenesis. They are prescribed for severe forms of psoriasis. They cannot be prescribed if the patient has TBC or hepatic malfunction. These drugs have many side effects and (depending on national health care policy) can be very expensive.

Scalp diseases and disorders in picture