Scalp Psoriasis (cont.)

The fact that this is a hair-bearing area in most people produces challenges in diagnosis as well as treatment. If scaling plaques are present on portions of the body in a distribution characteristic of psoriasis, then the diagnosis of the scalp disease is much easier to make.

The most important consideration in treating scalp psoriasis is getting an effective medication into the skin. Both the hair and any scale covering the disease is an impediment to treatment. Removal of the scale in a nontraumatic fashion is very important. This can be accomplished by washing the hair with a shampoo frequently. Using tar, selenium, or salicylic acid-containing shampoos can be helpful. This may have to be done at least twice a day initially if the scale is sufficiently thick. Gently rubbing the scale with the fingertips and not the nails is important.

It should be appreciated that scaling is not due to dryness but to the excessive production of the horny layer of the skin. Occasionally it may be necessary cover the scalp overnight with mineral oil. To avoid an unpleasant mess, it is necessary to cover the scalp with a shower cap or swim cap. With moderate or severe scalp disease, the addition of a topical steroid is often required. The strength of the steroid would depend on the severity of the condition. The type of vehicle (lotion, solution, or foam) depends on physician and patient preference. It is important to remember that the medication must get past the hair in order to reach the scalp skin. Occasionally other medications may be of benefit, such as topical calcipotriene (Dovonex, Sorilux) in a lotion or foam form.

Source: MedicineNet.com
http://www.medicinenet.com/scalp_psoriasis/article.htm