Scalp Psoriasis Diagnosis and Treatment in London

Understanding scalp psoriasis

Scalp psoriasis is a form of chronic plaque psoriasis where inflammation and rapid skin cell turnover lead to scaly, thickened patches on the scalp. It may occur alone or alongside psoriasis on other parts of the body, such as elbows, knees, or nails. The condition tends to flare and subside over time, influenced by stress, illness, or environmental triggers.

Causes and triggers

Psoriasis is an autoimmune condition where the immune system mistakenly speeds up the growth cycle of skin cells. While the exact cause remains unknown, several factors contribute:

• Genetics: Family history increases risk.
• Immune dysfunction: Overactive immune response causes skin cell build-up.
• Triggers: Stress, infections, alcohol, cold weather, certain medicines, and trauma to the skin (Koebner phenomenon).

Symptoms of scalp psoriasis

• Thick white or silvery scales on the scalp
• Red or inflamed skin beneath scales
• Persistent itching, burning, or soreness
• Flaking resembling severe dandruff
• Dry scalp and irritation behind ears and along the hairline
• Temporary hair shedding due to scratching or scaling (not scarring alopecia)

Scalp Psoriasis Diagnosis

A dermatologist typically diagnoses scalp psoriasis by examining the scalp. In uncertain cases, a skin biopsy may be taken to rule out seborrhoeic dermatitis, fungal infections, or other scalp conditions.

Scalp Psoriasis Treatment options

Treatment depends on severity and response to previous therapies:

• Topical treatments: Medicated shampoos with coal tar, salicylic acid, or ketoconazole. Corticosteroid lotions or foams help reduce inflammation.
• Vitamin D analogues: Calcipotriol and similar treatments slow cell growth.
• Light therapy (phototherapy): Controlled UV exposure to reduce inflammation and scaling.
• Systemic treatments: Oral or injectable medications (e.g., methotrexate, biologics) for severe, resistant cases.
• Adjunctive care: Emollients and scalp oils to soften scales and reduce itching.

Living with scalp psoriasis

Although not curable, scalp psoriasis can be managed effectively. Patients should follow a regular scalp care routine, avoid scratching, manage stress, and attend follow-ups with a dermatologist. Support groups and counselling can also help manage the emotional impact of this visible condition.

Your first visit — what to expect

1. History: Review of symptoms, triggers, and medical history.
2. Examination: Detailed inspection of scalp and other body areas.
3. Tests: Rarely, a biopsy if diagnosis is unclear.
4. Treatment plan: Tailored use of medicated shampoos, topical therapies, or advanced treatments.
5. Follow-up: Ongoing monitoring to adjust therapy and manage flare-ups.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 22 August 2025