Psoriasis is a chronic autoimmune condition primarily affecting the skin, characterized by an accelerated production of skin cells. These cells mature and reach the surface in just a few days, accumulating as thick, scaly patches called plaques. These plaques can be itchy, painful, and inflamed, commonly appearing on areas like the knees, elbows, trunk, and scalp. While psoriasis is not contagious, its unpredictable flare-ups and visible symptoms often lead to questions regarding its broader impact, particularly on hair health.
Understanding the Link to Hair Loss
Scalp psoriasis, affecting about half of all individuals with psoriasis, can indeed contribute to hair loss. The inflammation inherent in psoriasis can weaken hair follicles, making them brittle and prone to shedding. This inflammatory response disrupts the normal hair growth cycle, leading to thinning or breakage. The condition itself does not directly destroy hair follicles, but the environment it creates on the scalp can interfere with healthy hair growth.
Hair loss associated with scalp psoriasis is typically temporary. Hair usually regrows once the underlying scalp psoriasis is effectively managed and inflammation subsides. However, in rare instances of severe, long-standing, or untreated scalp psoriasis, persistent inflammation and trauma can potentially lead to scarring of hair follicles, which might result in more permanent hair thinning. Addressing the condition promptly can help prevent such outcomes and promote hair recovery.
Factors Contributing to Hair Thinning
Chronic inflammation from psoriasis can directly impact and weaken hair follicles, making hair shafts more susceptible to damage and shedding. This process disrupts the delicate balance required for healthy hair growth, leading to increased hair fragility.
Physical trauma to the scalp further exacerbates hair loss. The intense itching often experienced with scalp psoriasis can lead to forceful scratching or picking at the scales. This repeated trauma can dislodge hair, damage the skin, and weaken already delicate hair, leading to breakage and increased shedding. Vigorous brushing or combing to remove scales can similarly cause hair to break or fall out.
The thick, crusted plaques characteristic of scalp psoriasis can also physically impede hair growth. These layers of accumulated skin cells can “strangle” the hair shaft at its base, making it difficult for new hair to emerge and trapping existing hairs. This physical barrier contributes to the overall thinning effect.
Certain medications used to treat psoriasis can sometimes have hair thinning as a side effect. For example, oral medications like retinoids (e.g., acitretin) and methotrexate, used for more severe cases, can cause hair loss in some individuals. Discussing potential side effects with a healthcare provider is important when starting new treatments.
Stress also contributes to hair thinning in individuals with psoriasis. Living with a chronic condition like psoriasis can be stressful, and stress is a known trigger for psoriasis flares. Heightened stress levels can induce a type of temporary hair shedding known as telogen effluvium, where hair follicles prematurely enter a resting phase, leading to increased hair fall. This creates a cycle where stress worsens psoriasis, which can lead to more hair loss.
Managing Hair Changes
Effective management of hair changes associated with psoriasis often begins with treating the underlying scalp condition. Dermatologists commonly prescribe medicated shampoos containing ingredients like salicylic acid or coal tar, which help soften and remove scales while reducing inflammation and itching. Topical corticosteroids are also frequently used to quickly reduce redness, swelling, and scaling on the scalp. For more stubborn cases, light therapy or systemic medications may be recommended to control widespread psoriasis and promote a healthier scalp environment.
Gentle hair care practices are important to minimize further trauma to the scalp and hair. This includes avoiding harsh chemicals, minimizing heat styling, and using soft brushes to prevent physical irritation and breakage. After using medicated shampoos, applying a conditioner can help prevent hair from becoming overly dry and brittle. Allowing hair to air dry whenever possible can also reduce stress on the scalp.
A balanced diet can support overall hair health. Incorporating omega-3 fatty acids, found in oily fish, may help reduce inflammation and improve psoriasis symptoms, which could indirectly benefit hair. However, dietary changes alone are not a primary treatment for psoriasis or hair loss.
Seeking professional advice from a dermatologist is important for personalized diagnosis and treatment plans for both psoriasis and associated hair loss. A dermatologist can differentiate psoriasis from other conditions and tailor a treatment strategy to the individual’s specific needs. Early intervention and consistent management are key to controlling scalp psoriasis and supporting hair regrowth.