Psoriasis is a chronic autoimmune condition where the body’s immune system triggers an overproduction of skin cells. This accelerated cell growth leads to thick, scaly patches on various parts of the body. When this condition manifests on the scalp, it is known as scalp psoriasis, presenting unique visual characteristics and symptoms.
Visual Signs on the Scalp
Scalp psoriasis presents as distinct, red, inflamed patches that can range in size from small, localized areas to covering the entire scalp. These patches are often well-defined. The underlying skin is thickened and elevated.
Silvery-white scales form on top of these red patches. These scales are thick, dry, and flaky. While they may resemble common dandruff flakes, psoriatic scales are larger, more adherent, and have a distinctive silvery sheen.
They can appear anywhere on the scalp, often extending slightly beyond the hairline onto the forehead, around the ears, and onto the back of the neck. Severity varies significantly; some experience mild, barely noticeable flaking, while others develop thick, crusted plaques covering the entire scalp.
Common Accompanying Symptoms
Beyond the visual signs, scalp psoriasis often brings a range of sensory and physical symptoms. Itching is a common complaint, and its intensity can vary from mild irritation to severe, relentless itching that significantly impacts daily life. Persistent scratching can further irritate the skin and lead to secondary problems.
The affected skin on the scalp can become dry, which may lead to cracking, especially when scales are disturbed or removed. Vigorous scratching or forceful removal of scales can cause the skin to bleed. Individuals also report a burning sensation or general discomfort on affected areas of the scalp.
While scalp psoriasis does not directly cause permanent hair loss, inflammation, excessive scaling, and vigorous scratching can temporarily contribute to hair thinning or shedding. When thick scales are pulled off, they can dislodge hair strands, and chronic inflammation can weaken hair follicles. Hair regrows once the condition is properly managed and inflammation is reduced, as hair follicles are not permanently damaged.
Distinguishing from Other Conditions
Differentiating scalp psoriasis from other common scalp conditions, particularly dandruff (seborrheic dermatitis), is important due to their similar superficial appearance. The scales in dandruff are typically smaller, oilier, and have a yellowish tint. They often appear on an oily scalp, whereas psoriasis scales are silvery, dry, and form on inflamed, reddened skin.
Unlike dandruff, scalp psoriasis features distinct, well-demarcated red patches underneath the scales. Seborrheic dermatitis, while also causing redness and scaling, usually presents with less defined patches and a greasier appearance. The scales in psoriasis are also generally thicker and more firmly attached to the scalp compared to the finer, looser flakes of dandruff.
Other conditions like eczema, which can also affect the scalp, often present with more weeping or oozing lesions and less defined scales than psoriasis. Ringworm, a fungal infection, typically causes circular, scaly patches with broken hair shafts and can be highly contagious. The specific combination of silvery scales on well-defined red plaques indicates scalp psoriasis rather than these other conditions.
When to Seek Medical Advice
If you notice persistent flaking, redness, or itching on your scalp and are uncertain about the cause, consulting a healthcare professional is advisable. Seeking medical advice is important if your symptoms worsen, spread to other areas, or significantly impact your comfort and daily activities. Severe itching, pain, or discomfort that disrupts sleep or concentration requires professional evaluation.
If you suspect an infection, such as pus, increased redness, warmth, or fever, immediate medical attention is needed. When over-the-counter shampoos or topical remedies fail to provide relief after a few weeks of consistent use, a doctor can offer a precise diagnosis and discuss prescription treatment options. A healthcare provider can accurately distinguish scalp psoriasis from other conditions and recommend an appropriate management plan.