Does Psoriasis Cause Hair Loss?

Psoriasis is a skin condition that affects around 7.4 million people in the United States. Your immune system turns over skin cells too quickly, causing red, scaly patches and silver scales known as plaques to form on your skin’s surface.

If you have psoriasis, you may experience it on your scalp. At least 50 percent of people with plaque psoriasis will develop scalp psoriasis, according to the American Academy of Dermatology (AAD).

Scalp psoriasis can be mild or severe, with cases ranging from light scaling to thick plaques. The condition can appear anywhere on the scalp in the form of a small patch, or it may cover the entire area.

Scalp psoriasis can result in hair loss, but it’s only temporary.

You may scratch your head to relieve the itching caused by scaling. That could cause your hair to fall out. Methods of forcefully removing the scales to relieve psoriasis may also cause hair loss. Once you find an effective treatment, your hair will grow back.

To prevent scalp itching and possible resulting hair loss, try the following tips:

• Use a conditioner to keep your scalp moisturized.
• Limit the use of hot tools, such as blow dryers, when styling your hair.
• Try hair products that contain menthol.
• Press a wet towel or ice pack against the irritated section of the scalp.

If you have thin or thinning hair, scalp psoriasis breakouts can be even more difficult to cover up.

While you can’t completely prevent psoriasis breakouts, you can manage the condition. Talk with your doctor about ways to manage your stress level, alcohol intake, medications, and other changes in your health.

There are many ways to treat scalp psoriasis. Work together with your doctor or dermatologist to come up with a treatment plan before you begin self-administering any products.

It’s important to find a doctor who specializes in psoriasis and who’s familiar with the latest treatments. This is because many new methods to treat scalp psoriasis are available, including different topical methods, light treatments, and other medications.

Your doctor may recommend using topical applications for your scalp psoriasis. These include:

• creams, such as topical steroids
• oils, such as mineral oils, which you apply to the scalp overnight
• sprays, such as clobetasol propionate (Clobex)
• foams, such as steroid foams
• medicated shampoos containing ingredients such as selenium or tar

Over-the-counter (OTC) methods

There are several over-the-counter (OTC) options.

When choosing a product, remember that salicylic acid breaks down the scales, but could cause your hair to break off. This can cause temporary hair loss. Also, tar products can be effective, but they can stain fabric and gray hair.

Other medical shampoos treat psoriasis, but they may not help with managing your hair otherwise. Some medicated shampoos can actually damage your hair, as they contain harsher ingredients with the focus on treating psoriasis.

To counteract the damage and help manage your hair, you should also use a conditioner.

Prescription methods

Other topical treatments require a prescription and contain steroids, vitamins D and A, or antimicrobials, for example.

Vitamin D affects both cell growth and how the immune system functions, and increased vitamin D is thought to help treat psoriasis. Similarly, vitamin A directly affects how quickly skin cells grow and divide.

Your doctor may prescribe antimicrobials if they suspect a yeast infection is also present.

How to use

Treatments are often combined, and they should be used according to your doctor’s directions.

Typically, you should apply topical treatments every day for several weeks before slowly decreasing your usage.

Light treatments containing ultraviolet B (UVB) light are a new way to treat psoriasis. UVB light can be applied to the scalp by manually parting the hair throughout the procedure.

These treatments are more effective than previous methods because they can target the specific area where you have a psoriasis outbreak.

Home treatments include getting more sunlight and getting UVB light with a light unit at home.

Shoot for 5 to 10 minutes of noontime sun exposure, but follow your doctor’s orders. With UVB treatments, you’ll first be treated at a medical facility. After receiving a doctor’s instructions, you can treat yourself with a home light unit.

Laser treatments

Laser treatments may also help. XTRAC lasers can distribute a high amount of UVB light onto the skin. It takes approximately 4 to 10 sessions to see results and requires appointments at a medical facility.

Research is still being done to determine how long the results from treatment last.

Your doctor may determine that other treatments may help your scalp psoriasis.

Steroids

Steroids are frequently used to treat scalp psoriasis. They can reduce swelling and inflammation, along with the redness of the lesions.

Types of steroids that may be used include:

• corticosteroid creams
• corticosteroid injections
• short-term systemic steroids

Steroid injections should not be given more than every three to four months, and high doses of oral steroids should be prescribed in moderation. Both can have negative side effects if used too often.

These drugs are often the most effective ways to treat scalp psoriasis, though they won’t cure it. Many people need further treatment after a few months.

Oral medications

For severe cases of scalp psoriasis, doctors may decide to inject steroids directly into the affected area, or they may prescribe oral medications, such as:

• methotrexate (Trexall)
• oral retinoids
• cyclosporine (Gengraf, Neoral, Sandimmune)
• apremilast (Otezla)

Injectable or infusion drugs

Injectable or infusion therapies, including biologic agents for moderate to severe psoriasis, may also be prescribed. Examples of biologics include:

• secukinumab (Cosentyx)
• etanercept (Enbrel)
• adalimumab (Humira)
• ustekinumab (Stelara)
• ixekizumab (Taltz)
• risankizumab (Skyrizi)

Certain lifestyle changes may help treat scalp psoriasis and improve the health of your hair, particularly when used in combination with scalp psoriasis treatments.

• Reduce your alcohol intake. Alcohol can trigger psoriasis flares, making your scalp psoriasis worse.
• Reduce your stress levels. Like alcohol, stress can cause psoriasis flares.
• Avoid scratching. Many people with scalp psoriasis will scratch at the scalp to relieve itching or to remove scales. Over time, this can cause hair loss.
• Be cautious in extreme weather. It’s another common trigger for psoriasis.

Scalp psoriasis should be treated with the help of a doctor. If it goes untreated, you’ll experience symptoms that include itching and other discomforts, as well as possible hair loss.

Once you and your doctor have determined the proper course of action, it’s likely that your psoriasis will improve and your hair will grow back.

Treatment plans can take up to several weeks to take effect, though you may see positive results sooner. In some cases, it can take up to eight weeks to control plaques.