Understanding Scalp Psoriasis: Insights from Experts

Scalp psoriasis is a common and persistent skin disorder that manifests on the scalp, often extending to the forehead, the back of the neck, or behind the ears. Characterized by red patches, severe scaling, and dandruff-like flaking, scalp psoriasis can be both a physically uncomfortable and emotionally distressing condition. This comprehensive guide draws on expert insights to delve into the causes, symptoms, treatments, and specific concerns related to scalp psoriasis, particularly in seniors.

What is Scalp Psoriasis?

Scalp psoriasis is a manifestation of psoriasis, an autoimmune disease that speeds up the life cycle of skin cells. This accelerated growth leads to the accumulation of cells on the surface of the skin, forming scales and red patches that are sometimes painful or itchy. Unlike other forms of psoriasis, scalp psoriasis is often more challenging to treat due to hair coverage, which can obstruct topical applications and reduce the efficacy of ultraviolet light exposure.

Causes and Risk Factors

While the exact cause of scalp psoriasis remains unclear, it is believed to be primarily driven by genetic factors and an overactive immune system. Risk factors include:

  • Family history: A strong genetic predisposition can be observed, with many patients reporting a family history of psoriasis.
  • Environmental triggers: Stress, skin injuries, certain medications, and infections can trigger or exacerbate symptoms.
  • Lifestyle factors: Smoking and alcohol consumption have been linked to both the onset and severity of scalp psoriasis.


The most common symptoms of scalp psoriasis include:

  • Red patches of skin covered with thick, silvery-white scales.
  • Dry scalp that may bleed when scales are picked or scratched.
  • Itching, soreness, or a burning sensation.
  • Temporary hair thinning as a result of scratching or the removal of scales, although scalp psoriasis does not cause permanent hair loss.


Diagnosis typically involves a physical examination of the scalp. In some cases, a biopsy may be necessary to differentiate scalp psoriasis from other conditions like seborrheic dermatitis or fungal infections.

Treatment Options

Treatment aims to reduce inflammation and clear the scales. Options include:

  • Topical treatments: Medicated shampoos, creams, and ointments containing tar, salicylic acid, or corticosteroids.
  • Light therapy: Exposure to ultraviolet light under medical supervision can help slow skin cell turnover.
  • Systemic treatment: For severe cases, oral or injected medications that affect the whole body may be necessary.
  • Biologics: These are newer drugs that specifically target the immune system’s interactions that lead to the development of psoriasis.

Scalp Psoriasis in Seniors

Managing scalp psoriasis in seniors requires special consideration. Aging skin is generally more sensitive and may have decreased moisture, making it more susceptible to irritation from treatments. Additionally, seniors are more likely to have comorbid conditions such as diabetes or heart disease, which can complicate the use of systemic treatments due to their side effects. When treating older adults, physicians often adopt a more conservative approach, prioritizing gentler treatments and closely monitoring for adverse effects.

Managing Flare-Ups

Flare-ups can be managed by:

  • Avoiding known triggers: Stress management techniques and avoiding alcohol and smoking can help.
  • Routine skin care: Using moisturizing products can prevent dryness and itching.
  • Diet: Some evidence suggests that a healthy diet low in inflammation-causing foods may help manage symptoms.

Living with Scalp Psoriasis

Living with scalp psoriasis involves both managing the condition and coping with the emotional and psychological impact:

  • Support groups: Many find solace and practical advice in community resources and support groups.
  • Educational resources: Understanding the condition can alleviate anxiety and help individuals make informed decisions about their care.


Scalp psoriasis is a complex condition influenced by genetic, immune, and environmental factors. Effective management requires a comprehensive approach that includes medical treatment, lifestyle adjustments, and psychological support. Particularly for seniors, it’s crucial to balance efficacy with safety, considering the potential sensitivities and health implications that come with age. By staying informed and engaged with a healthcare provider, individuals with scalp psoriasis can maintain a high quality of life and minimize the impact of this chronic condition on their daily lives.