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Scalp psoriasis is a chronic immune condition that requires medical assessment; while dandruff is often benign and manageable.
Early detection of psoriasis can prevent hair loss and related health issues.
Scalp flaking is commonly experienced with many different types of flakes on the scalp. Although most flakes on the scalp are harmless, repeated flaking, redness and itchiness may be indicative of scalp psoriasis – a chronic skin disease that should be assessed by a physician. The sooner you can determine the difference, the better it will be to treat the symptoms.
Recognising the Difference
Dandruff is a common problem caused by the excess amount of a yeast-like fungus (Malassezia), which grows on the scalp, causing mild inflammation of the scalp and shedding of skin. The condition usually reacts favorably to anti-dandruff shampoos and generally worsens when colder.
Scalp psoriasis is an autoimmune disorder whereby the immune system exponentially quickens the production of skin cells, which produces thick, silvery-white scales and red patches on the scalp. This may also extend to the forehead, ears or neck, and unfortunately, scalp psoriasis can last for months or years, unless treated accordingly.
Dr. Priyanka Kuri, Consultant – Dermatology, Aster Whitefield Hospital, Bengaluru, explains that being able to notice those symptoms early can not only allow you to differentiate between scalp psoriasis and dandruff, but also to get initiated on treatment promptly.
1. Thicker Scales – Unlike dandruff, which has light and powdery flakes, psoriasis leads to the accumulation of dead skin cells, which creates thick membranes that may feel hard to the touch. The scales may be silvery-white or yellowish in appearance and are sometimes tightly adhered to the scalp, requiring more effort to remove. Thickness may also result in some tightness or tenderness in the areas involved.
2. Persistent Redness – The redness associated with psoriasis is deeper and has a more inflammatory quality, and is generally seen more along the hairline, temples or neck. The redness/pink is longer lasting than a typical easy-scalp irritation associated with dandruff. Sometimes it is accompanied by some swelling or warmth, signalling continuing inflammation under the skin. There can even be times when some flakes can be rubbed off, and some of the redness remains visible.
3. Itching with burning or pain – Psoriasis can have a significant amount of itching that is sometimes accompanied by burning or soreness. Itching will interfere with sleep, considering the annoyance of pyosiorhiasis, such as itching and tenderness, might make one feel that sleep is practically impossible. Excessive scratching will also result in minor injuries, bleeding, or loss of temporary hair loss on the affected area. It can even become difficult to carry out normal functions with this itchiness. This irritation can even make it difficult to function.
4. Flakes Beyond the Scalp – Scaling can occur on the forehead, behind the ears or on the neck. This happens because, as in other areas of the body, psoriasis does not stay localised to the scalp; rather, it tends to affect adjacent skin areas. There can also be patches at the hairlines of the scalp and sideburn areas in the more advanced cases.
5. Nail or Skin Changes Somewhere Else – Pitting, thickening, or discoloured nails, or scaly patches on elbows and knees, could mean psoriasis is affecting multiple body areas. These changes can occur with scalp symptoms as well as precede the scalp symptoms, allowing for clues for the diagnosis. The fact that nails are involved is an indicator that this disease is more systemic in nature.
Importance of Early Detection
Psoriasis is a lifelong management condition with flare-ups and remissions. If left untreated, psoriasis gets worse and leads to hair loss from scratching and increases your chances of developing related health problems, including heart disease and arthritis. A dermatologist may usually diagnose psoriasis based on how your skin looks and perhaps a skin biopsy.
Managing Scalp Psoriasis
There is no cure for scalp psoriasis, but treatment can help manage the symptoms that it presents:
- Medicated shampoos that contain coal tar, salicylic acid or ketoconazole to help reduce the scaling.
- Using topical corticosteroids and vitamin D analogue creams will help soothe the inflammation.
- Use mild hair care to prevent further irritation; avoid vigorous brushing and hairstyling with lots of chemicals.
- Using oils for moisturising (e.g. coconut oil) can soften the scales, which will then help when you wash them off.
Dandruff is common, but scalp psoriasis is treated with a medical approach. If you notice any weird symptoms like thick scaling, sweating/itching, persistent redness, or patches spreading past the scalp, don’t take it lightly. A correct diagnosis and early treatment can minimise hair loss, help with the symptoms, and improve skin health overall.
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Delhi, India, India
