Health Promotion Manager, Irish Skin Foundation
Scalp psoriasis: how to correctly treat it
It is important to remove the scale before you apply any prescribed treatment.
Soften the scale
Coconut oil, olive oil, or almond oil all soften the scale. For best results leave oil on scalp overnight. Topical tar preparation such as Cocois® can be effective at softening and removing scale (use as directed).
Gently remove scale
Try to locate the scale with your fingertips and use a plastic, fine-toothed comb, flat against the scalp and slowly move the comb in an upward motion so that the teeth of the comb loosen the scale. Take care not to remove scales too forcefully as this can damage the skin and flare your psoriasis.
To remove the coconut/olive/almond oil, it may be useful to apply shampoo before wetting your hair and massage it in. Then use warm water to wash your hair and get rid of any loose scale. Tar-based shampoos are useful for treating the scale that is present in scalp psoriasis. Your doctor, nurse or pharmacist can recommend a suitable shampoo.
Apply prescribed treatment
Topical steroids are often prescribed to settle psoriasis flares. These are absorbed better and are more effective when the thick scale is removed. Apply topical steroids as directed by your doctor/nurse. When applying scalp treatments, it is useful if someone can help you apply scalp treatments so that the treatment is applied to the scalp and not the hair. If your whole scalp is affected, part the hair into sections and gently massage treatment into affected areas. Wash hands after application of treatment.