Psoriasis Capitis

Scalp Psoriasis – silvery dry scales on firm raised plaques sometimes with red margins which do not disappear with shampooing. Whereas symptoms of this troublesome disease can often be reduced, ‘cure’ may not be an appropriate word.

This article is published for general information. It is not intended as an aid to self diagnosis. Professional advice should be sought.

A chronic skin disease effecting 3% of the population (more females than males). It presents in various formats. 

Plaque psoriasis is more frequently seen on scalps. It appears as raised inflamed skin lesions topped with silvery white scales. An isolated lesion may exist, but moderate to extensive areas of skin may be involved.
It may also present as small red lesions which increase in size and produce scales which exfoliate easily. Beneath psoriasis scales the skin is red, often serous, tender and may bleed.

Severe psoriasis may cover large areas of the body. This article focuses on the scalp.

Psoriasis is not contagious, but may be genetically transmitted. Psoriasis affects approx. 3% of the population.
Patients with visible psoriasis lesions understandably suffer embarrassment and depression.

The cause of psoriasis is unknown, but research suggests white blood cell abnormalities trigger rapid skin cell proliferation and exfoliation. The skin cycle (from basale cell creation to exfoliation) in healthy individuals is approximately 28-40 days. With a psoriatic this period may be reduced to perhaps 3 – 4 days.

Recurrences may be seasonal and may be associated with reduced natural sunlight.

Psoriasis comes in many forms.

Nails if affected may be pitted. In extreme cases they may loosen, thicken and crumble.

Arthritis may co-exist. Some psoriatics suffer arthritis and related functional disability. Arthritis may improve as the skin recovers.

Treatments available.

There is no cure for this disease, but topical and systemic therapies may be helpful. Continuous treatment may be required.

Use of keratolytics with careful grattage to remove shedding skin. anti inflammatory medication, tar lotions and shampoos, special diets, natural sunlight or judicious ultra violet irradiation.

PUVA (Psoralen + UVA) is effective in extreme cases. Treatment involves the drug Psoralen + exposure to UVA (Ultra Violet). Many treatments may be required. Psoralen remains in the lens of the eye, therefore patients must wear UVA blocking eyeglasses throughout the remainder of the treatment day. PUVA treatments increase the risk of skin ageing, freckling, and skin cancer. Treatment is always monitored.

Medications containing cortisone compounds, coal tar, or anthralin may be used in combination with ultraviolet light.

Sunlight and ultraviolet therapy are amitotic (slow the proliferation of skin cells).

Methotrexate. Possible side effects: nausea, dizziness, possible liver disease. Regular blood tests are necessary.

Steroids (Cortisone) weak medications as creams, ointments, and lotions may bring relief. Stronger cortisone preparations may produce as side effects thinning of the scalp with associated adverse effects on hair, bruising, and skin colour changes.

Calcipotriene (synthetic Vitamin D) .There may be side effects.

Retinoids: contraindicated in pregnancy, and those who may become pregnant within 3 years. Used alone or in combination with ultraviolet light for severe cases. Side effects: drying of the skin, lips and eyes.

Cyclosporine – an immuno-suppressant drug. Monitoring of blood pressure and kidneys is essential.

A cure

Not yet !
Research is progressing the understanding of the the immune system’s response to the disease
and any underlying genetic causes.

The Society is pleased to reproduce the following treatment regime offered by one of its readers.

I had suffered with scalp psoriasis since childhood. Occasionally it would disappear but then flare up again. After research on the Internet, something lead me to believe that there was a relationship between psoriasis and arthritis, which my family is particularly afflicted with. Six months ago I stopped eating foods of the Nightshade family e.g. tomatoes, white potatoes, peppers, chili peppers, cayenne, paprika, pimento and aubergine (eggplant). My psoriasis which was always part of my life disappeared almost immediately and my scalp felt better.

I have not eaten foods containing tomato or potato for months and would prefer to go without them in the future than go back to the itching and problems of psoriasis.
Perhaps this might give some other Psoriasis sufferers some hope.

©2004 – B Stevens FTTS (Fellow of The Society) Contact the author

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