Psoriasis Hair Shampoo: How to Choose the Best Shampoo for Scalp Psoriasis

15.12.197627.10.2021 by alexxlab

What is the best shampoo for scalp psoriasis? Discover the key ingredients to look for and expert tips on choosing an effective psoriasis shampoo.

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Understanding Scalp Psoriasis and Shampoo Ingredients

Psoriasis is a chronic skin condition that can affect the scalp, leading to symptoms like flaking, redness, and intense itching. To manage scalp psoriasis, it’s important to use specialized shampoos that contain key ingredients like coal tar or salicylic acid.

Coal tar has been used to treat psoriasis for over a century, as it helps slow down the rapid growth of skin cells and can ease itching and improve the overall appearance of the scalp. Shampoos with coal tar require leaving the product on the scalp for 5-10 minutes before rinsing.

Salicylic acid is another common ingredient in psoriasis shampoos, as it helps lift, soften, and remove stubborn scales. These shampoos should be used at least twice a week, or as directed by your dermatologist.

Prescription Steroid Shampoos for Severe Scalp Psoriasis

For more severe cases of scalp psoriasis, your doctor may prescribe a shampoo containing topical steroids. These are typically used for only a few weeks to help reduce inflammation and redness. After that, your doctor may suggest transitioning to a coal tar or salicylic acid shampoo.

It’s important to use prescription steroid shampoos exactly as directed, applying to the dry scalp and leaving it on for 15 minutes before lathering and rinsing. Avoid getting these shampoos on your face or near your ears, as the skin is thinner in those areas.

Potential Side Effects of Psoriasis Shampoos

While psoriasis shampoos can be highly effective, they do come with some potential side effects to be aware of:

Coal tar shampoos may increase sun sensitivity and potentially darken light-colored hair.
Salicylic acid shampoos can be drying and irritating, especially if used too frequently or over a large area.
Steroid shampoos should not be used long-term, as they can thin the skin over time.

It’s important to follow the instructions carefully and consult your dermatologist if you experience any adverse reactions.

Choosing the Best Psoriasis Shampoo for Your Needs

When selecting a psoriasis shampoo, consider the severity of your symptoms and any other skin conditions you may have, like a yeast infection. Shampoos with sulfur can be helpful for treating fungal infections on the scalp.

Start with over-the-counter options containing coal tar or salicylic acid, and if those don’t provide sufficient relief, talk to your dermatologist about trying a prescription-strength shampoo. Remember to be gentle when washing and follow the usage instructions carefully to avoid exacerbating your symptoms.

Top Recommended Psoriasis Shampoos

Based on expert recommendations and customer reviews, some of the best shampoos for scalp psoriasis include:

Neutrogena T/Gel Therapeutic Shampoo
Derma-Smoothe/FS Scalp Oil Shampoo
MG217 Medicated Conditioning Shampoo
Sebcur Scalp Purifying Shampoo
DHS Tar Shampoo

Maintaining Healthy Hair and Scalp

In addition to using a specialized psoriasis shampoo, it’s important to be gentle when washing your hair and scalp. Avoid scrubbing too vigorously, as this can further irritate the skin. After shampooing, you may also want to follow up with a gentle, fragrance-free conditioner to help keep your hair soft and manageable.

Remember, everyone’s skin and scalp are different, so it may take some trial and error to find the right psoriasis shampoo and hair care routine for your needs. Don’t hesitate to consult a dermatologist if you’re struggling to find relief.

Key Takeaways

Scalp psoriasis requires specialized shampoos containing ingredients like coal tar or salicylic acid.
Prescription steroid shampoos may be used for short-term relief of severe symptoms.
Be aware of potential side effects like increased sun sensitivity and dryness.
Start with over-the-counter options and consult a dermatologist if needed.
Maintain a gentle hair care routine to avoid further irritation.

Psoriasis Shampoo: How to Choose

Most shampoos are designed to clean and care for your hair, but if you have psoriasis on your scalp, you should find shampoos that are made specifically for your scalp. These shampoos can help with flaking, redness, and itching. In some cases, that may be all you need to get a handle on it.

Often the shampoos have some of the same ingredients as the medicines and lotions your doctor might recommend for psoriasis on other parts of your body. You can get ones that treat mild to moderate psoriasis off the shelf at your local pharmacy. The two main ingredients in those are coal tar and salicylic acid. If you need something stronger, your doctor can prescribe it for you.

Whether prescription or over-the-counter, these shampoos should be used only for short periods of time. And you’ll need to be gentle with them. Your psoriasis can get worse if you scrub too hard. It’s also important to follow your doctor’s instructions.

Coal Tar Shampoos

Coal tar has been used to treat psoriasis for more than 100 years. You can find it in shampoos as well as creams, oils, and lotions.

Shampoos with coal tar help with scaling, hardening, and thickening of the skin on your scalp by slowing down the growth of skin cells. They also can ease itching and make your scalp look better overall.

To use this kind of shampoo, massage it into your scalp, leave it on for 5 to 10 minutes, and then rinse.

Be aware, though, that shampoo with coal tar might make your scalp more sensitive to the sun. Tar can stay on your skin for 24 hours or longer, and your chances of sun damage go up during that time. Protect your head with a hat or stay in the shade if you’re outside.

If you have blond or other light-colored hair, shampoo with coal tar could make it darker. Treatments with coal tar also can stain clothes or skin.

Some people don’t like the way coal tar shampoos smell. You may want to use a regular shampoo and conditioner afterward to make your hair smell good and keep it shiny.

Salicylic Acid Shampoos

Salicylic acid works well for a lot of skin problems because it helps you shed dead skin. With psoriasis, it helps to lift, soften, and get rid of scales on your scalp.

To use one of these shampoos, wet your hair and work the shampoo into a lather. Rinse and repeat. Use it at least twice a week or follow your doctor’s advice. Try not to get it in your mouth, eyes, or nose, and don’t use it if you have a rash or a cut.

Shampoos with salicylic acid can make your scalp dry, and that can lead to more flaking. They also can irritate your skin, make you nauseated, or cause other problems if you use them too long and over too big of an area of your head. Talk to your doctor before trying one of these.

Some salicylic acid shampoos have sulfur, which can stop fungus. If you also have a yeast infection on your scalp, this kind of shampoo may be right for you. You need to use it once or twice a week after the infection has gone away to keep your scalp healthy.

Shampoo With Steroids

You’ll need a prescription from your doctor for these. They’re usually used for only a few weeks to help with swelling and redness. After that, your doctor may suggest you switch to a coal tar shampoo.

Don’t wet your hair before using this shampoo — you put it on your scalp when your hair is dry and leave it for 15 minutes. Then wet your hair, lather in the shampoo, and rinse it out.

Be sure to keep it off your face and away from your ears — your skin is thinner in those areas. It’s also important to wash your hands well afterward.

5 Best Shampoos for Scalp Psoriasis — Best Psoriasis Shampoos, According to Dermatologists

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Psoriasis is a serious condition that affects more than 8 million people in the U.S. The disease creates raised “plaques” or “scales” on a person’s body when skin cells don’t shed normally. Those lesions can be itchy, painful or just plain bothersome to deal with — especially when they appear on a person’s scalp.

“Treatments can include shampoos, topical medications, ultraviolet light treatments, oral systemic medications and biologic medications,” says Abby Van Voorhees, M. D., a professor and chair of dermatology at Eastern Virginia Medical School and emeritus chair of the National Psoriasis Foundation’s Medical Board.

The best thing you can do is talk to a dermatologist to figure out the right option (or more likely, combination of treatments) for you, but in the meantime, we’ve rounded up a list of some doctor-approved shampoos that might help, as well as tips on how to pick one.

First thing’s first: look at the ingredient list. “If psoriasis is limited, and one is going to manage with shampoo alone, then products with tar or salicylic acid are preferred,” says Dr. Van Voorhees. “No one knows how tar works; in fact, we’re not even sure what ingredients in tar are effective, but tar has been used for psoriasis for over a hundred years and probably works as an anti-inflammatory agent.” While some people have raised concerns that tar might put you at risk for cancer, research shows no link between the two. “Salicylic acid shampoos are good if someone has a lot of scaling since they tend to remove some of the scaling in a gentle way,” says Dr. Van Voorhees. “The key with both is to leave them in contact with the scalp for about five minutes because if they are rinsed out too quickly, then they don’t work.”

Whether you’re using a shampoo or another hair product, make sure it doesn’t cause any irritation. “Psoriasis has a property that if the skin is irritated, it makes more psoriasis,” explains Dr. Van Voorhees. One helpful tool is the National Psoriasis Foundation’s Seal of Recognition program, which features “over-the-counter products that have been created or intended to be non-irritating and safe for those living with psoriatic disease, as well as for those with severe sensitive skin or joint mobility limitations.”

Below, you’ll find some of the best shampoos for scalp psoriasis:

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T/Gel Therapeutic Shampoo Extra Strength

Neutrogena
walmart. com

$11.87

“This is a perennial dermatologist favorite,” says Annie Gonzalez, M.D., a board-certified dermatologist at Riverchase Dermatology in Miami. “This formula contains Neutar® (1% Coal Tar), proven to control flaky, itchy scalp for hours after it’s rinsed out.”

Psoriasis Medicated Shampoo + Conditioner

Dermarest
amazon.com

“This has a zinc complex and 3% salicylic acid,” says Gretchen Frieling, M.D., a triple board-certified dermatopathologist in the Boston area. “It packs a punch by attacking multiple symptoms of scalp psoriasis by addressing redness, itching and even severe flaking. The salicylic acid is essential because it works to remove scales and soften scalp psoriasis plaques — even those that are thick. An added benefit is that this enables topical medications to more deeply penetrate the scalp post-shampoo. ”

SAL Shampoo

DHS

“This product has salicylic acid to efficiently break down the scales so they’re easier to eliminate without damaging the hair or agitating the scalp,” says Dr. Gonzalez. “This shampoo is also very good for those with very crusty scales that are even more difficult to get rid of.”

5% Coal Tar Psoriasis Shampoo

Psoriatrax
amazon.com

“The 5% Coal Tar in the shampoo functions to preclude scale build-up and skin-cell growth,” says Dr. Frieling. “This reduces redness, itchiness and inflammation. The shampoo should be left on for 5 to 10 minutes to allow it to penetrate for maximum effectiveness.”

Clinical Strength Seborrheic Dermatitis Treatment

Head & Shoulders
amazon. com

“This shampoo contains 1% selenium sulfide,” says Dr. Gonzalez. “This ingredient reduces skin flaking through its antifungal and oil-controlling abilities. As a bonus, it combats excess oil which can exacerbate flaking and itchiness.”

Kaitlyn Pirie
Sr. Editor
Kaitlyn started her career as a reporter in the research department at Real Simple and went on to become a health editor at Family Circle before joining the Hearst team.

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Tips for Managing Symptoms of Scalp Psoriasis

1. Pretreat Your Hair Before Applying Any Rx

When it comes to scalp psoriasis, priorities count. Apply scale-softening agents or oils to psoriasis patches first, before you dab on medication. Any treatment you use afterward will penetrate the skin more easily, upping the benefits. Next, choose a peeling agent that includes salicylic acid in the ingredients list, which softens scales, making them easier to remove. (Urea and lactic acid work the same way.)

2. Try a Parting of the Ways

When applying a product, part your hair to expose your scalp so you can target plaques directly, says Fran Klapow, a hairstylist from Long Island, New York, who has scalp psoriasis. Repeat this sectioning piece by piece so you can treat your scalp without getting the gooey stuff all over your hair.

RELATED: 9 Things You Only Understand if You Have Psoriasis

3. Follow the 5-Minute Rule for Shampooing

Before you rinse, let the lather sit for five. “If you carefully lather your hair without touching your scalp, it won’t end up smelling like medicine,” Klapow says. As far as topical treatments, these are meant to stay on longer — for 12 hours or more before shampooing. (Check the label and ask your doctor for specifics.)

RELATED: What to Do if Topical Treatments Aren’t Enough for Your Psoriasis

4. Don’t Scratch That Itch

Refrain from rubbing or scrubbing your scalp when shampooing, as tempting as it may be to dig into those itchy spots. “Scratching induces trauma which in turn induces psoriasis, a process known as Koebnerization,” Bagel explains.

If you’re finding it hard not to scratch, try applying a dab of hydrocortisone, a mild corticosteroid, to itchy spots, to help decrease itching and inflammation, the NPF says. Start with the least powerful topical steroid that works for you, and use it just three to four times a week. (If you overuse steroids, your scalp psoriasis could get worse instead of better.)

5. Avoid Products With Mint

“Minty shampoos and conditioners can irritate plaques,” Bagel says. A good rule of thumb for shampooing when you have scalp psoriasis? The fewer ingredients on the label, the better.

6. Look for Coal Tar

Coal tar is often listed as the active ingredient in shampoos for people with scalp psoriasis. It works by slowing the growth of new skin cells and helping shed dead skin cells, the NPF says.

7. Try the Mediterranean Diet — for Your Hair

Like the beneficial Mediterranean diet, this tip relies on olive oil. Apply it to your scalp and keep your head under wraps overnight, Bagel advises. In the morning, apply Neutrogena T/Sal shampoo to any plaques, wait 10 minutes, then wash out. (You may want to follow up with another round of shampooing.)

8. Avoid Alcohol

Wine, beer, and spirits may exacerbate psoriasis, Bagel says. Psoriasis is an inflammatory disease, and according to a study published online in August 2019 in Psoriasis, alcohol seems to cause and aggravate inflammation.

9. Cover Your Ears

To avoid irritating your ears with chemicals, apply petroleum jelly to two cotton balls and gently place one in each ear before using a medicated shampoo or other treatments.

10. Taper Off Gradually

It can take eight weeks or more for scalp treatments to have an effect, Bagel says, so don’t bail out too soon. No matter what, it’s important to not stop a treatment abruptly, even if your scalp psoriasis clears up. Continue to use a tar or medicated shampoo once or twice a week to maintain the results.

11. Get Yourself Conditioned

If you have scalp psoriasis, itching can be a real problem, and itching is caused by a dry scalp. To keep things lubricated, look for over-the-counter products designed to ease that itch. Klapow recommends using conditioner every time you shampoo to keep your scalp moisturized (and your hair looking glossy).

12. Don’t Blow It

Hot air from a blow dryer can worsen dryness and itching, so let your hair air dry, Klapow recommends. If you must use a blow dryer, keep it on the lowest setting.

13. Talk With Your Doc

If you still need relief, ask your dermatologist about new treatment options, including biological agents, says Bagel. A study published in June 2020 in the Journal of Dermatological Treatment found that patients with moderate to severe scalp psoriasis saw improvement within two weeks when given biologics and small-molecule drugs.

RELATED: 10 Signs It’s Time to Call Your Dermatologist About Psoriasis

5 Best Scalp Psoriasis Treatments & Remedies, Say Dermatologists

This article was medically reviewed by Caroline Chang, MD, a board-certified dermatologist and member of the Prevention Medical Review Board, on August 17, 2019.

For most people struggling with an itchy scalp or dandruff, switching shampoos is enough to find relief. But for those with scalp psoriasis—a type of psoriasis that forms on the top of the head and can also spread to the top of the forehead, the back of the neck, and behind the ears—it’s not always so simple.

Scalp psoriasis typically appears as pink and/or red patches and silvery scales that may be accompanied by itching, soreness, or a burning sensation. The more severe it is, the more likely you’ll feel the crusty plaques on your head—and maybe even see them fall off if you scratch them. Scratching can also make the scalp bleed and cause temporary hair loss. As you can imagine, the condition can be incredibly difficult to live with, and can make some people feel embarrassed and ashamed of their symptoms.

About 50% of people with psoriasis get it on their scalp.

Most patients with scalp psoriasis also have psoriasis on other areas of their body, and symptoms can flare up and recede over time. For instance, they’re often worse in the winter months or whenever you’re feeling stressed.

Just like with other types of psoriasis, it’s not clear what the cause of scalp psoriasis is and, unfortunately, there is no cure. But here’s the good news: There are plenty of safe and effective treatments that can help you find significant relief, according to board-certified dermatologists.

The best scalp psoriasis treatments

Psoriasis on the scalp can creep down to the neck.

Getty Images

Shampoos and solutions

Dandruff shampoos like Selsun Blue or Head & Shoulders might help a very mild case of scalp psoriasis. “Anything beyond mild scaling will likely require a prescriptive agent for consistent control,” says Bobby Buka, MD, CEO and dermatologist at The Dermatology Specialists in New York City.

Anti-Dandruff Shampoo (Pack of 2)

Head & Shoulders
amazon.com

There are several types of prescription-strength shampoos that your doctor might suggest. In the past, tar-based shampoos were often used, but they smell lousy and can stain things, so many dermatologists are moving away from those now. Rhonda Q. Klein, MD, MPH, a board-certified dermatologist at Modern Dermatology of Connecticut will typically prescribe a zinc or selenium sulfide shampoo and have the patient rotate that with a steroid shampoo, or sometimes she’ll recommend an antifungal.

How often do you need to use a prescription shampoo? “There are patients that start off using one every day and after several weeks to months, they may only need it once every two weeks or once a month,” says Dr. Buka.

But there are some caveats. “It’s really important to take a thorough history of people’s hair-washing behaviors to figure out what the best topical treatment will be,” says Dr. Klein. For instance, some women don’t wash their hair every day, so for them, putting a solution in their hair at night two or three times a week, sleeping in it, and then washing their hair the next morning may be a better option.

Oral medications

If topical treatments aren’t providing enough relief, a dermatologist may move on to a systemic treatment. There are pills that you can take—anywhere from once weekly to twice daily, depending on the medication—to treat scalp psoriasis. One that is commonly prescribed is called apremilast.

Another option for some patients is acitretin, a vitamin-A derivative, but it can’t be used in women with childbearing potential because you can’t get pregnant within three years of taking it.

Other drugs like methotrexate and cyclosporine may also be considered, though they can have serious side effects. “With methotrexate, you can have liver issues and cyclosporine can affect the kidneys and blood pressure,” says Dr. Klein.

Light or laser therapy

You can go to a dermatologist’s office two or three times a week to receive what’s called narrow-band UVB phototherapy. (Most dermatologists no longer use full-spectrum light that contains UVA rays because that would increase your risk for skin cancer.)

It feels a lot like going to a tanning salon—you step into a vertical box that’s filled with lights. “You don’t really see maximum benefit until 10 to 12 weeks and many patients continue to do it for six months,” says Dr. Klein. “There are also home light box units that we try to get insurance to cover.” Light therapy is generally a good choice if you have scalp psoriasis, as well as psoriasis on other areas of your body.

Another variation: “You can get a comb with a light in it, so you can essentially brush with this light turned on that emits UVB rays,” says Dr. Buka. “That’s one way to suppress inflammation on the scalp without using a steroid.”

There’s also an excimer laser, which is a form of ultraviolet laser and can be used in a doctor’s office two to three times a week. “This works great for the scalp because it’s more of a targeted therapy and we actually put the laser where we see the plaques,” says Dr. Klein.

Biologics

“Biologic therapy is the hottest thing to hit dermatology and psoriasis in the last 10 years,” says Dr. Buka. It’s a shot or infusion that a patient can conveniently receive in a more spread-out fashion—sometimes every other week, sometimes every six weeks, or sometimes every three months.

Biologic therapy is typically used only if the psoriasis is covering a large percentage of the body or if the patient also has psoriatic arthritis. “Biologics are very safe and the success rate is in the 80 to 90 percent range,” says Dr. Buka. The downside is that they can be super expensive, so it’s a good idea to check with your insurance provider ahead of time to see what your out-of-pocket cost would be.

Home remedies

If you’re interested in trying home remedies, always talk to your dermatologist first to make sure they’re safe. As for their effectiveness, some home remedies might help a little, especially if you have a mild case of scalp psoriasis. But you will likely need something stronger and clinically proven to find major relief.

“There’s definitely great anecdotal evidence for acupuncture use. There’s wonderful, small-group evidence surrounding Chinese herbal medicine. Do I believe that non-traditional therapies can clear a heavily crusted scalp? No. Do I believe holistic medicine can result in significant improvement on a scalp? Definitely,” says Dr. Buka. “Patients who are dedicated to meditation, massage, stress reduction, and acupuncture can achieve marked improvements on their psoriasis.”

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Jane Bianchi
Jane Bianchi is a writer and editor with more 13 years of experience specializing in health; she formerly worked as a health editor at Family Circle, and her work has appeared in Men’s Health, Women’s Health, Esquire, and more.

Management of scalp psoriasis: current perspectives

Shampoos

Hair makes the treatment of scalp psoriasis especially challenging. Vehicle formulations play a large role in patient satisfaction and adherence. Shampoos provide patients with an easy, non-messy treatment option, either alone or in combination with other therapies. Few studies have evaluated the actual efficacy of these preparations, reporting shampoos have a modest, at best, effect on treating psoriasis of the scalp.¹⁵ There are some studies available that support the use of coal tar shampoo, containing 2%–10% coal tar solution, in scalp psoriasis;¹⁶^,¹⁷ however, no double-blind studies are available to support this practice and many patients do not find tar shampoos cosmetically acceptable. Salicylic acid shampoo, due to its keratolytic effect, has also been used to enhance the penetration of other topical medications including corticosteroids, and has been recommended by The National Psoriasis Foundation as a first-line therapy. ⁵ However, a recent Cochrane review of clinical trials on scalp psoriasis found no evidence to support the first-line use of a tar-based shampoo, with or without a keratolytic such as salicylic acid.¹⁸ Alternatively, clobetasol propionate (CP) shampoo 0.05% has been proven to be highly effective for scalp psoriasis. This formulation has been found to be both safe and efficacious for the initial treatment phase of disease, as well as maintenance therapy to prevent disease relapse once a patient has achieved remission with other topical or systemic therapies (see Topical corticosteroids).¹⁹^–²¹

Topical treatments

Salicylic acid

Salicylic acid 5%–10% has a potent keratolytic effect. Salicylic acid is generally formulated in an ointment or mineral oil and applied for an extended period to reduce the hyperkeratotic scale characteristic of plaque psoriasis. In such cases, removal of scale can help with the penetration of adjunctive medications. ⁵ Due to its formulation, patients frequently report difficulty removing the product from their hair; this can be circumvented by applying a clarifying shampoo to the hair prior to entering the shower to aid in removal of the product.

Coal tar

Coal tar has been used as a treatment for psoriasis for several decades due to its anti-proliferative and anti-inflammatory actions, and its potent anti-pruritic properties.²² Although crude coal tar is the most effective tar available for the treatment of psoriasis, the application of crude coal tar to the scalp presents a challenge. As such, coal tar solution or liquor carbonis detergens 5%–20% is frequently recommended, formulated as a lotion, or added to a corticosteroid preparation. Of note, the use of coal tar has largely fallen out of favor to newer topical medications. Tar’s malodor, adverse effects (hair staining and drying), and carcinogenicity limit its use, although newer studies challenge these findings. ²³^,²⁴ The use of coal tar in cosmetic preparations has been banned in Canada and the European Union over concerns regarding carcinogenicity.

Dithranol (anthralin)

Dithranol, one of the oldest medications used in the treatment of psoriasis,²⁵ works by inducing free radical production, thus inhibiting several aspects in the pathogenesis of psoriasis.²⁶^,²⁷ Dithranol is commonly prescribed as a 0.1%–3% cream, starting at a low concentration and increasing as tolerated. Dithranol is generally indicated in patients with resistant disease, as treatments are generally provided at specialized centers or inpatient departments. This is another treatment that has been replaced by newer, more cosmetically appealing options.

Topical corticosteroids

Of all the topical treatments available, corticosteroids have shown the greatest efficacy in clinical trials for scalp psoriasis, and are the most commonly prescribed treatment. ⁵^,¹⁸ Given the importance of vehicle formulations in patient adherence, topical corticosteroids are now available as creams, lotions, ointments, oils, gels, foams, solutions, sprays, and shampoos. Several reports suggest that patients prefer newer cosmetically appealing options such as sprays and foams. Although some caution exists against prescribing potent topical corticosteroids for chronic use in scalp psoriasis, the scalp is relatively resistant to atrophy induced by these medications.⁵

In randomized controlled trials, super-potent CP in various formulations has been shown to be the most efficacious topical treatment for scalp psoriasis. In a recent vehicle-controlled, randomized, double-blind study involving 81 patients with moderate-to-severe scalp psoriasis, 85% of patients using CP spray were clear or almost clear of their disease after 4 weeks of twice daily application compared with only 13% in the vehicle control group (P<0. 001).²⁸ Another recent study involving 168 patients with moderate scalp psoriasis evaluated the efficacy of once daily CP 0.05% shampoo. This study demonstrated similar results, with 42% of patients using CP shampoo found to be clear or almost clear of their disease after 4 weeks of treatment compared with only 2% in the vehicle control group (P<0.001).²¹ Continued twice weekly use of the CP shampoo provided continued benefit to the treatment group, significantly prolonging the time to first relapse, and increasing the total percentage of patients without relapse.²¹ Importantly, both studies stated similar adverse event profiles between the treatment and vehicle arms, with no significant differences in scalp atrophy, telangiectasias, hypothalamic-pituitary-adrenal axis suppression or other adverse events. A recent Cochrane review found the most evidence for the use of CP in the treatment of scalp psoriasis, with four high-quality clinical trials demonstrating a combined 1. 9-point change in participants’ psoriasis on a six-point global improvement scale (Investigators Global Assessment of Improvement).¹⁸

In addition to sprays and shampoos, the foam or mousse vehicle has become popular with many patients. CP foam has also been found to be highly efficacious in the treatment of scalp psoriasis. One randomized, double-blind study in 188 patients with moderate-to-severe scalp psoriasis compared the use of CP foam 0.05% to both CP solution 0.05% and placebo. Following a 2-week treatment period, 74% of patients treated with CP foam were clear or almost clear of their disease, compared with 63% in the solution treated group.²⁹ Another, more recent, open-label trial on 12 patients with scalp psoriasis used CP 0.05% foam twice daily for 4 weeks. In this study, the PASI score dropped from 5.7 to 1.7 (range: 0.2–4.8, standard deviation [SD]: 1.1) by week 2, and to 1.1 (range: 0.2–2.2, SD: 0.6) by week 4.³⁰ The study is limited by small size and lack of a control group, but demonstrates the significant benefit that can be derived from the use of corticosteroid foams in the treatment of scalp psoriasis.

Although there are fewer trials to support their benefit, other very potent topical corticosteroids (eg, betamethasone dipropionate) and medium to potent topical corticosteroids (eg, betamethasone valerate [BMV]) were reported to have a similar beneficial effect to CP.¹⁸ The medium potency 0.12% BMV foam (Luxiq^®; Prestium Pharma, Newtown, PA, USA) was shown to be highly efficacious in the treatment of scalp psoriasis, and to be significantly more efficacious than BMV 0.1% lotion with enhanced penetration.³¹ In a placebo-controlled study including 179 patients with moderate-to-severe scalp psoriasis, 72% of patients using BMV foam achieved clear or almost clear status, compared to only 47% using BMV 0.1% lotion and 21% of patients using placebo foam or lotion.³¹ A cross-over, multi-center study comparing the foam to standard therapies had 210 patients complete the treatment period. Eighty-eight percent of patients using BMV 0.12% foam had complete or near complete resolution of scaling compared to only 66% of patients using standard therapies of corticosteroid or calcipotriol (P<0. 001).³² Patients also reported that the foam was a more convenient formulation to use as opposed to standard therapies.³² Another trial on 79 patients showed that once daily application of BMV 0.12% foam was as effective as twice daily application for 4 weeks.³³ This is important given that once daily efficacious treatment has a much higher adherence rate as compared to twice daily treatments.³⁴

Vitamin D derivatives

Vitamin D analogs have been shown to induce dose-dependent anti-proliferative and pro-differentiating effects in the epidermal keratinocytes of psoriatic skin.³⁵^,³⁶ Unlike the corticosteroids, vitamin D analogs do not induce skin atrophy, and so have become a regular player in the roster of topical therapies for psoriasis.

The efficacy and long-term safety of calcipotriol has been evaluated in a number of studies. One randomized, double-blind study of 49 patients evaluated the efficacy of twice daily calcipotriol solution (50 mcg/mL) over a 4-week treatment period. The study reported that 60% of patients treated with calcipotriol solution were clear or demonstrated marked improvement in their symptoms as compared with only 17% in the placebo group. The total sign score for scalp psoriasis (ie, sum of the scores for redness, induration, and scale) decreased by 49% in the treatment group compared with 19% in the placebo group (P=0.005). Patients’ self-reports also demonstrated that calcipotriol was superior in reducing scalp flaking and itch.³⁷

A more recent open-label, non-controlled study evaluating the effect of twice daily treatment of scalp psoriasis with calcipotriol scalp solution (50 mcg/mL) found the total sign score for scalp psoriasis reduced from 5.9 to 2.5 (P<0.001) over a 28-day treatment period.³⁸ No further reduction in disease severity was observed with continued treatment for a total of 52 weeks, but the percentage of patients assessing their scalp psoriasis as moderate-to-severe had decreased from 72% to 21%. There were no significant changes in mean serum calcium, parathyroid hormone or urinary calcium/creatinine ratio.³⁸

Studies directly comparing the effects of vitamin D analog monotherapy with very potent or potent steroid monotherapy consistently demonstrate the superiority of corticosteroids for the treatment of scalp psoriasis. A recent analysis of such trials revealed that corticosteroids provided approximately a 10% improvement in average scores compared with calcipotriol on a six-point global improvement scale (Investigators Global Assessment of Improvement).¹⁸ In addition, vitamin D derivatives take longer before an optimal improvement can be seen, approximately 8 weeks, as compared with only 2–3 weeks for corticosteroids.³⁹ Given the efficacy of both corticosteroids and vitamin D analogs in the treatment of psoriasis, it is not surprising that combination products have been developed and have quickly become a favored medication in the treatment of scalp psoriasis.

Vitamin D/corticosteroid combination products

A combination product containing calcipotriol 0.005% and betamethasone dipropionate 0.05% (Ca/BMD) (Daivobet^®/Dovobet^® gel; Leo Pharma Inc., Copenhagen, Denmark) has been found to be superior to its individual ingredients with a fast onset of action, and with no reports of atrophy, striae, purpura, or significant changes in serum calcium. Head-to-head with calcipotriol, more than twice as many patients (69% versus 31%) had absent or very mild disease after only 8 weeks of use.⁴⁰ Two additional long-term studies evaluating the efficacy and tolerability of Ca/BMD gel demonstrated similar results. In these studies, patients with scalp psoriasis evaluated for a 52-week treatment period reported absent-mild disease in 92%–100% of visits with Ca/BMD gel.⁴¹^,⁴² In addition, this product has now been tested in the adolescent population and has been shown to be safe and effective. ⁴³^,⁴⁴ Due to the formulation of Ca/BMD gel, use of clarifying shampoo applied to hair prior to entering the shower has been recommended to aid in removal of the product.

This combination of Ca/BMD is also being developed into an aerosol foam product with enhanced penetration. This combination foam product has been proven to be both safe and effective for body psoriasis and currently studies are underway in scalp psoriasis.⁴⁵^,⁴⁶

Intralesional therapies

Intralesional corticosteroids have been applied in practice, although specific studies evaluating the effects of this treatment regimen on scalp psoriasis are lacking. Anecdotal reports of their use exist, and in 2009, the US National Psoriasis Foundation recommended intralesional corticosteroids as second-line treatment for scalp psoriasis.⁵

TNF inhibition

Etanercept

The anti-TNF receptor fusion protein, etanercept, has the most clinical trial data supporting its use in scalp psoriasis. Etanercept was given in an open-label trial of 2,555 patients to compare continuous versus interrupted therapy.⁴⁸ PGA was the primary end point and ScPGA was reported as a secondary end point. All patients (continuous therapy and interrupted therapy groups) were treated with etanercept 50 mg twice weekly for the first 12 weeks of the study. Subsequently, the continuous therapy cohort continued with 50 mg once weekly for an additional 12 weeks; subjects in the interrupted therapy cohort held therapy (if subject achieved PGA ≤2) until they lost response, at which point etanercept was restarted at week 16 or 20 and was continued up until the end of the study at week 24.⁴⁸

After 12 weeks of etanercept 50 mg twice weekly, the continuous and interrupted groups achieved a mean percentage improvement from baseline in Psoriasis Scalp Scores of 57.5% and 58%, respectively. Up to week 24, after the continuous therapy group remained on 50 mg once weekly, the mean percentage improvement from baseline scalp score was maintained at 57. 6%, however the intermittent therapy group dropped to 42.9% improvement over baseline.⁴⁸

Also reported is a randomized, placebo-controlled trial assessing the safety and efficacy of etanercept for scalp psoriasis over a 24-week period.⁴⁹ In this study, Group A received etanercept 50 mg twice weekly for 12 weeks, followed by etanercept 50 mg once weekly for 12 weeks (n=62). Group B received placebo twice weekly for 12 weeks followed by 12 weeks of etanercept 50 mg twice weekly (n=62). The primary end point was percentage change in PSSI at week 12.⁴⁹ The etanercept group (Group A) had a mean PSSI improvement at week 12 of 86.8%, compared to only 20.4% in the placebo group (Group B) (P<0.0001). By week 24, Group A had a mean PSSI improvement of 90.6%, which was not significantly different from Group B, which had 79.1% improvement subsequent to initiating etanercept therapy at week 13. Eighty-six percent of patients in Group A achieved a PSSI-75 at week 12, compared with only 11% in Group B (P<0. 0001). However, at week 24, the PSSI-75 rates were similar at 86% and 72% for Group A and B, respectively. There was also improvement noted in scalp surface area involvement, with a mean percentage improvement at week 12 in Group A of 84.6% versus only 14.9% in Group B. At week 24, Group A maintained this benefit at 84.8%, while Group B showed improvement at 75.4%. Changes in overall PASI improvement were consistent with the PSSI improvements and time to improvement was similar; treatment also provided a high level of patient satisfaction.⁴⁹

Adalimumab

Although no formal study with the anti-TNF monoclonal antibody adalimumab in scalp psoriasis has been performed, a sub-analysis of the Phase 3 BELIEVE study was recently published.⁵⁰ Of the patients enrolled, 663/730 (91.3%) had scalp involvement. The BELIEVE study compared adalimumab with or without Ca/BMD ointment (applied to body, not scalp) in a randomized, controlled safety and efficacy trial. Patients with baseline scalp psoriasis had more severe disease and were slower to respond initially compared to patients without, but this was no longer significant by week 8, at which point the majority of patients had achieved a PASI-75 response and continued to improve by week 16. PSSI responses correlated with PASI responses. The median PSSI score in patients at baseline was 14, at week 8 was 1, and at week 16 was 0. By week 8, 75.6% of patients had achieved a PSSI response (PSSI ≤4) and by week 16, a median decrease from baseline of 100% (mean 77.2%±96.9%).⁵⁰

Infliximab

There are no formal studies of the anti-TNF chimeric monoclonal antibody infliximab in scalp psoriasis. However, one report on the results from different body regions of the combined three Phase 3 clinical trials (EXPRESS 1, EXPRESS 2, and SPIRIT) showed that the improvement in head and neck psoriasis (≥75% and ≥90% improvement) was significant for infliximab 3 mg/kg and 5 mg/kg versus placebo. Improvement was consistent with the overall PASI responses in all regions.⁵¹

Another sub-analysis of the PSUNRISE trial, a trial evaluating the effect of infliximab in patients who failed etanercept, was done looking at disease activity within four designated body regions (scalp, face, nails, and palms/soles) as assessed by investigators using a 10 cm visual analog scale at weeks 1, 10, and 26. Improvement was defined as a minimum of 1.1 cm reduction from baseline in patients who had clinically active disease in all areas. The regional response rate was highest for the scalp at week 10, compared to other areas examined.⁵²

IL-17a inhibition

Ixekizumab

A monoclonal antibody against IL-17a, ixekizumab, was analyzed in a post hoc analysis of the Phase 2 trial to determine the effect on scalp psoriasis.⁵⁵ A total of 105/142 (74%) patients enrolled in the Phase 2 program had scalp involvement with a mean baseline PSSI of 18.7 (SD 14.1). At week 12, the percentage improvement of PSSI from baseline was 87.1% (25 mg), 94.8% (75 mg), and 84.8% (150 mg) compared to 30.5% (placebo). By week 20, a PSSI of 0, or clear, was achieved in 58.3%, 66.7%, and 86.4% of patients receiving ixekizumab (25 mg, 75 mg, and 150 mg, respectively) compared to only 10% in the placebo group. At the end of the open-label period at week 48, all patients were receiving ixekizumab 120 mg every 4 weeks, and 78% of all patients had a PSSI of 0. ⁵⁵

Secukinumab

Secukinumab, another monoclonal antibody against IL-17a, which was approved for treatment of plaque psoriasis in 2014, currently has a Phase 3b trial in progress for patients with scalp psoriasis. Approximately 94 subjects who have a PSSI ≥12, a modified Investigators Global Assessment of ≥3 and ≥30% scalp area affected are included in the study. This 24-week study has a 12-week placebo-controlled period and is comparing secukinumab 300 mg to placebo in a 1:1 ratio.⁵⁶ Results of this study are eagerly awaited.

Psoriasis, Psoriatic Arthritis, and Hair Loss: Causes and Treatments

If you’re one of the roughly 2 percent of Americans who have psoriasis, a chronic condition that typically causes raised, red patches of skin topped with silvery scales, there’s a good chance that it has impacted your scalp. This also holds true for the more than 40 percent of people with psoriasis who also have psoriatic arthritis (PsA), a form of arthritis that can appear in combination with psoriasis.

Psoriasis causes skin cells to divide about 10 times faster than normal. The excess cells pile up on the surface of the skin, causing scaly patches of itchy, dry skin. Known as plaques, these lesions often itch, burn, and sting.

How Psoriasis and Psoriatic Arthritis Affect the Scalp

For many patients, the scalp is the only part of the body where psoriasis occurs — or it’s the first location where the autoimmune disease develops.

Research shows that at least a quarter of people with plaque psoriasis, the most common type of psoriasis, initially present with lesions on the scalp.

“It’s very common for psoriasis to affect the scalp — statistics show a range of 40 percent to 80 percent of people with psoriasis have scalp involvement,” says Mount Kisco, New York, dermatologist David Bank, MD, who is also an assistant clinical professor of dermatology at Columbia Presbyterian Medical Center in New York City. “It may occur in isolation or with psoriasis in other areas.”

Scalp psoriasis can run the gamut from mild (with thin dandruff-like flakes that are hardly noticeable) to severe (in which plaques can be so thick and inflamed that they’re visible through your hair).

Sometimes, in addition to the scalp, plaques also cover nearby areas such as the forehead, back of the neck, and the skin around the ears.

The Impact of Scalp Psoriasis and Hair Loss

It’s not really known why the scalp is so susceptible to psoriasis. One possible reason it’s such a prime area is that the high follicular density of the scalp (meaning: there are a lot of hair follicles there) reduces natural light exposure. Ultraviolet rays from light exposure can help clear or prevent psoriasis.

Although scalp psoriasis alone involves a small percentage of the body, it can have a profoundly negative affect on a person’s quality of life and self-esteem. But when it leads to hair loss —psoriatic alopecia in doctor-speak — it can be particularly distressing.

“The decrease in hair density is typically mild and difficult for the doctor to see, but of course, we take it very seriously,” says Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida, and medical advisor for CreakyJoints.

Rest assured, once scalp psoriasis is under control, most people with hair loss experience complete regrowth of their hair.

The key is to seek medical help promptly, since scarring that results from psoriasis — common in longstanding scalp psoriasis — can cause permanent hair loss.

The Connection Between Hair Loss and Psoriasis and Psoriatic Arthritis

There are a few causes of psoriatic alopecia, including the disease itself.

Inflammation

“Psoriasis is an inflammatory condition and when the scalp is inflamed, the hair follicles [where hair is produced] can be affected,” says Mona Gohara, MD, associate clinical professor of dermatology at Yale School of Medicine in New Haven, Connecticut.

Damage from Scratching

Trauma to the scalp that often results from scratching or picking at the scaly spots can also trigger hair loss. “Scalp psoriasis can be particularly itchy. Scratching it to remove the scale can aggravate the problem and lead to more hair loss, a response known as the Koebner phenomenon,” says Dr. Gohara.

Increased inflammation can, in turn, increase itching, which creates an ever-worsening cycle that can ultimately (though, thankfully, rarely) lead to scarring. Hence the reason mane management requires early intervention. “Once the follicle is scarred, it’s not going to regrow hair,” says Dr. Gohara.

Medication Side Effects

Some medications used to treat psoriasis and psoriatic arthritis are also associated with hair loss, which tends to affect the areas covered in plaques. Hair loss is most common with methotrexate, a type of DMARD (disease-modifying antirheumatic drug) that works to quiet the immune system.

“It’s technically a chemotherapy medication and most of them affect the turnover of cells, including those responsible for hair growth,” Dr. Bank explains. While hair loss is not a very common side effect of methotrexate, it can cause 5 to 10 percent of people to experience hair loss.

Stress

Ironically, because stress is a trigger for psoriasis and psoriatic arthritis, the anguish over losing your hair can exacerbate plaques and potentially make hair loss even worse. “People don’t often talk about the stress associated with psoriasis, but having that in your hair and not being able to style your hair, or having to scratch or to have the flakes on your clothes, it’s embarrassing,” says Dr. Gohara. “All of that can create stress.”

Treatments to Clear Scalp Psoriasis and Stop Hair Loss

The good news is that there are many effective ways to treat scalp psoriasis. Once your skin clears, your hair will usually grow back.

The bad news is that scalp psoriasis can sometimes be difficult to treat. Hair makes the scalp inaccessible for topical therapies, which are thick and gooey and hard to get in and out of your hair.

“The practicality of applying a cream, ointment, or foam into the scalp makes it difficult for topical treatment of psoriasis of the scalp,” says Dr. Gohara. “If you don’t wash your hair every day, who the heck wants to slather creams and ointments on their scalp?”

This is especially problematic for Black and brown-skinned people, she says, who tend to wash their hair more infrequently.

Treatment depends on the severity of the condition.

Topical steroids

For mild-to-moderate cases of scalp psoriasis, your doctor will likely recommend topical treatments. Corticosteroids, which work to normalize cell production, are the mainstay of topical treatments, though they’re often used in conjunction with phototherapy and systemic and targeted drugs.

Steroids are available in prescription creams, ointments, foams, and are prescribed for twice-daily use for two weeks.

Usually, doctors recommend that you apply the steroid to your scalp at night and then wash your hair in the morning. “For people who shower at night, it becomes more challenging because they don’t want to use the treatment during the day,” says Dr. Domingues, who prescribes a steroid shampoo in those cases. “Allowing it to sit on your scalp for about 10 minutes helps make it more effective,” he says.

Topical therapy may exacerbate hair loss by friction and breakage of the hair, so it’s important to gently apply medication only to roots.

Steroid injections

If the topicals don’t clear the plaque lesions and control symptoms, or the plaques are very thick and scaly, steroid injections directly into the scalp can be administered. Though these can be painful, they can address the psoriasis and be more compatible with people’s hairstyles and hair-care practices.

Medicated shampoo

Steroids are often used in conjunction with over-the-counter shampoos formulated with coal tar and salicylic acid, ingredients that act to slow skin cell growth and soften and remove scales so prescription topicals can penetrate better.

Shampoos to look for include:

Neutrogena T/Sal shampoo (contains salicylic acid)
Dermarest Psoriasis Medication Shampoo Plus Condition (contains salicylic acid)
MG217 3% Coal Tar Formula Shampoo
Psoriatrax 5% Coal Tar Psoriasis Shampoo

Medicated shampoos work best if left on the scalp for five to 10 minutes.

Systemic treatment

For psoriasis and psoriatic arthritis, systemic therapy means taking a medication — such as an oral pill, an injection, or an infusion — that helps stop the immune system overactivity that is causing plaques to develop.

Systemic treatment for psoriasis or psoriatic arthritis that is affecting the scalp generally falls into three main categories:

Conventional disease-modifying antirheumatic drugs (DMARDs), which are usually taken orally and include medication such as methotrexate
Targeted disease-modifying antirheumatic drugs (DMARDs), which are oral pills that are more targeted than conventional DMARDs
Biologic disease-modifying antirheumatic drugs (DMARDs), which are administered as injections or infusions and are more targeted than conventional DMARDs

It isn’t usually considered unless scalp psoriasis is moderate to severe, but Dr. Gohara reports that even in mild-to-moderate cases of scalp psoriasis, many patients request to be put on biologics, a type of drug that targets specific parts of the immune system that are overactive.

“Scalp psoriasis is like this bugaboo where people go from zero to 100,” says Dr. Gohara. “Patients are like, ‘I’m not going to do the creams, I’m going to do the biologics.’ Scalp psoriasis really bothers people, especially if it’s bad. It can be inflamed and get infected easily.”

It often makes people very self-conscious. “If you have it on your elbow, you can cover it,” says Dr. Gohara. “You can’t cover psoriasis on your scalp.”

Targeted therapies that are FDA-approved to treat both psoriasis and PsA fall into several categories based on the specific immune system proteins they target.

Biologics (injections and infusions)

Approved biologic disease-modifying antirheumatic drugs (DMARDs) for psoriasis and psoriatic arthritis include:

Tumor necrosis factor (TNF) inhibitors

Adalimumab (Humira)
Certolizumab pegol (Cimzia)
Etanercept (Enbrel)
Golimumab (Simponi, Simponi Aria)
Infliximab (Remicade)

Interleukin inhibitors (IL-23 and IL-17)

Guselkumab (Tremfya)
Ixekizumab (Taltz)
Secukinumab (Cosentyx)
Ustekinumab (Stelara)

T-cell inhibitors

Targeted synthetic DMARDs (oral pills)

Approved targeted synthetic disease-modifying antirheumatic drugs (DMARDs) for both psoriasis and psoriatic arthritis include:

Janus kinase (JAK) inhibitors

PDE4 inhibitors

As effective as they are, targeted therapies don’t completely erase the need for topical treatment. “They might clear your psoriasis, but most derms will have you on a topical as well — it’s like the cherry on top to help keep your scalp clear,” says Dr. Gohara. The need for topicals should be lessened, though, when you’re on a systemic therapy.

It’s important to be aware that people lose hair for many reasons, so if treatment isn’t stopping your hair loss, be sure to tell your health care provider. Your hair loss could be caused by something other than scalp psoriasis.

For instance, people with psoriasis are at greater risk of developing alopecia areata, an autoimmune disease that develops when the body attacks its own hair follicles, which can cause hair loss. Your health care provider can help determine the cause of your hair loss.

Tips for a Healthy Scalp and Hair with Psoriasis and Psoriatic Arthritis

Psoriasis and psoriatic arthritis are chronic conditions that can flare up. These tips for treating your tresses (and your scalp) with TLC can help prevent or manage a flare and a subsequent bout of hair loss:

Brush and comb hair gently

“Psoriasis scale can adhere to the hair, which gets pulled out when the scale is removed,” says Dr. Bank. Instead of forcefully removing the scale by picking at it, aim to first loosen it by gently brushing or combing and then remove it by washing with a salicylic acid or coal tar shampoo. Be sure to keep nails short to minimize hair breakage and gently blot and squeeze — don’t rub — post-shampoo with a soft T-shirt or microfiber towel to remove excess water.

Scratching, scraping, or irritating your scalp can trigger a psoriasis flare.

Shampoo regularly

“Psoriasis responds well to frequent hair washing,” says Dr. Bank. “People often decrease hair washing because they erroneously think their scalp is dry and that the additional shampooing is worsening the condition.”

Dryness is due to the buildup of skin cells; shampooing regularly with a medicated shampoo (twice a week for maintenance) breaks down or softens the crusty scales so they’re easier to remove without damaging the hair or further irritating the scalp. It helps make topical medications more effective as well.

Condition regularly

Dry hair is more likely to break, which can lead to hair loss. If medicated shampoo is overly drying, alternate it with a gentler, non-medicated shampoo.

Be cautious about coloring your hair

Don’t dye your hair unless your psoriasis is under control, advises Dr. Domingues. “Putting chemicals on an already inflamed area can worsen your condition.”

Minimize the use of heat

Allow your hair to air dry or use a blow dryer on the lowest setting. Don’t let curling irons, flat irons, or other thermal instruments touch your scalp. The heat can irritate or burn your scalp, which can trigger a flare.

Avoid tight hairstyles

Pulling too tightly on the hair can irritate the scalp and cause a flare. Over time, the continuous tension on the hair follicles caused by the constant pulling of hair can lead to hair loss.

Track Your Psoriatic Arthritis Symptoms with ArthritisPower

Join CreakyJoints’ patient-centered research registry and track symptoms like fatigue and pain. Learn more and sign up here.

Dermarest Shampoo Plus Conditioner, Medicated, Psoriasis, 8 fl oz (236 ml)

Dermarest Shampoo Plus Conditioner, Medicated, Psoriasis, 8 fl oz (236 ml) | Rite Aid

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From the Manufacturer

PRODUCT DETAILS

Item No. 0313224

The Demarest Shampoo Plus Conditioner medicated formula relieves itchy scalp caused by psoriasis and seborrheic dermatitis. Its added conditioner restores moisture. The zinc complex combined with salicylic acid soothes dry scalp and strengthens hair while reducing and controlling crusty build-up. This shampoo plus conditioner is fragrance-free and contains natural extracts.

Relieves and helps prevent recurrence of scalp itching, irritation, redness, flaking and scaling due to psoriasis
Specially formulated with 3% salicylic acid and a unique zinc complex to treat psoriasis and relieve the symptoms of psoriasis
This fragrance-free shampoo plus conditioner removes and controls scalp build-up, soothes irritation, eliminates itching, and restores moisture
This medicated shampoo plus conditioner is dermatologist tested and recognized by the National Psoriasis Foundation

MORE INFORMATION

More Information
Product Name	Dermarest Medicated Shampoo Plus Conditioner for Psoriasis – 8 fl oz
Package Count	1
Container Type	box
Hair Type	Dry
Model	73020
Country of Manufacture	United States
Ingredient Preference	Dermatologist Tested, Fragrance Free
Prop 65	No

INGREDIENTS

Active Ingredients: Salicylic acid (3%). Purpose: Psoriasis and Seborrheic Dermatitis Treatment Inactive Ingredients: Purified Water, Ammonium Lauryl Sulfate,

SAFETY

For external use only. Ask a doctor before use if you have psoriasis that covers a large area of the body. When using this product: avoid contact with the eyes. If contact occurs, rinse the eyes thoroughly with water. Stop use and ask a doctor if: condition worsens or does not improve after regular use as directed. Keep out of reach of children. If swallowed, get medical help or contact a poison control center right away.

Reviews 1

Customer Reviews

Irritated scalp
Skin is very irritated to some shampoos
Review by

J J
Posted on

11/28/20

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Choice of shampoo for psoriasis

For scalp affected by psoriasis, conventional and universal shampoos are not suitable at all – they can further increase inflammation. Such products contain harder and more aggressive components that wash out the microflora from the roots. Synthetic preservatives, flavors and colors in the formulation can cause an allergic reaction. For damaged skin, only those preparations are suitable that have healing properties and can provide gentle care.

Specialized shampoos for the treatment of psoriasis contain medicinal substances or natural extracts that have a mild effect on tissues and have antibacterial properties. Try mineral psoriasis shampoos and you will see immediate positive effects.

The main task of such products is to relieve inflammation as much as possible, remove irritation and itching, cleanse the skin of dead skin particles. Therefore, with psoriasis, you should abandon the usual shampoo in favor of a remedy.

Tar shampoos soothe itching, reduce skin irritation and strengthen the scalp, which also serves as an additional preventive measure against hair loss in psoriasis. Gentle cleansing without overdrying the skin, the most delicate effect is exactly what is needed for proper care.

Antimycotic shampoos are effective in the complex therapy of secondary fungal infections. The balanced composition and content of antimycotic components make them effective, but the most effective option is recommended to be selected based on the characteristics of the course of the disease.

Cosmetic maintenance shampoos. Gentle scalp care is necessary during periods of exacerbation and during remission. Cosmetics from this category help to cope with dandruff, get rid of excessive dryness of the scalp, which can lead to aggravation.

You can select and buy shampoo for the treatment of psoriasis in the online store Psor-service.ru

90,000 Most Effective Shampoos for Psoriasis, Seborrhea and Dandruff

Common treatment options for scalp psoriasis include dermatological shampoos that can be used at home, but for severe scalp psoriasis, the person usually needs to be treated by a dermatologist who may prescribe steroid creams or salicylic acid.Although psoriasis can come back multiple times, it rarely lasts for a long period of time and usually escalates into flare-ups.

Dermatologists, to help their patients get the most out of scalp psoriasis treatment and seborrhea treatment , often give the following advice to their patients:

Try not to damage the scalp, do not scratch. Dermatologists understand that 90,019 scalp psoriasis 90,020 causes very severe itching, but scratching worsens psoriasis and the condition gets worse.Scratching can cause bleeding on the scalp. It can also lead to noticeable hair loss. Therefore, it is necessary to relieve itchy skin by treating psoriasis. When the psoriasis clears up, the itching stops. It is necessary to use shampoo against psoriasis, but do not rub the shampoo into the head, as is often done, in order to speed up the release of psoriasis, as this makes psoriasis even worse. Remove the scale with care, first loosen the scale and then remove it gently.Descaling can cause psoriasis flare-ups, and combing can also lead to hair loss.

Dermatologists recommend using a skin emollient that contains salicylic acid and is able to soften thick and inflamed psoriasis spots. Softening of such spots is also possible with medical methods, various ointments. When using medications (ointments), do not forget to comb your hair to the side so that the ointment is applied to the skin and not to the hair.

Try not to psychologically get hung up on psoriasis, psoriasis outbreaks can be stressful, and stress can worsen the situation.Stress can also trigger psoriasis and hair loss. Try to be relaxed, a satisfied psychological state can work wonders.

90,000 Best American Shampoos for Psoriasis, Dandruff and Seborrheic Dermatitis

Common scalp psoriasis 90,019 treatment options include 90,019 dermatological shampoos 90,020 that can be used at home 90,019 90,020, but for severe scalp psoriasis 90,019 90,020, the person should generally be treated by a dermatologist who can prescribe steroid creams or salicylic acid.Although psoriasis can come back multiple times, it rarely lasts for a long period of time and usually escalates into flare-ups.

Dermatologists often give the following advice to their patients to help their patients get the most out of their scalp psoriasis and seborrhea treatments:

Try not to damage the scalp, do not scratch. Dermatologists understand that 90,019 scalp psoriasis causes very severe itching, but scratches make psoriasis 90,020 worse and worse.Scratching can cause bleeding on the scalp. It can also lead to noticeable hair loss. Therefore, it is necessary to relieve itchy skin by treating psoriasis. When the psoriasis clears up, the itching stops. It is necessary to use shampoos, but not to rub the shampoo into the head, as is often done, to speed up the release of psoriasis, as this makes psoriasis worse. Remove the scale with care, first loosen the scale and then remove it gently. Descaling can cause psoriasis flare-ups, and combing can also lead to hair loss.

Dermatologists recommend using a skin emollient, anti-dandruff shampoo that contains salicylic acid and is able to soften thick and inflamed psoriasis spots. Softening of such spots is also possible with medical methods, various ointments. When using medications (ointments), do not forget to comb your hair to the side so that the ointment is applied to the skin and not to the hair.

90,000 Local treatment of scalp psoriasis

Relevance

People with chronic plaque psoriasis often have lesions on the scalp. In addition to itching, redness, scaly lesions are visible and often cause shame / embarrassment in patients. “Topical” treatments (drugs applied directly to the skin, such as creams) are usually used first, but hair is difficult to apply to the scalp.There are many topical medicines such as corticosteroids (also known as steroids), vitamin D, tar or tar preparations, tacrolimus, dithranol, or salicylic acid. Some topical corticosteroids are more potent than others. Therefore, they are categorized according to four levels of strength: weak, moderate, strong, and very strong. Since psoriasis is a long-term (long-term) condition, it is very important to know which drugs work best, what side effects they might have, and how likely they are to occur.

Review Question

What are the safest and most effective treatments for scalp psoriasis?

Characteristics of research

We reviewed 59 randomized controlled trials with 11,561 participants. Thirty studies were either conducted or sponsored by the manufacturer of the investigational drug.

Quality of evidence

Overall, the overall quality of the evidence was moderate for the three most important comparisons involving corticosteroids (eg betamethasone dipropionate), vitamin D (eg calcipotriol), and combinations thereof.We evaluated the reduction in the severity of psoriasis, the improvement in quality of life, and the harmful side effects of treatment. Most of the results were based on short-term treatment, lasting less than six months.

Key Outcomes

Previous investigators found that the combination drug was more effective than the steroid alone [monotherapy], but the clinical benefit was questionable. Both treatments reduced psoriasis more than vitamin D.

Due to insufficient information, we could not assess which of the treatments improved the quality of life the most. Most studies simply did not assess (measure) the improvement in quality of life.

Participants who received vitamin D supplements were more likely to discontinue treatment for harmful side effects than those who received topical steroids or combination medications. Discontinuation rates due to side effects were similar for both steroid and combination drugs.However, only a small number of participants using one of the three drugs experienced harmful side effects. None of the studies reported the type of side effect that led to discontinuation of treatment.

Participants rated the efficacy of treatment similarly to researchers: those who received steroids or combination drugs responded better than participants who used vitamin D. was questionable.

The most common harmful side effects of these treatments were skin irritation, itching and soreness at the site of application. Side effects elsewhere in the body were very rare and most likely not caused by the drug.

Other results were as follows: steroids, vitamin D and their combinations were more effective than drug diluents (cream, shampoo, etc.) that did not contain the active substance. Compared to each other, steroids showed similar efficacy and similar side effects, although some were more potent.

We have not been able to adequately assess the efficacy and safety of other topical treatments such as salicylic acid, tar or dithranol.

Conclusions

Steroids and a two-component combination of steroid and vitamin D were most effective with the least risk of harmful side effects. Given the similar safety profile and only marginally greater benefits of a two-component drug than a steroid monotherapy (steroid only), topical steroids alone may be completely acceptable for short-term treatment.

The following questions remain unanswered and need to be investigated in future clinical trials: Are there really no differences in efficacy and safety between topical corticosteroids of different potency? Can the diluent of the drug (for example, cream or shampoo) have any effect on the action of the active ingredients of the drug? Which topical treatment can control the disease over a longer period of time without compromising patient safety? Finally, more research is needed to assess which topical treatments are most likely to improve quality of life.

Shampoos for scalp psoriasis: the best shampoos for psoriasis on the scalp

Psoriasis is a chronic ailment not related to infections. The disease is characterized by the presence of flaky patches of red hues. Sites of the disease include elbows, knees. There may also be a disease of the scalp. In severe forms, joint diseases appear. Psoriasis can occur due to genetics. It also manifests itself due to interaction with chemicals, detergents.The occurrence of the disease is influenced by an unstable emotional state, climate change, dry skin, and medication.

Itching occurs on the scalp, which causes scratching. Don’t scratch your head too much. In comparison to dandruff, the scaling causes small blood sores. In the treatment of psoriasis of the scalp, medicinal ointments, solutions and shampoos are used. Alopecia can occur due to psoriasis. Naturally, patients are interested in the question of how to wash their hair with psoriasis.Against these ailments, you can use the “Etrivex” therapeutic shampoo.

The most effective shampoo for eliminating psoriasis of the scalp has an analgesic, anti-fungal, anti-inflammatory effect. Medicinal plants compete with him.

Psoriasis: ointments, creams, shampoos. What I used, what helped and what did not. My Creams and ointments for today.

Using tar shampoos

Tar shampoo for psoriasis consists of birch tar, willow, pine, juniper.With the help of active substances in tar, excess sebum is eliminated. As a result, the skin is cleansed, fat is eliminated, inflammation, peeling, itching are removed. Tar eliminates skin fungus. The best remedies against the disease are shampoos “Friderm” Tar “,” Psorilom “,” Tar for a bath “from” Granny Agafia “,” Algopix “.

Shampoo for psoriasis “Psoril” is enriched with birch tar, St. John’s wort extract, celandine, chamomile, string. It relieves itching. Shampoo “Friderm” Tar “is used to eliminate oily seborrhea.

Medicines based on tar can be used to treat psoriasis, seborrhea, dermatitis. If you are allergic to the substances of the tar agent, then it is better to choose another drug. The shampoo is applied to moisturized hair. After 5 minutes of massage, it can be washed off.

Tar shampoo its benefits and how to use

Antifungal shampoos

Against psoriasis of the scalp, shampoos such as Nizoral, Keto Plus, Squafan, Boderma, Vichy are used.They rid the scalp and hair of fungi. Their main substance is ketoconazole. The constant use of funds eliminates fungal infections, itching, wounds.

“Nizoral” should be used like a classic shampoo. It is used for lichen, dandruff, seborrheic dermatitis. Shampoo “Keto Plus” eliminates flaking and painful itching.

Antifungal shampoos for humans: the price of medicinal preparations

Healing shampoos for psoriasis

These shampoos are made with ichthyol, zinc, salicylic acid, urea.These substances have an antibacterial, antimicrobial effect. This effect has a shampoo “Etrivex”. With them, the skin is moistened, fungi are eliminated. You can buy psoriasis shampoo over the counter. One of the best is Skin-Cap shampoo, which treats dermatitis, seborrhea, psoriasis. It should be used on damp hair and then rinsed. It should be used once a week.

There is an aerosol from the “Skin-Cap” company. It is intended for outdoor use. The tool has an excellent effect when used about 3 times a day.Shampoo “Etrivex” brings results.

My hair care for psoriasis of the scalp. How do I dye my hair?

Cosmetic shampoos

Cosmetic shampoos are used against the scalp. They can also be used for sensitive skin types. They contribute to its recovery, normalization of sebum production, and elimination of dandruff.

Against the disease are used “Friderm Balance”, “Sulsena” with antifungal action.There is no need to expect the effect of eliminating psoriasis, since their main purpose is cosmetic.

Anti-dandruff shampoos: work or not, how to choose, how to use

Children’s shampoos

Children’s shampoos contain no fragrances, preservatives, dyes, or aggressive ingredients. These products have an optimal ph level, due to which dry, irritated skin is eliminated. The best products are shampoos such as Johnsons Baby, Bubchen, Natura Siberica.

https://youtu.be/DAf_cnei7k0

Tips for eliminating psoriasis

It is important to follow the recommendations against an ailment:

Do not scratch sores so as not to infect the skin, because this can cause inflammation to spread greatly …
Rub the psoriasis ointment with your fingers, not your nails.
Use any shampoo according to the instructions.
When treating an ailment, do not dye your hair.
No need to use a hairdryer.
To prevent chlorinated water from aggravating the situation, use a rinse aid. To prepare it, you need to mix vinegar (60 g) and water (180 g). The composition is used to rinse the head.
A compress based on olive oil has a soothing effect. It is advisable to perform the procedure at night. Massaging the oil is rubbed into the skin, after which you need to rinse your head with shampoo and water.

Whichever shampoo you choose, you need to use it regularly.The alternation of funds has an excellent effect. For example, you can first use medicated shampoos, and then tar. The most suitable remedy can only be prescribed by a doctor. And the wrong method of treatment can only aggravate the disease. If you start treatment on time, you can quickly get rid of it.

SUPER TIPS! PSORIASIS! CAUSES OF PSORIASIS AND METHODS OF FOLK TREATMENT!

CreamMe dermatological agent

CreamMe shampoo has an effective effect.It is prescribed for psoriasis, atopic dermatitis, urticaria, dry skin. Regular use brings results quickly.

Shampoo for all hair. Its therapeutic effect helps to eliminate dermatological ailments. The composition contains only natural ingredients that cure skin and hair.

Application of the “Etrivex” shampoo

For the treatment of psoriasis, the “Etrivex” shampoo is used. It must be used with caution, since an exacerbation of the disease is possible after the end of treatment.In any case, it is worth starting to use Etrivex after consulting a doctor.

Etrivex shampoo should only be used as directed, that is, for the treatment of psoriasis. It should not come into contact with the skin of the face, eyelids, eyes. If, nevertheless, Etrivex remains in these areas, rinse thoroughly with running water. Shampoo should be used for a short time. If the disease remains, then a second course with “Etrivex” is necessary.

Hair care for psoriasis

In addition to using medications for psoriasis, proper hair care is important.It is necessary to wash your hair often. Baby soap is suitable for dry hair. If the disease is intense, then you need to use it for 1.5 months. 1 hour before the washing procedure, it is necessary to treat the skin with vegetable oil, after which it is necessary to tie it with polyethylene and a towel.

Dry and oily hair types after washing must be rinsed with boiled water and vinegar (in a ratio of 1 liter to 1 tbsp. L.). Lemon juice (from 1 fruit) can be used instead of vinegar. In rinsing, tinctures of nettle, oak bark, St. John’s wort, coltsfoot are used (8 tbsp.l. mixture for 1 liter of water).

Hair must be combed carefully, only after it is completely dry. Dandruff is eliminated with “Karmazin”, “Cinchona bark extract”. For normal and oily curls, they are used every day. To eliminate itching, you can use a tincture with calendula (1 tsp for 1 glass of water).

It is necessary only in rare cases to use hair dryers, electric tongs, hot rollers. Chemicals are also harmful to use. And it is better to dye your hair with henna, basma, coffee and other natural ingredients.The procedures with them are quite simple, and the preparation of cosmetics is very simple.

It is not so easy to eliminate psoriasis. Constant use of medicinal products is necessary. In addition to shampoos, ointments are sold in pharmacies. High-quality care with the use of medicinal products will allow you to get rid of psoriasis at home.

Psoriasis of the scalp. Shampoos

In this article, we will offer our patients a range of choices for the care of the scalp affected by psoriasis.These shampoos can significantly make life easier for patients, but it is still better to use an integrated approach to treating the disease and use natural medicines as the main treatment for psoriasis. Of natural creams and ointments, it is best to use products that are generally free of side effects and are hypoallergenic; among similar drugs on the pharmaceutical market, highly effective antipsor phyto-ointment is in wide demand, which is known for its effectiveness in treatment in 96% of cases, according to statistics from world scientists.Remission of psoriasis promises a duration of up to tens of years, taking into account the observance of all medical recommendations. Today it is the most relevant and effective remedy of all available on the pharmaceutical market. Antipsor is also the best preventive measure. Using Antipsor, as well as all the recommendations of a dermatologist, and the most suitable shampoos for you, you will easily achieve successful results in the fight against psoriasis of the scalp.
So, let’s consider what shampoos are available:

NanoNaftalan Hair Shampoo

Perfectly removes the surface layer of the epidermis from the scalp, eliminating itching, and promotes the fastest healing of wounds.Well softens the skin, activating regeneration processes in the epidermis. Nanocapsules penetrate into the deep layers of the skin, maintain the natural level of hydration, provide remission for a long time, exfoliating psoriatic plaques. NanoNaftalan Hair Shampoo makes the scalp more delicate, giving the hair a fresh and pleasant scent. The line of cosmetics “NanoNaftalan” also contains shower gel and cream-hair balm. NanoNaftalan Shampoo – Order

Nizoral

It is very popular among patients with psoriasis in its use.Dermatovenereologists advise using this shampoo, which helps to get rid of psoriatic plaques as easily as possible. The effect of the shampoo can be observed already after 3-4 head washes. At first, there may be a burning sensation, but this side effect usually disappears several times after using the shampoo. In some cases, it can dry the skin, the individual reaction of the body is unpredictable, therefore, in this case, you can use a moisturizer suitable for your skin type, but not oily, but water-based.Shampooing can be alternated with a neutral shampoo, it is best to take a baby shampoo.

Friderm tar

This shampoo is excellently practiced in dermatological practice, it contains refined coal tar. This shampoo is actively used for seborrheic dermatitis, seborrheic dermatitis and psoriasis. It inhibits the proliferation of epidermal cells, has a vasoconstrictor, astringent and antifungal effect. Removes the surface layer of dead cells of the epidermis from the skin.This shampoo has 2 drawbacks – it can cause dry skin and has an unpleasant odor.

Shampoo “Tana Tar”

This shampoo basically contains highly purified birch tar, a complex of dietary supplements – provitamin B5, allantoin. Suitable for patients with psoriasis as well as atopic dermatitis and eczema. The Tana line of cosmetic products also includes shower gel, hair balm and liquid soap.

Biorg Laboratories Squafan S Shampoo

This shampoo has been specially developed for hygiene of the scalp with severe flaking.It contains salicylic acid, resorcinol, red juniper essential oil. It has a calming effect and relieves itching well, as well as skin irritation, and, most importantly, has a rather pleasant smell. Perfectly combined with Squafan cream mask.

Node K shampoo-cream from Bioderma

Created specifically for patients with a pronounced chronic squamous condition of the scalp, which is accompanied by severe inflammation and itching, i.e.e. with psoriasis. The shampoo has a keratolytic, keratolytic and soothing effect. This shampoo contains ichthyol, zinc pyrithione, juniper essential oil, salicylic acid.

Kertiol S from Ducray

This is a kerato-regulating shampoo containing curtiol, salicylic acid, zinc thiosalicylate. Perfectly removes flaking and soothes itching. Can be used in combination with Kertiol S.

Keratoregulating Cream

Read also:

Types of therapy for pediatric psoriasis

Localization of children’s psoriasis.Antipsor therapy

Types of children’s psoriasis

Psoriasis Shampoo For shiny, vibrant, lush hair Trending Beauty Items

Product & Suppliers:

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Psoriasis Shampoo on Alibaba.com can be conveniently used in hotels, spas, salons and at home. The form. Psoriasis Shampoo can range from gel, powder to liquid. Nourishing ingredients such as Moroccan argon oil or tea tree oil will keep your hair healthy and plump. shampoo for psoriasis are suitable for effectively cleansing the scalp and rejuvenating the mane. The main advantages of the products are moisturizing, herbal, environmentally friendly, sulfate-free and much more.They moisturize, nourish and add shine to the hair. The volume and packaging of the bottle can be changed according to your needs. OEM / ODM printing options are also available.
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Psoriasis Hair Shampoo: How to Choose the Best Shampoo for Scalp Psoriasis

Understanding Scalp Psoriasis and Shampoo Ingredients

Prescription Steroid Shampoos for Severe Scalp Psoriasis

Potential Side Effects of Psoriasis Shampoos

Choosing the Best Psoriasis Shampoo for Your Needs

Top Recommended Psoriasis Shampoos

Maintaining Healthy Hair and Scalp

Key Takeaways

Psoriasis Shampoo: How to Choose

Coal Tar Shampoos

Salicylic Acid Shampoos

Shampoo With Steroids

5 Best Shampoos for Scalp Psoriasis — Best Psoriasis Shampoos, According to Dermatologists

Tips for Managing Symptoms of Scalp Psoriasis

5 Best Scalp Psoriasis Treatments & Remedies, Say Dermatologists

The best scalp psoriasis treatments

Shampoos and solutions

Oral medications

Light or laser therapy

Biologics

Home remedies

Management of scalp psoriasis: current perspectives

Shampoos

Topical treatments

Salicylic acid

Coal tar

Dithranol (anthralin)

Topical corticosteroids

Vitamin D derivatives

Vitamin D/corticosteroid combination products

Intralesional therapies

TNF inhibition

Etanercept

Adalimumab

Infliximab

IL-17a inhibition

Ixekizumab

Secukinumab

Psoriasis, Psoriatic Arthritis, and Hair Loss: Causes and Treatments

How Psoriasis and Psoriatic Arthritis Affect the Scalp

The Impact of Scalp Psoriasis and Hair Loss

The Connection Between Hair Loss and Psoriasis and Psoriatic Arthritis

Inflammation

Damage from Scratching

Medication Side Effects

Stress

Treatments to Clear Scalp Psoriasis and Stop Hair Loss

Topical steroids

Steroid injections

Medicated shampoo

Systemic treatment

Biologics (injections and infusions)

Targeted synthetic DMARDs (oral pills)

Tips for a Healthy Scalp and Hair with Psoriasis and Psoriatic Arthritis

Brush and comb hair gently

Shampoo regularly

Condition regularly

Be cautious about coloring your hair

Minimize the use of heat

Avoid tight hairstyles

Track Your Psoriatic Arthritis Symptoms with ArthritisPower

Dermarest Shampoo Plus Conditioner, Medicated, Psoriasis, 8 fl oz (236 ml)

Choice of shampoo for psoriasis

Shampoos for scalp psoriasis: the best shampoos for psoriasis on the scalp

Using tar shampoos

Antifungal shampoos

Healing shampoos for psoriasis

Cosmetic shampoos

Children’s shampoos

Tips for eliminating psoriasis

CreamMe dermatological agent

Application of the “Etrivex” shampoo

Hair care for psoriasis

Psoriasis of the scalp. Shampoos

Psoriasis Shampoo For shiny, vibrant, lush hair Trending Beauty Items

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