Scalp Psoriasis

Factual Questions
1

I’ve done a bit of googling but I was hoping the Teeming Millions could give me the dope on this nasty affliction…

I’ve never had a worse “disease” than a cold but at the ripe old age of 34 my head is breaking out all nasty like…

I bought some coal tar shampoo and some salicylic acid ointment… even shaved my whole damn head today.

So are these treatments a real cure or do they just treat the symptoms? What would bring this on out of nowhere?

Is scratching and peeling off big tasty chunks of skin ill advised?

2

Psoriasis is one of Gods little practical jokes. Had it for years. Pulling up chucks of scalp is normal, but not advised. Basically, your skin is always wearing off and replacing itself at a steady state rate. But if you have a cut or abrasion it goes into hyper growth. With psoriasis this doesn’t turn off and skin piles up faster than is sloughs off. It’s common to have outbreaks where you’ve previously had an injury. Topical tar has some effect, salicilates are more for the itching, and my best relief is from topical steroids for my scalp and UV for my skin. Beach is good, and I have a light. Immune system mediation is a factor, stress can trigger it and hardcore anti-inflamatory or immunosuppresants are used for severe cases. Don’t let the lesions dry out, good luck,
Larry

3

If you really shaved your head, try and get some sun on it. Sorry to say, but it’s managable at best

4

Thanks for the reply outlierrn. So maybe I caused it by scratching too hard and causing an abrasion? I did exactly that before Christmas when I was on a camping trip and couldn’t shower for a few days.

Are the topical steroids available OTC or would I need a prescription?

And yeah, while I did take off all the hair using clippers, I can’t say I shaved it. The hair is roughly 0.5mm all over now.

Sun, huh?

5

Also can you please elaborate on “Immune system mediation is a factor”?

I’m not sure I follow.

6

After re-reading a few times (it’s late and while my reading comprehension might be compromised, my immune system has never been), I take it that the mere fact that I almost never get sick could actually be a contributing factor?

And come to think I had always prided myself on my near impervious immune system. I even started a thread about it once which I let die because it came across as gloating.

7

Try psoriasis.org for lots of info.

8

Heh Heh, real funny one too.

I second the UV thing. I’ve had it most of my life, on the scalp as well as the nose and chin. About 3 years ago a friend suggested taking zinc and going to a tanning bed. I don’t particularly like taking zinc, but just tanning about every 2-3 weeks keeps most of it under control. I’ve also had some success with Tea Tree oil. There are a lot of products out now with Tea Tree oil in them but I’ve found the best way is to just get a small bottle of oil (most health food stores, also at a lot of chain stores like Wal-Mart) and add a couple of tablespoons to a normal size bottle of shampoo, more or less to personal taste. Smells like washing your hair with Ben Gay but it does the trick.

I have to second this too, I would much rather deal with moist flakey skin than the dry scabby crusty painfull stuff.

Good Luck

9

Shampoos: If you use shampoos to treat the symptoms, you shoudl rotate through the different types. Each uses different ingredients, and most people report better results when switching every few months.

Immune system: Either an overreactive or weakened immune system is sometimes linked to these types of problems. The best advice to to learn to manage stress or reduce stress - if possible. Stress often precedes the worst outbreaks. Stress affects the immune system.

General Health: Often, the onset is after a period of weight gain and/or lifestyle change. For example, an active person gets a stressful desk job, gets married and moves to a new state and gains 15 pounds.

When it comes to immune system and health, this is where I took my fight. I really have been trouble free since I returned to an active lieftstlyle and got my body fat % down. Staying active, healthy and fit = no more problems for me. For me, I wanted to eliminate variables, so I did what I could do.

10

I’ve had psoriasis on my scalp since I was a baby, so I’ve had a lot of experience here. When I was a kid, my mom always made me use those horrible tar shampoos and Selsun Blue. IME, None of that shit never worked. If my head was itchy I couldn’t scratch hard or else my scalp would bleed. It was flaky, crusty and burning red all the time. I had a liquid ointment prescribed for awhile to let soak into my scalp. Tried hot oil treatments also. None of this worked.

What I found actually made a huge difference in later years is washing my hair every day, scrubbing and massaging the scalp with my fingertips. I find if I go more than a day without washing, it seems to flare up. I also started using only natural shampoos, which cut way down on irritation. The frangrances and chemicals in most store-bought shampoos only made the problem worse. Check health food stores for organic, all-natural shampoos. Make sure you condition your hair well also, applying natural conditioner, massaging in well and letting sit for several minutes before rinsing. DON’T blow-dry your hair. By following these practices, I’ve managed to control the psoriasis so that at most times the worst I have is some dandruff-like flakiness in a small spot near my temples, which is leaps and bounds better than the bleeding mess I had as a kid.

Try these tips and see if they work for you. They’ve been the best thing for me.

11

Go see a dermatologist.

12

I’ve had psoriasis intermittentely nearly my whole life. Getting lots of sun seems to be the best; I sunburn easily so I go to a light booth (not a tanning bed; it’s at a medical clinic.) If I go enough (once or so a month) I have almost no outbreaks.

Scalpicin - the hydrocortisone alcohol, not the salicylicsathsomething kind, helps a ton with the itching.

T/Gel shampoo works better than anything else for me. I also scratch and scratch and scratch when washing my hair. Dandruff and coal tar shampoos don’t do anything for me.

Definitely see a dermatologist. One of the odd things about psoriasis is that everyone responds differently; it’s just a matter of figuring out what works best for you. Lanolin helps one of my friends a lot; it makes mine worse. A sympathetic doctor can be your best friend in this situation.

13

I have folliculitis, which is a very similar disease. In fact, if a doctor didn’t tell you that it’s psoriasis you may want to go in for a medical evaluation to see exactly what you have. I will warn you now that some types of folliculitis and psoriasis are just impossible to cure. I’ve been dealing with this damn disease for 15 years and finally gave up on getting it cured. The “cures” that the doctors were giving me were making me sicker than the disease was, and they weren’t helping the problem any.

Before you get discouraged though, you should know that many people are able to get rid of the disease. The first thing you need to do is figure out if its fungal or bacterial. If its viral though then you’re just plain screwed. I believe fungal is fairly easy to get rid of.

A selenium sulfide shampoo may help. Selsun Blue has selenium sulfide in it. You can get shampoos with a higher concentration of selenium sulfide from a dermatologist.

UV treatments also have a fair success rate. Your dermatologist may put you on a drug to make the UV treatment more effective. You have to be careful while on this drug because it will give you cataracts if you go out in sunlight without wearing UV sunglasses while you are on the drug.

Folliculitis usually strikes males in their 30’s, for reasons that aren’t really well known.

You now have an increased risk of developing cellulitis in the infected areas of your head. If the infected areas start to swell up, see a doc immediately. The worst case outcome of this is death due to a brain infection, so I’m not kidding here.

Hydrocortizone creams may help. Anti-bacterial creams may help. In my own case, I found that anti-bacterial ointments made things worse, because my skin didn’t like having the thick ointment over top of the disease. In one case I literally had the ointment version of an antibiotic make things worse, and the cream version of the exact same antibiotic made things better.

There’s a lot of YMMV with this disease. What works for some people doesn’t work for others.

Hot compresses supposedly help. They never did much for me.

In my own case, I’ve found that washing my scalp with dial anti-bacterial soap helps a bit. I try to keep the dead skin down to a minimum, otherwise that makes things worse as well.

I’ve been talking mostly about folliculitis, but like I said psoriasis is very similar. Most of the folks in the office where I was treated with UV had psoriasis.

14

T-Gel shampoo works best for me too. It was prescribed by my dermatologist a few years ago and I have been using it faithfully since then without any more problems with psoriasis. I keep just keep using it like the doctor said to do.

15

Have had problems with psoriasis for about 13 years----since about the age of 50.

Strange thing it is. Makes very little sense. It may well be “God’s little trick”.

Scared me to death the first time I had an outbreak ever so long ago. Thought those strange red itchy and scaly blotches popping up every place (including my scalp) were a sign of my impending doom.

Saw a dermotologist------He said -glancing at it—

—“You are not dying. That is psoriasis. Here is a (what turned out to be a very expensive) prescription and that will be $55 please”

Prescription didn’t do shit. Never went back to any dermatologist. Don’t think they really know what they are doing when it comes to psoriasis.

I have noticed over the years that psoriasis seems to have a mind of its own. Sometimes, for no reason, it just flat out goes away. (always comes back though-- for unknown reasons)

Stress does contribute to making it worse. Sunlight does help. Almost any lotion or cream–cortisone, coal tar, zinc, tea tree oil based------all help for a little while and then lose effectiveness. Switching types of treatment regularly helps the best.

There is no real cure.

Is why it is called “the heartbreak of psoriasis”

16

Well, if that isn’t a cite for psoriasis. :smiley:

17

For any of you that are sun-phobic, or don’t want to use the tanning beds because of fears of skin cancer, you should know (if you don’t already) that what is achieved through the UV exposure is an increase in the amount of vitamin D that your skin produces. Vitamin D is a natural anti-inflammatory that has been found to reduce the incidence and/or severity of several autoimmune diseases, including rheumatoid arthritis, multiple sclerosis, and Type 1 diabetes. Some of the most common treatments for psoriasis are vitamin D analogs.

Obligatory disclaimer - IANAD - I just work with some of the best vitamin D researchers in the country.

Vitamin D is generally available in 400 IU and 1000 IU pills at most health food stores. The current safety data indicates that doses up to 4000 IU per day are safe, and that most people who don’t get out into the sun a lot need at least 1000 IU per day to keep their body stores at a level sufficient to minimize inflammation and maximize calcium absorption. I would suggest finding a doc who keeps up with the literature, or is open to discussion, and who will take your circulating 25(OH)D levels (not 1,25-(OH)D) once or twice a year to monitor your levels.

Cites :slight_smile: Others available upon request if you are interested.

CE Hayes. Vitamin D: a natural inhibitor of multiple sclerosis. Proceedings of the Nutrition Society 2000 59:531-535.

RP Heaney, KM Davies, TC Chen, MF Holick, and MJ Barger-Lux. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. American Journal of Clinical Nutrition 2003 77:204-210.

MF Holick. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. American Journal of Clinical Nutrition 2004 79:362–371.

BW Hollis. Circulating 25-Hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. Journal of Nutrition 2005 135:317-322.

E Hypponen, E Laara, A Reunanen, M Jarvelin and SM Virtanen. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 2001 358: 1500-1503.

LA Merlino, J Curtis, TR Mikuls, JR Cerhan, LA Criswell and others. Vitamin D intake is inversely associated with rheumatoid arthritis. Arthritis and Rheumatism 2004 50:1;72-77.

AL Munger, SM Zhang, E O’Reilly, MA Hernan, MJ Olek, and others. Vitamin D intake and incidence of multiple sclerosis. Neurology 2004 62:60-65.

18

Man, I’ve had this #&!%! disease my whole life… mostly concentrated on my scalp, like so many others here. I have also used every product ever manufactured with little success of abatement. A few years ago, I stumbled upon a shampoo called Pentrax, which has a 5% Coal Tar extract, unlike TGel etc, which only have 1%. That extra 4% can really make a difference!! I don’t have the awful crusty white crap on my scalp anymore,and best of all–I DON’T ITCH!!! YAY!!! :slight_smile: :slight_smile:
I’ve inlcuded a link, since it is hard to find in drugstores.
Pentrax
What I’ve found that helps is to use it every day until the red soreness subsides, and then every other day after that. It’s quite powerful (and powerfully stinky too) and gets the job done. Highly reccommended!!

19

Coal tar? You are talking coal tar?

God that stuff do stink, even at lower concentrations. And you are talking 5 times?

Although I might try what you recommend. Hell -----I will try anything.

Psoriasis though is an animal within itself. It is like a vixen. No matter what you try---------nothing really works in the long run.

At least -----that is my experience.

(actually my psoriasis is not too bad lately. No psoriasis on my body showing at all right now. And scalp not half bad----at least for the time being ------and Lord knows why?----but I will take what I can get and be very grateful)

Psoriasis is a demon of sorts. Will let you alone for a while.

And then come back.

Just waiting for the next serious and completely untreateable outbreak.

20

Eleusis - haven’t you said you have a baby coming? And were for a time unemployed? THAT’S prob’ly enough stress in and of itself.