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Alopecia Caused by Psoriasis

According to the National Psoriasis Foundation, at least half of the people who have psoriasis have it on their scalp. Psoriasis can be light, mild or severe, with levels of crusted plaques that cover the scalp in powdery, silver sheen. Other skin problems may look the same as psoriasis, but it is very distinctive in its color and sheen.

  1. Relationship Between Alopecia and Psoriasis

    • Psoriasis of the scalp can appear anywhere from the hairline to the forehead, and from the ears to the back of the neck. Severe psoriasis, can cause thick crusts on the entire scalp. This crust may cause follicular scaring. Any level of psoriasis can cause extensive hair loss called alopecia areata. The type of alopecia caused by severe scaring is called cicatricial alopecia (or scarring alopecia).

    What Is Alopecia?

    • Alopecia is defined as hair loss. The most common form of alopecia in conjunction with psoriasis is cicatricial alopecia, which is a form of hair loss that stems from follicular damage and scarring. It occurs when the hair weakens, and falls out of the follicle, and the hair is then replaced with scar tissue from the scalp. When this happens, hair no longer grows from the affected areas. Cicatricial alopecia can affect men or women, and is more common among adults.

    Signs and Symptoms

    • Signs and symptoms of cicatricial alopecia due to psoriasis are patchy bald spots on the scalp that show scaling. This may be accompanied with itching, pain or burning. The scalp may also show redness, dryness, cracked skin that bleeds and soreness. These symptoms are accompanied with the silver scaling and crusting that are seen as classic hallmarks of psoriasis.

    Diagnosis

    • There is no one test to provide a diagnosis of psoriasis of the scalp, or cicatricial alopecia. The first thing your physician will do is to visually examine the scalp for signs of psoriasis and in some rare cases a biopsy may be required to give a more accurate diagnosis.

    Hair Regrowth Options

    • If the follicles on the scalp are destroyed, no hair can grow back from the damaged areas. The key to treating cicatricial alopecia in this situation is to first treat the psoriasis. Scalp psoriasis can usually be treated with the use of over the counter medicated shampoos that contain one of these ingredients: ketoconazole, tar, pyrithione zinc, selenium sulfide or salicylic acid. You may be recommended to use a topical cream, ointment or solution that contains tar, corticosteroids or Vitamin D. These will all help stop further alopecia as well as treat alopecia that has not yet entered the scaring stage (alopecia areata). After the scalp heals,your doctor may prescribe you Minoxidil two or five percent, to help with hair re-growth in mildly affected areas. This is also available over the counter under the trade name, Rogaine.

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