Psoriasis of the scalp: how to reduce flare-ups?

Psoriasis is a disease that cannot be cured, but it can be managed. Some treatments proposed by professionals can space out flare-ups over several months or even years. It should be noted that scalp psoriasis can manifest in various areas. It can disappear completely, but recurrences are not uncommon.

Medicinal treatments for this chronic inflammatory disease are administered based on the severity of its onset. In the case of localised scalp psoriasis, for example, local treatments may be prescribed by the dermatologist. Here are a few examples:

• Use of lotions or shampoos containing dermocorticoids. Locally applied, dermocorticoids help to soothe the skin by combating inflammation. They inhibit the NF-kB transcription factor by activating the transcription of the IkB gene, thus providing anti-inflammatory effects;

• Use of Tazarotene which is a retinoid derived from Vitamin A: it regulates the differentiation of keratinocytes by reducing the activity of the enzyme TGase-K which catalyses the development of the corneal cell envelope (the final stage of keratinocyte differentiation).

• Use of Vitamin D3 analogues: they act on the multiplication and maturation of keratinocytes, although their mechanism is not yet known;

• Combination of dermocorticoids and vitamin D3 analogues: This combination is very effective, it is used in daily application for the first month, followed by a maintenance treatment at a rate of weekly applications over the weekend to prevent relapses.

• Use of 10% Salicylic Acid, a keratolytic agent, to thin the superficial layer of the epidermis (stratum corneum) by dissolving it.

Phototherapy also allows for the treatment of scalp psoriasis. It includes two modes, namely UVB phototherapy and PUVA therapy.

For severe cases, a systemic treatment based on Ciclosporin, retinoids or methotrexate may be suggested by the dermatologist. This type of treatment is necessary when the hair follicles are permanently damaged by the disease.

In addition to the various existing treatments, there are also some simple actions that can help to lessen the impact of scalp psoriasis on daily life:

• Use of gentle shampoo;

• Natural hair drying or adjusting the temperature to cool or lukewarm when using a hairdryer;

• Avoid tight and tied hairstyles (braids, ponytails, etc.);

• For hair colouring, delay the dyeing or highlighting process during flare-ups.