SCALP PSORIASIS
Psoriasis, derived from the Greek word “psora” meaning itch, is one of the most disfiguring and irritating skin conditions of all time. Scalp psoriasis affects about one in fifty men and women of all ages. It is truly cosmopolitan, considering its occurrence worldwide and in all ages. Also, the disease though symptomatically curable for varying periods of time is actually incurable, recurrences can occur anytime. The condition lasts a lifetime. Psoriasis in itself does not take lives but plays an invaluable part in reducing the quality of life. The disease can occur at any part of the body, but usually involved areas are the scalp, elbows and knees.
The scalp is the most common site for the appearance of psoriasis. The diagnosis may be delayed because most people, including doctors, think of dandruff when you have flaking and itching, as seen in scalp psoriasis. It usually takes another patch to appear elsewhere on the body to consider psoriasis as a differential diagnosis.
The exact cause and pathogenesis of psoriasis are still not very clear. The causative factors include certain genetic agents and environmental triggers. Psoriasis can be aggravated by direct injury to the skin, emotional stress etc. To understand the pathogenesis, it is important to clearly study the physiology of normal skin. Normal skin is made up of many layers of cells, the innermost of which is the proliferative layer, or the younger layer. Usually, it takes about 28 days for this innermost layer to become outermost by turnover. In psoriatic patients this time is shortened to only about 3 to 4 days, that is reduced about sevenfold. Psoriasis somehow speeds up the cell cycle. This can be seen as intense flaking, similar to dandruff in scalp psoriasis. Active changes also occur in blood vessels of the skin, causing bleeding spots to appear in psoriatic patches when scraped.
Scalp psoriasis may occur solely in the scalp or extend downwards to the forehead, causing severe embarrassment and may be considered disfiguring the face, or it may even extend to either side, involving the ears. It may be aggravated by vigorous combing, stiff brushing, use of tight curlers, picking or scratching the lesions. In addition, allergens present in dyes, tints and other hair products may trigger scalp psoriasis.
It may present over extensive or limited areas of the scalp with severe itching, flaking and bleeding spots. The presence of excessive flaking, not relieved by the use of anti-dandruff hair products should be consulted with your dermatologist and the possibility of scalp psoriasis be ruled out.
The treatment of scalp psoriasis should include both pharmaceutical therapy and lifestyle modifications. Drugs used for the treatment of scalp psoriasis are tar, anthralin, topical corticosteroids etc. Lifestyle modifications focus on the management of emotional stress and healthy diet, proper exercise etc.
Being a chronic, literally incurable skin condition, it is important to recognize scalp psoriasis in its early stage and prevent its progression, after all prevention is better than cure!
