What happens when psoriasis affects the scalp? We spoke with Professor. Marcello Monti , head of the Unit of Dermatology at Humanitas and professor of Dermatology at the University of Milan.



Professor Monti, what happens when psoriasis attacks the hair?

Psoriasis is often localized to the capillitium or scalp, as well as the only place of expression; in this case, it is particularly annoying and uncomfortable. Very often, it causes itching and releases visible flakes on clothing.



How can scalp psoriasis be treated?

Scalp psoriasis is difficult to treat and if you do not use drugs, natural reducing agents are a possibility. Among the most common ones used are colloidal sulfur and salicylic acid, formulated in evanescent cream without vaseline, to be applied in the evening and massaged until they are completely absorbed. The only unpleasant side effect is a slight odor from the sulfur when it is applied.  Seawater (thalassotherapy) and sulfur water springs may also be useful to treating scalp psoriasi.



What precautions should be taken?

For those who suffer from scalp psoriasis, particular attention should be paid to washing the hair. In fact, shampoos are mixtures of surfactants designed to degrease and wash your hair, but they can also cause irritation.



Which shampoo should you use if you suffer from scalp psoriasis?

The shampoo for psoriasis must contain selected ingredients, in addition to the active antipsoriatic, in order to avoid causing irritation: Ichthyol sulphonate, for example, being a natural reducing agent can be added to the shampoo for its anti-inflammatory and antipruritic effect. However, oily or tar-based plant shampoos are not effective and should be avoided.



Are there alternatives to shampoo for those suffering from scalp psoriasis?

In place of the shampoo, you can use a washing cream (free of lauryl-sulphate), also called a cleansing base. This cleanses the hair without causing dryness or irritation and decreases itching and flaking.



How should you wash your hair if you are suffering from psoriasis?

I recommend wetting the hair before applying shampoo or cream and avoiding massaging the hair in order not to irritate the skin and wash the products off completely. Hair should be dried preferably with a cotton cloth and a hair dryer should only be used to finish off drying the air, all the while avoiding direct air flow to the scalp.