Is Your Dandruff Actually Scalp Psoriasis?

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When you’re dealing with an itchy, flaky, and straight-up unhappy scalp, your mind probably jumps to dandruff—not something like scalp psoriasis. The condition, which can be much more difficult to diagnose and treat than your run-of-the-mill dandruff, can cause scaly skin patches or plaques to develop on the scalp, and you may not even know it because they’re hiding under your hair1. To better understand what you may be dealing with, SELF asked a leading expert to explain what scalp psoriasis looks like, plus the condition’s most common triggers and treatments, so you can finally get the relief you deserve.

What is scalp psoriasis?

Scalp psoriasis is not officially recognized as a subtype of psoriasis, but the scalp is a commonly affected2 area for people who struggle with the autoimmune condition. For a person with psoriasis, the immune system goes a bit haywire and mistakenly tells skin cells to grow too quickly3. Because those extra skin cells aren’t needed by the body, it results in a “pile up” of skin, forming those telltale psoriasis plaques, according to the American Academy of Dermatology (AAD).

When the condition affects your scalp, which happens in approximately 80% of people with psoriasis, according to a 2016 paper published in the journal Psoriasis: Targets and Therapy4, it’s commonly known as scalp psoriasis. Some people may have plaques only on their scalps, while others may have them on their scalps and other areas of their bodies, according to Tina Bhutani5, M.D., an associate professor of dermatology and the co-director of the Psoriasis and Skin Treatment Center at the University of California, San Francisco.

What are the most common scalp psoriasis symptoms?

You’re probably wondering, What does scalp psoriasis looks like? Generally, you might notice flaking or scaly patches of raised skin on your scalp first, Dr. Bhutani says. These patches can also be inflamed, thick, and swollen6, and sometimes extend to the forehead, the back of the neck, or behind the ears. On light skin tones, psoriasis plaques on the scalp typically appear pink or red with silvery scales. For people with dark skin, these lesions may range in color and appear salmon-y pink, silvery white, violet, or brown, depending on your specific skin tone7.

But the signs of scalp psoriasis go far beyond the physical effects. “Scalp psoriasis, honestly, causes some of the largest impact on quality of life,” Dr. Bhutani says. That’s because severe symptoms can interrupt sleep, create feelings of anxiety, and hurt a person’s self-esteem, especially if the scalp psoriasis plaques are clearly visible.

In addition to plaques, other scalp psoriasis symptoms include6:

  • An extremely itchy scalp that can be distracting
  • A burning sensation or soreness on your scalp
  • Cracked and/or bleeding skin from scratching too much or from having a dry scalp
  • Temporary hair loss if you excessively touch your scalp or attempt to “pick” off your scales, which can forcibly remove hair follicles

What causes scalp psoriasis?

While we know what causes psoriasis plaques to develop on the scalp (an overactive immune system causes the body to make too many skin cells), experts don’t fully understand why someone develops the condition in the first place or what determines where those lesions will appear. Experts suspect there is a genetic component to psoriasis because people who have a family history of the condition are more likely to develop it, but the specific genes that could be linked to psoriasis are unknown8.

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