Psoriasis of the scalp and face

Psoriasis is a chronic inflammatory skin disease with the following symptoms:

Psoriasis vulgaris (plaque psoriasis) is the most common phenomenon and the affected areas are:

  • Scalp
  • Elbow
  • Knee
  • Lumbar region
  • Hands and nails

According to conventional medicine, psoriasis is an incurable disorder, but its symptoms can be alleviated by medication in acute conditions.
According to alternative medicine, the most important therapy is proper nutrition, as food is considered to be the cause of the disorder.

It is no coincidence that summer is the best time for those suffering from psoriasis.
The improvement is due to the following circumstances:

  • More natural diet with fruits and vegetables typical of the season
  • Being exposed to the sun’s rays
  • Increased outdoor physical activity

Psoriasis of the scalp

Psoriasis forms on the scalp in 50% to 75% of cases.
Scalp psoriasis can be very mild and with a very fine scaling.
It can also be very severe, with plaque build-up and crusts covering the entire scalp.
Psoriasis can spread beyond the hairline to:

  • Forehead
  • Neck
  • Area and ears

Other skin disorders may resemble psoriasis, for example, seborrheic dermatitis.

  • psoriasis of the scalp generally occurs with scattered scaly patches with silvery reflexes on dry skin;
  • Seborrheic dermatitis usually occurs all over the head, yellowish and with oily skin.

Treatment of scalp psoriasis
Often, treatments are combined and alternated because a person may be less sensitive to the medicines after taking it for a long time.
In general, systemic treatments are not used for scalp psoriasis, but can be given when the disease occurs elsewhere in the body and/or the psoriasis is moderate or severe.

Mild psoriasis of the scalp
In general, the following products are sufficient for mild forms of scalp psoriasis:

  • Sulfur
  • Mineral-based tar
  • Sulfonated ichtychol
  • Salicylic acid

There are many medicated shampoos available that contain tar with and without coal.
Mineral coal has contraindications and the following undesirable effects:

  • Change in hair color.
  • Intolerance in sensitive areas (face, genitals).
  • Causes stains on clothes that are not washable.
  • It is a light-sensitizing substance that causes skin reactions when exposed to sunlight.

Sometimes doctors prescribe cortisone as a cream or gel to apply it to the lesions on the scalp.
However, this only occurs if the psoriasis of the scalp is minor and covers only a few areas.
The cortisone-based drugs must be used sparingly, as they can cause various side effects.

Moderate to severe scalp psoriasis If scalp psoriasis
is severe, it may be necessary to try different treatments until the most effective one is found.

There may be a mycotic infection if the following is shown:

1. Crusting on the scalp
2. Chapped skin
3. Enlarged lymph nodes on the neck
4. Broken and damaged hair (without shine and color)

In this case, the doctor may prescribe antifungal treatment.

The most common local treatments for scalp psoriasis are provided with:

1. Healing ointment (Vellutan)
2. Daivonex®
3. Zorac

Systemic medical treatment of psoriasis includes:

1. Methotrexate
2. Oral retinoids 3. Ciclosporin
4. Biological pharmaceuticals

5. Ultraviolet light

The hair blocks ultraviolet rays (UV) even before they reach the scalp.
A better result is achieved after shaving.
Sunlight can help if the hair is very fine or the head has been shaved.

Itching on the scalp Itching is often a problem for people with scalp
Shampoos with sulfonated ichtychol can reduce itching.
Topical steroids (Evocal) are effective in relieving itching on the scalp.

Psoriasis on the face

Psoriasis on the face often affects:

  • Eyebrows
  • Skin between nose and lips
  • Forehead
  • Hairline

A biopsy may be necessary to confirm the disease.
Psoriasis on the face should be treated with caution, as the skin is particularly sensitive here.
Occasional use of locally acting cortisone preparations may be effective.

Other methods of treatment include:

  • Daivonex ® Healing Ointment (Calcipotriol)
  • Zorac ® Gel (Tazarotene)
  • keratolytic products
  • ultraviolet rays

The Food and Drug Administration in the United States of America has approved two drugs for the treatment of neurodermatitis:

  • Protopic
  • Elidel (based on Tracrolimus)

Many dermatologists have also observed good results in the treatment of psoriasis on the face and other sensitive areas.
In patients with a weakened immune system, external use of drugs based on tracrolimus is not recommended, as these can be the cause of:

  • T-cell lyphoma
  • Malignant skin cancer tumors

The drugs used to treat psoriasis on the face should be applied with caution and sparingly; the creams and ointments can irritate the skin and eyes.
Prolonged use of cortisone can:

  • make the (already sensitive) skin thin,
  • expand the capillaries.

Steroid therapy can be safe if a conscientious treatment program is followed.

Psoriasis on the eyelid When psoriasis affects the eyelids, dandruff can:

  • be white and dry,
  • cover the eyelashes.

The eyelid edges may redden and form crusts.
If the inflammation persists for a long time, the eyelid edges can fold inwards (entropion) or outwards (ectropim).
If the eyelid edges fold inwards, the eyelashes can rub the eyeball and cause irritation.
Eye psoriasis is extremely rare.

If it occurs, it can cause:

Locally effective antibiotics can be used to treat the infection.

In some cases, corticosteroids may be used to treat dandruff.
The doctor must control the effect of the treatment, because the skin of the eyelids can be easily damaged.
When using cortisone:

Protopic ointment and Elidel cream do not cause glaucoma and are useful in the treatment of eyelid psoriasis. However, in the first days of use, they can cause stinging discomfort.

Psoriasis in the ears Psoriasis in the ears
can lead to an accumulation of dandruff, which causes blockage of the ear canal.
These deposits can lead to temporary hearing loss.
In general, the disease affects the external auditory canal and does not occur inside the ear.

There are prescription cortisone-containing drops that:

  • dripped into the ear canal,
  • can be used on the external auditory canal.

In the mouth and nose area
Rarely, skin injuries of psoriasis are found on:

  • Gums
  • Tongue
  • Inside of the cheeks
  • inside the nose
  • on the lips

The lesions are usually white or gray.
Psoriasis can be very bothersome in these areas.

It can cause difficulty chewing and swallowing.

In most cases, topical corticosteroids are available for the treatment of psoriasis in the nose and mouth area, which are suitable for the treatment of moist skin areas.
Improving hygieneand frequent rinsing with a saline solution can help relieve the discomfort.
Medications such as Protopic and Elidel can be used to effectively treat psoriasis inside and outside the mouth.
These drugs can be applied to the mucous membranes.

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