How to Cure Scalp Psoriasis Permanently ?

Psoriasis affects 2%–5% of the population, and the scalp is a common site of involvement (up to 80%). Different types of alopecia can occur in the setting of psoriasis: patchy or diffuse hair loss in areas of psoriasis, telogen effluvium, and scarring alopecia. The most common presentation (75%) is circumscribed hair loss within psoriatic plaques affecting the scalp. The diagnosis is based on the clinical, dermatoscopic, and histologic features that help distinguish psoriasis from seborrheic dermatitis, tinea capitis, and a more recently described entity of anti–tumor necrosis factor blocker–induced psoriasiform alopecia. The latter is characterized by psoriasiform plaques with or without alopecia most commonly in patients treated with infliximab or adalimumab for Crohn disease. A thorough clinical examination commonly reveals psoriasiform lesions outside the scalp.

The scalp is the most commonly affected part of the body in patients with psoriasis. Signs and symptoms of scalp psoriasis vary significantly for individual patients. A task force of the National Psoriasis Foundation was convened to evaluate treatment options. Reports in the medical literature were reviewed regarding scalp psoriasis therapy. There is a paucity of evidence-based and double-blind studies in the treatment of scalp psoriasis particularly for long-term therapy. Many of the studies in scalp psoriasis were designed to attain Food and Drug Administration approval for a medication and not to provide treatment guidance.

Results :The recommended short-term or intermittent therapy for scalp psoriasis is topical corticosteroids. The primary alternatives are topical retinoids, vitamin D analogues, and salicylic acid. Combination therapy has many advantages. The choice of an appropriate vehicle is crucial to increase patient compliance. While scalp psoriasis can often be adequately treated with topical therapy, recalcitrant disease may require more aggressive approaches, including systemic agents.

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