How to Choose the Right Shampoo for Psoriasis

Treatment for scalp psoriasis often involves over-the-counter (OTC) or prescription shampoos. Finding the right shampoo for your scalp can help you manage the condition and prevent complications.

This article discusses shampoos for scalp psoriasis, side effects, and safety.

What Is Scalp Psoriasis?

Scalp psoriasis is a chronic, inflammatory condition affecting the scalp's skin. Psoriasis affects 1% to 2% of North Americans; 80% have it on their scalp.

There are many types of psoriasis. Scalp psoriasis is a form of plaque psoriasis resulting in raised patches of thick skin called plaques.

How Shampoo Relieves Symptoms

Scalp psoriasis can be tricky to treat because the hair on the scalp makes applying topical treatments messy. Shampoos help solve that problem by making it easy to use topical medications through a cleaning agent.

Different ingredients in shampoos work to target scalp psoriasis symptoms. Some ingredients soften scales, so they're easy to remove, while others help reduce itching.

Types of Scalp Psoriasis Shampoo

Both OTC and prescription scalp psoriasis shampoos are available. The right one for you depends on the severity of your condition. There are some key ingredients to look for when choosing a psoriasis shampoo. A dermatologist (a healthcare provider specializing in skin conditions) can help you determine which is best for you.

Salicylic Acid

Salicylic acid treats skin conditions, including acne and psoriasis. It is in a class of drugs called keratolytic agents. It works to soften plaques so they can more easily be removed. Salicylic acid is a first-line therapy for scalp psoriasis.

Coal Tar

Coal tar is derived from coal to treat psoriasis. It slows skin cell growth and reduces inflammation, itching, and scaling. For some people, tar can irritate and dry the skin, so you should test it out on a small patch before using it on your entire head. It also causes photosensitivity (increased sensitivity to UV radiation) while the medication is active (usually 24 hours). Be extra careful in the sun when using this medication.

Clobetasol Propionate

Clobetasol propionate is a topical medication that treats itching, redness, scaling, and pain associated with scalp psoriasis. It is in a class of drugs called corticosteroids, the most prescribed treatment for psoriasis.

Long-term use of these medications is not advised. Be sure to work with a healthcare provider to determine how long to use these shampoos.

Does Natural Shampoo for Psoriasis Work?

Instead of medications, some shampoos contain natural ingredients to combat psoriasis. These may include:

• Aloe vera: Common skin soother
• Apple cider vinegar (ACV): Relieves itching but avoid it if you have cracks in your skin
• Capsaicin: A spicy ingredient in chili peppers and helps with psoriatic pain
• Dead sea salts: Used as an exfoliant
• Oats: Soothes skin and reduce the itch
• Tea tree oil: Used for its antiseptic properties
• Turmeric: Anti-inflammatory
• Mahonia aquifolium (Oregon grape): Helps fight fungal or bacterial infections
  

These natural ingredients may relieve symptoms for some people, especially if the psoriasis is mild. However, these are often not effective enough to be used alone. More frequently, they are used alongside standard medical care.

How to Choose a Treatment for Scalp Psoriasis

Choosing the appropriate treatment depends on how severe your psoriasis is and other factors related to your overall health and lifestyle. A healthcare provider will help you determine which treatment may be best.

Since scalp psoriasis can be stubborn, it's best to seek medical guidance. This can speed up the experimentation phase because healthcare providers know what tends to have the best track record. They can also ensure that you have an appropriate diagnosis.

When Will You See Results?

How long it takes treatment to work depends on the severity of your psoriasis. For mild scalp psoriasis, you may immediately see results from a medicated shampoo. On the other hand, a more moderate or severe case may require a few weeks before you experience relief or improvement.

Side Effects and Safety

Most of the medications used in psoriasis shampoos are safe. However, as with all medicines, there are risks and potential side effects. These may include:

• Skin irritation
• Hair loss
• Photosensitivity
• Acne
• Rash
• Skin discoloration

You can reduce your risk by ensuring that a healthcare provider and pharmacist know all the medications and supplements you take and follow the product instructions carefully.

What to Do Next If Shampoo Doesn’t Work

If shampoos alone do not help your scalp psoriasis, you may require additional psoriasis treatment. A dermatologist can help you determine what next steps are appropriate. Some other psoriasis treatment options include:

• Topical medication
• Scale softeners
• Light treatments
• Biologics (given via injection or IV)
• Other systemic (bodywide) medications (disease-modifying antirheumatic drugs (DMARDs).
• Phototherapy (uses UVB lights to slow the growth of the affected skin)

Summary

The vast majority of people with plaque psoriasis have it on their scalp. Medicated shampoos that target scalp psoriasis may help. These shampoos often contain ingredients like coal tar, salicylic acid, and Clobetasol, which target flaking, itching, and inflammation. Scalp psoriasis is notoriously stubborn, so working with a healthcare provider, like a dermatologist, can ensure you see results more quickly.