SCALP PSORIASISPsoriasis is a common and chronic skin disorder. The most common type of psoriasis is plaque psoriasis. It is characterised by red skin covered with silvery scales and inflammation. Patches of rounded to elliptical shaped red plaques that itch or burn are the classic appearance of plaque psoriasis.
The scalp is a well-known predilection site for psoriasis. Scalp psoriasis is characterised by thick silvery white scale on patches of very red skin. It is frequently found at the back of the head but various areas of the scalp or even the whole scalp may be affected. The sharply demarcated erythematosquamous lesions with silver-white scaling characterise scalp psoriasis. The quality of life can be seriously affected by this condition and therefore long-term treatment is needed in most patients.
Psoriasis most commonly appears between the ages of 15 and 25 years but can occur at any age. It affects both sexes equally.
Scalp psoriasis may not cause any symptoms at all or may be very itchy. It is usually a chronic or long-term condition that often lasts for many years. Like other skin diseases, it causes not only physical but also social anxiety as well. In severe cases there may be temporary localised hair loss although scalp psoriasis does not cause permanent balding.
Psoriasis is not a contagious condition.
Research indicates that psoriasis may result from a disorder in the immune system. The immune system is the body’s defense against infection. But sometimes, for unknown reasons, the immune system does not work properly. Instead of attacking foreign invaders, it can start attacking the body itself.
The immune system makes leukocytes (white blood cells) that protect the body from infection. In patients with psoriasis, the T cells (a type of white blood cell) send a false alarm to the skin cells. These T cells inappropriately cause inflammation and cause skin cells to grow more rapidly than normal and to pile up in raised patches on the surface of the skin. In psoriasis, a skin cell matures in 2 to 3 days while a normal skin cell matures in 21 to 30 days.
Those with a family history of psoriasis have a greater probability of having the disease. Some people carry genes that make them more likely to develop psoriasis. An individual may have a 50% chance of developing psoriasis when both parents have psoriasis. About 30% of those with psoriasis have at least one family member with the disease.
There are certain occasions that can cause psoriasis to get worse or make it return, including:
- Weather changes
Cold, dry weather may worsen symptoms while hot weather, sunlight, and humidity may improve symptoms.
Stress may cause flare-ups of psoriasis, as well as emotional trauma
Bacterial infections such as streptococcal throat infections can cause psoriasis to appear abruptly
- Certain medicines
Drugs such as beta-blockers, NSAIDs, and lithium have been found to make symptoms worse
- Skin injury
An injury to the skin can cause patches to form anywhere on the body
Scalp psoriasis requires a slightly different approach from psoriasis affecting the skin elsewhere in the body. This is due to hair in the scalp, which makes application of many topical products difficult and protects the scalp from the effects of ultraviolet light. Most treatments will have to be used regularly for several weeks before a benefit is seen. Moreover, many treatments for scalp psoriasis are oftentimes messy and smelly.
TREATMENT:While there are medications and other therapies that can help to clear up the patches of red, scaly, thickened skin that are the characteristic features of psoriasis, there is no absolute cure.
Coal tar shampoos are quite effective in scalp psoriasis. These contain 2 to 10% coal tar solution. Tar can help slow the rapid proliferation of skin cells. In addition, tar can help lessen the inflammation, itching and scaling of psoriasis. Patients may notice improvement within a couple of weeks of starting tar treatment, but it may take up to eight weeks to see the maximum benefit. However, treatment is best for people with limited psoriasis or those with well-defined lesions.
There are side effects in using tar. Tar can irritate and redden the scalp. There have also been concerns regarding the possible carcinogenic effects of coal tar products. Anyone using coal tar regularly should be wary of the signs of skin cancer and have a regular checkup schedule.
Tar also stains clothing, bedding, and furniture. Occlusion of tar preparations on the scalp may be done to enhance its effectiveness. Some tar gels and lotions can dry the skin. An emollient of moisturiser must be applied over the tar to decrease drying effects.
Salicylic acid 5 to 10% has a pronounced keratolytic effect. It helps remove scales and is often combined with steroids or tar to enhance its effectiveness. Salicylic acid is available over the counter but concentrations more than 3% are only available with prescription. Salicylic acid can cause skin irritation if left in contact with the skin too long. It should not be used for long periods of time or used under occlusive dressing. It should not be used in children younger than two years of age. Weigh the possible benefits against the potential risks before using this medication while breastfeeding.
Crude coal tar is the most efficient tar available for the treatment of psoriasis. An important feature of coal tar is its potent efficacy against pruritus. Crude coal tar has been used for decades to manage scaling, itching, and inflammation of psoriasis. At the scalp, the application of crude coal tar is difficult. It may temporarily discolour bleached, tinted, or grey hair. It also stains skin and clothing.
Imidazole antifungals have been used in the management of scalp psoriasis. Overgrowth of the scalp with pityrosporon is a well-known feature of scalp psoriasis. Pityrosporon yeasts are normally found in the human skin but are opportunistic pathogens.
Topical corticosteroids are the most frequently used treatments for scalp psoriasis. Corticosteroids reduce inflammation, inhibit epidermal cell proliferation, and alleviate itching. No data are available to support the efficacy and safety of topical corticosteroids during long-term use. However, the majority of patients use it for more than 8 weeks. Side effects can include burning, irritation, and dryness. In most cases, patients develop tolerance to the drug and hence become ineffective.
Synthetic forms of vitamin D3 have been developed for the treatment of psoriasis. Vitamin D3 analogues inhibit epidermal proliferation and inhibit inflammation. It should be used with care and should not be applied to normal skin. Treatment should be limited to no more than 100g in one week. Symptoms of vitamin D3 overdose include weakness, fatigue, drowsiness, dizziness, headache, decreased appetite, nausea, vomiting, and hypercalcemia (elevated calcium levels in the blood).
All of these traditional treatments for scalp psoriasis are with possible side effects that may range from mild ones to severe adverse results. This has led to alternative and safer ways to manage scalp psoriasis.
Recently, it has been reported that several people with psoriasis have tried using Nisim Shampoo for Normal to Dry Hair to treat scalp psoriasis and have gotten positive results. The combination of herbs, amino acids, and vitamins in NISIM gently normalize and balance the condition of the scalp.
NISIM Shampoo contains Panax ginseng (Korean ginseng). Ginseng has been used since ancient times. The primary benefit of ginseng comes from its immune-stimulating properties, thus helping normalize the conditions of the scalp. NISIM shampoo improves the perfusion and acts in a supportive way as in the case of scalp psoriasis.
Arnica montana in NISIM works by increasing the capillary blood flow under the skin. Arnica montana has a long history of use in herbal healing. It also has mild anti-inflammatory, antibacterial, and pain-relieving actions. It has been used for scalp psoriasis with promising results since it reduces inflammation and because of its healing properties.
Hedera helix plant has great anti-fungal properties. Hedera helix also has excellent itch-relieving properties, which makes it an effective ingredient of NISIM in the management of scalp psoriasis.
Another natural ingredient in NISIM is geranium oil has very positive effects on the scalp. It boosts circulation and also invigorates the scalp because of its general cleansing action. It also creates a balance between oily and dry scalp and skin. It reduces inflammatory conditions, heals wounds, and is highly beneficial for unbalanced scalp conditions.
Vitamin B complex is necessary for proper circulation and healthy skin. NISIM contains Vitamin B5 that acts as moisturiser and Vitamin B7 (biotin) that is helpful in allergic skin conditions and scalp psoriasis.
Management of scalp psoriasis requires long term strategies in order to attain the most advantageous improvement of the condition, while avoiding the adverse effects associated with the long-term use of conventional drugs and treatments.
Nisim Shampoo for Normal to Dry Hair and Nisim Gel Extract have been particularly effective in successfully managing several skin and scalp disorders such as psoriasis, alopecia areata, dandruff and itchy scalp, and even cradle cap. Its active ingredients are herbal and organic in origin and NISIM products are guaranteed safe and completely drug-free. The mild but effective ingredients have been known to help those suffering from skin and chronic scalp conditions like psoriasis. Furthermore, because theyre made largely from natural ingredients, it can be used with confidence for even long periods unlike other treatments that can only be used for a limited time.
Following on from the success of the Nisim Shampoo, Nisim have also release 2 other products for problem skin - the Nisim Body Wash and Nisim Body Lotion. These are extremely effective on those suffering from psoriasis and eczema. Other products we have heard of that benefit eczema and psoriasis sufferers is the aptly named Egyptian Magic cream which contains all natural ingredients.