What’s the Best Way to Wash Your Hair if You Have Scalp Psoriasis?

If you have psoriasis on your scalp, it can cause redness, thick scales or patches, itching, and even pain. It can also cause temporary hair loss. It’s similar to psoriasis on other parts of the body, but hair can trap the scales, causing them to build up more.

There are a few prescription medications that are commonly used to treat scalp psoriasis. But you can get better results from your medications if you wash your hair with psoriasis-specific shampoo.

For moderate to serious psoriasis, psoriasis shampoos are not that effective alone, but they can help your medications work better when used in combination with them.

“These shampoos should be thought of as a complementary therapy,” says Lawrence J. Green, MD, a clinical professor of dermatology at George Washington University School of Medicine in Washington, DC. “They’re not on your hair and scalp for long enough to be a primary treatment.”

For some people with very mild scalp psoriasis, the shampoos may be enough to keep it under control, says Alix Charles, MD, a dermatologist in Hinsdale, Illinois.

Here’s a breakdown of the different types of shampoos, how to use them, and what else you should be doing to keep your scalp psoriasis under control.

Psoriasis shampoos may contain other ingredients that can soothe irritation, reduce itching, and restore moisture to your scalp.

“I don’t use prescription shampoos because they’re not on the scalp long enough to help much, and we have better medications,” says Green.

We think of shampoo as being for the hair, but it’s important to apply psoriasis shampoo to your scalp as much as possible. Here’s how to do it:

• Apply shampoo to your scalp. Try to separate sections of the hair and apply the shampoo to the scalp.
• Gently massage. After applying the shampoo, gently massage it into your scalp. Don’t vigorously rub your scalp, as that can irritate your skin and make the psoriasis worse.
• Wait. Leave the shampoo in for five minutes.
• Alternate between psoriasis-specific and regular shampoo. It’s a good idea to alternate a medicated shampoo with a regular shampoo, so that you don’t dry out your hair and scalp, says Green. If you have thick scales that need to be removed, you can use the salicylic acid shampoo daily until it improves. Use the medicated shampoo at least three times a week.
• Stop when your scalp clears. When the psoriasis clears, you don’t need to use the medicated shampoo anymore. “These are only meant to be used when using medication, not as long-term maintenance therapies,” says Green.

“If you’re using one of the prescription medications, you don’t usually need [a scale softener], because you can get enough of the scale off with a medicated shampoo,” says Green.

It’s important to use a conditioner whenever you shampoo. Psoriasis shampoos can be very drying to your hair. Using a conditioner on the hair shaft can add moisture back in.

Some psoriasis shampoos contain ingredients that moisturize your hair, but the additional step of using a conditioner can add extra moisture.

You may want to also apply a few drops of hair oil or serum to your scalp to keep it moisturized.

When you use a psoriasis shampoo, you need to have a slightly different approach than with regular shampoo. Some common mistakes people make when using psoriasis shampoo may prevent them from getting the full benefit of the shampoo — and in some cases, they can even make the psoriasis worse. Here are few mistakes dermatologists see:

1. Washing your hair not your scalp: Try not to think of shampoos as just being for your hair. It’s important for the active ingredients to have contact with your scalp. Be sure to gently massage it into your scalp.
2. Rinsing the shampoo out too quickly: Make sure the shampoo is in contact with the your scalp for at least five minutes before you rinse it out, says Dr. Charles. Contact time is important for the ingredients to work.
3. Skipping shampoos: It’s helpful to shampoo every day, as it can help clear out the debris and oils that can make psoriasis worse. Just be sure to alternate a medicated shampoo with a regular shampoo.
4. Scratching or rubbing your scalp: Scalp psoriasis can be very itchy, and shampooing and massaging it may trigger the itchiness. Still, it’s important to avoid scratching or trying to rub away the itch. That can make psoriasis worse and may make your scalp bleed or cause hair loss.
5. Blow-drying your hair: Scalp psoriasis can make your scalp very dry. Using a blow-dryer with hot air can dry it out even more. Instead, let your hair air-dry or use a dryer on the cool setting.
6. Picking at the scales: Shampoo and medication may help loosen scales, which is the goal. But picking at them can cause psoriasis to flare, may cause bleeding, and can even cause scarring and hair loss.

• Using a medicated shampoo that contains coal tar or salicylic acid can help to alleviate scaling and itching caused by psoriasis.
• Apply the shampoo directly to your scalp, gently massage, and leave it in for at least five minutes to give the active ingredients enough time to work.
• Moisturizing with a conditioner after shampooing can help keep your scalp hydrated and reduce dryness-associated itchiness.
• Avoid scratching or rubbing your scalp, as it can worsen psoriasis and lead to complications like bleeding and hair loss. Instead, talk to your healthcare provider about additional treatments if symptoms persist or worsen.