15 Ways to Treat Scalp Psoriasis, According to Dermatologists

Soften Scales With Salicylic Acid-Based Shampoo

Dr. Garshick recommends using salicylic acid. "Salicylic acid acts as a keratolytic to help soften the scales and decrease the thickness of the plaques. Salicylic acid-based products, also known as scale softeners, are generally best to help soften and eliminate the scales," she says. She adds that it's important to be proactive when it comes to psoriasis: "Daily washing of the hair can help to eliminate some of the dead skin."

You can also leave the salicylic-based product on to let it penetrate deep in areas where thicker plaques persist. Let it sit for up to 10 minutes before rinsing. If this proves ineffective in breaking down the scales, a board-certified dermatologist can prescribe a stronger concentration of salicylic acid for relief.

Calm Inflammation With a Tar-Based Shampoo

Another effective ingredient to treat itchiness and plaque formation is tar. "Tar made from coal or wood works to slow skin cell growth and reduce inflammation, itching, and scaling," says Dr. Green.

According to Dr. Green, you can "apply the coal tar shampoo by massaging it into the scalp, and leave it on for 5-10 minutes before rinsing it out." An indulgent favorite is Sangre de Fruta's Botanical Hair Elixir, known for its purity of ingredients and luxe botanical properties.

Reduce Yeast With Mild Anti-Dandruff Shampoo

In milder cases of scalp psoriasis, where thick plaques and scales are not as persistent, Dr. Garshick favors a dandruff shampoo, such as Dove's DermaCare Scalp Dryness and Itch Relief Anti Dandruff Shampoo or Head and Shoulders' Classic Clean 2-in-1, as these contain zinc pyrithione. "[This] can help with scalp psoriasis in addition to seborrheic dermatitis, as it can reduce yeast on the scalp," she says.

Daily washing is crucial for people with scalp psoriasis, adds Dr. Garshick. "Finding a shampoo formula that you like is most important, as it is often recommended for those with psoriasis to wash their scalp daily or every other day. This helps eliminate excess build-up of dead skin, which can worsen the flaking."

Treat Scalp With Witch Hazel

One of the most well-known potential herbal treatments is witch hazel. To use, Dr. Green says, "Massage it directly onto the scalp after washing. Continue to massage the area until the witch hazel is fully absorbed. From there, you can rinse your scalp and style your hair as you normally would."

Apply Aloe Vera to Scalp

Dr. Green finds that aloe vera cream can have some soothing and healing properties for people with mild to moderate scalp psoriasis.

"Aloe vera creams that contain 0.5% aloe can help reduce itching, inflammation, flaking, and redness on the scalp," she says. "This cream should be applied up to three times per day to keep skin moist. It may take up to a month to start feeling and seeing positive effects."

Note that it's also a good idea to run your home remedy by your dermatologist before proceeding.

Try an Apple Cider Vinegar Rinse

A natural way to combat itchiness involves applying an apple cider vinegar rinse as it may help reduce itchiness associated with scalp psoriasis, according to Dr. Green.

"Dilute the apple cider vinegar with water, apply to the scalp, and rinse the skin thoroughly to prevent irritation," she says. Use up to a few times per week. You can expect to see results in several weeks.

Mix Tea Tree Oil Into Your Shampoo

Dr. Green says that tea tree oil, due to its antioxidant properties, can be soothing to scalp psoriasis. "You can try mixing psoriasis-friendly ingredients, such as apple cider vinegar or tea tree oil with your usual shampoo," she says. "This can serve as a gentle, homemade psoriasis remedy. However, this is usually only an effective measure in very mild presentations of scalp psoriasis."

She underscores the importance of using a shampoo with active ingredients. In addition to those listed above, look for ketoconazole and selenium sulfide to treat and soothe scalps.

Massage Coconut Oil Onto Scalp

A coconut oil hair treatment might be one of the more indulgent ways of managing scalp psoriasis; plus, the healthy fats are known to boost skin health.

"Massage a few drops onto your scalp and put on a shower cap," says Dr. Green. "Once the oil is on your scalp, set your timer for 20 minutes. After your time is up, you may remove the cap and wash your hair as usual."

Another favorite soothing hair treatment is the ultra-healthy Mighty Majesty Fortifying Hair Serum by Ranavat. This scalp-nourishing serum includes a high concentration of oleic acid, vitamin C, vitamin E, jasmine oil, and sunflower oil.

Avoid Scratching

Scalp treatments are important for people with scalp psoriasis to help eliminate some of the dead skin. However, do not attempt to manually remove plaques.

Dr. Garshick cautions against picking off the scales since it could trigger increased scaling and flaking. "Patients with psoriasis can experience the Koebner phenomenon, which describes a new plaque of psoriasis that can develop anytime the skin is injured or traumatized in some way. As much as possible, avoid scratching the scalp as not only can it make psoriasis worse, it can also lead to bleeding and possible hair loss," she says.

Limit Your Use of Styling Tools

Be gentle when styling your hair to avoid irritating the scalp. "It is best to avoid tight hairstyles, as pulling too tight on the scalp can lead to irritation," says Dr. Garshick. "Additionally, curling irons, rollers, coloring, perming, or relaxing your hair should be limited—especially if there is an active flare—as these can be irritating to the scalp." 

If you're concerned about concealing plaques, Dr. Green suggests "a low pony with added texture to hide irritation at the nape of your neck. You can add volume to down-dos by gently teasing strands at the root to conceal any scaliness behind the ears. If the hairline is typically your trouble zone, full or side-swept bangs can help hide redness."

Avoid Bleaching Your Hair

Along with hair dyes, you should avoid bleaching your hair if you have psoriasis, says Dr. Thacker. "The itchiness can lead to micro-cuts on your scalp, which can make bleach feel like a burning sensation," she says. "Both bleaching and psoriasis can also cause hair strands to break."

If you want to color your hair, Dr. Thacker recommends opting for an ammonia-free dye, and "semi-permanent dye is gentler on your hair than permanent options."

Try Exfoliating Shampoo

Instead of picking at your scalp, Dr. Thacker recommends using an exfoliating pre-shampoo treatment with glycolic acid—an alpha hydroxy acid (AHA) that works to exfoliate dead skin cells on your scalp. "This helps shed the build-up that causes adherent scales," she says.

Removing dead skin cells can also improve the absorption of other scalp treatments like serums or foams often used for psoriasis. "Apply glycolic acid to dry scalp areas with thick scale buildup, leave it on for 10-20 minutes, then wash as usual," Dr. Thacker adds. She also says, "Once a week is a good starting point to avoid over-drying your scalp. I recommend Ordinary's Glycolic Acid Toner, as it is affordable and effective."

Avoid Using Hair Growth Products

Hair loss related to psoriasis is treated differently than female or male-pattern hair loss, according to Dr. Thacker, with untreated scalp psoriasis causing thick plaques that lead to hair loss.

"Although Rogaine—or minoxidil—works wonders for female or male-pattern hair loss, I don't recommend using it if you have psoriasis because it can irritate your scalp." Instead, Dr. Thacker suggests treating the psoriasis to calm the inflammation. "As the plaques and scales clear, your hair will start to grow back," she says.

Try UV Light Combs

There are many topical benefits to using UV lights—for psoriasis, Dr. Foad says that UV light hair tools can help control scalp psoriasis. "These handheld combs are phototherapy devices designed to let the light pass through the hair and reach the affected parts of the scalp," she explains. "UV light is beneficial in treating psoriasis because it reduces inflammation and itching, and slows down the growth of skin cells."

Consult a Dermatologist

If you don't see improvement with over-the-counter remedies, it's time to see a board-certified dermatologist. Dermatologists can prescribe prescription shampoos, topical steroids, and non-steroidal anti-inflammatories in the form of solutions, foams, gels, sprays, or oils. Dr. Garshick notes that another course of treatment includes "intralesional steroid injections into the plaques themselves, oral medications such as Otezla, or biologics."

On the topic of steroid injections, Dr. Foad adds, "These injections can provide temporary clearance for tougher, more resistant plaques, sometimes lasting a month or longer, and can be used alongside topical treatments. These injections should also be covered by your insurance."

Another option might be a type of laser treatment known as the Excimer laser which, according to Dr. Garshick, delivers ultraviolet light at 308 nm to the psoriatic plaques on the scalp. Both Drs. Garshick and Green advise you to keep an open dialogue with your dermatologist about lifestyle and treatment, as consistency is key for effectiveness.