Scalp Psoriasis, and Other Affected Areas

This form of psoriasis is extremely common, affecting as it does half or more of all people with psoriasis. It presents in the normal fashion as raised red lesions which later produce scale.

Scalp psoriasis runs the entire range from a very slight presence to extremely severe development; in fact the whole scalp can be encrusted causing severe distress and even lead to loss of hair. It often develops beyond the scalp onto the neck, forehead and ears.

Treating Scalp Psoriasis - soothing and healing

Psoriasis scalp treatment often takes the form of medicated mild shampoos or conditioners.

There are many forms of psoriasis scalp treatment, but you should consider how the treatment you adopt will affect your daily life. The most important thing to do is to get control of the lesions and crusting.

Expect treatment to take at least eight weeks, maybe more to take full effect. The first thing to do is to remove the crusting and plaque and reduce or eliminate the itching. To do this, soften the psoriasis with warm water and gentle shampoos specially designed to help the condition, followed by a psoriasis conditioner, or use a gel or cream formulated to help psoriasis. This should bring relief from itching and allow for removal. After sufficient time, this should allow you good control over the condition, often virtually or actually eliminating it. Scalp psoriasis also self-terminates on occasion.

Tars, steroid and other treatments are also available, and may be used if the above fails to work, but they are less pleasant and not always necessary. Your doctor will advise you if your first treatment (as above) is unsuccessful.

Tars can be painful and unpleasant smelling, whilst steroids can worsen the condition if stopped too soon. Again your doctor knows best if these are routes you should follow.

Psoriasis affecting hands and feet

Standard surface-application treatment of of psoriasis on the hands and feet involve the use of steroids, tar and salicylic acid. Treatments combining these ingredients are frequently better than the use of just one on its own. 

Normally sufferers also use gels or creams, mild soaps and moisturisers.

When psoriasis flares up acutely on the hands or feet, it should be treated as soon as observed. Sometimes these cases also involve skin-swelling, blisters and even skin cracking.

Your medical adviser may recommend covering the affected area after surface treating the surface with gel or cream, and this will enhance the effect. Various forms of cover maybe used – plastic and cotton are both fine.  

Soaking the affected area in warm water can help to soften the skin and to reduce plaque build up before applying treatment.

Your doctor will advise you best on the use of more potent medications if required and since these forms of treatment may involve potential side effects medical advice is essential.

Psoriasis affecting the Nails

A minimum of 80% of sufferers from psoriatic arthritis and as much as 50% of people with other forms of psoriasis suffer from psoriasis of the nails.

Psoriasis patients with nail problems mainly suffer from:
Nail thickening
Nail shape change as it deforms
Small holes of varying depth appearing in the nails
Nail discoloration
Nail coming off its bed – known as Onycholysis

The Treatment of Nail Psoriasis

The problem with successfully treating nail psoriasis is that the nail is affected during its formation and the area where that occurs is very difficult to get at with treatments applied to the skin or nail as they find it hard to penetrate sufficiently deeply.

The nails can be surgically removed and replaced with artificial nails.

Steroids can be applied topically though as stated with limited success, whilst steroid injections are sometimes tried but are very painful so not used unless there is no option.

Frequently where psoriasis is present on other parts of the body, ingested treatment for it can assist the nail psoriasis as well – sometimes very favourably.

Psoriasis of the nails is sometimes accompanied by Onychomycosis. This is a fungal infection and results in thickening of the nails. It can also be treated in its own way.

Caring for Nails affected by Nail Psoriasis

If your nails are mainly intact you can use artificial nails or hardeners, but be cautious in case of unfortunate reactions, so test on a small area first.

Soaking your nails in warm water followed by drying and applying a moisturiser can be helpful.

You should keep your nails cut as far back to the quick as possible without breaking the skin or causing yourself discomfort. Protect the nails from damage by wearing gloves whenever possible. Treat the nails gently and do not work on them too hard with metal instruments as you may break the skin and worsen matters.

Treat toenails by soaking in warm water for 10 minutes or so at a time and keep them cut short.

All affected nails, hands or feet, should be kept well trimmed as close to the quick as possible, with clippers, but be sure not to cut yourself or cause pain. Be especially careful when using hard metal or other implements that you create no damage.

Psoriasis affecting the genitals

Psoriasis sometimes occurs in the genitals alone or together with outbreaks elsewhere on the body, and can affect large or small areas, most commonly in the form of inverse psoriasis (see above).

This form of psoriasis is usually fairly amenable to treatment but care should be taken as the skin in that area is very sensitive. It is best to consult your doctor before commencing treatment.

Psoriasis on the Face

Psoriasis usually appears on the face at the hairline, forehead, eyebrows, or the upper lip and sometimes responds to topical treatments such as petroleum jelly, gentle moisturisers and special creams or gels developed to help psoriasis.

Steroids are sometimes used but can cause skin-thinning, veining and shiny skin.

If initial treatment as suggested above does not work, consult your doctor.



"Dear Katharine,

Your face cream is amazing!!

Best wishes



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