What should you know about bald psoriasis?

Psoriasis does not usually destroy hair follicles. Hair can often regrow after inflammation settles and rubbing or picking stops, although another cause of patchy loss may need to be excluded.

Scalp psoriasis commonly presents with sharply defined, inflamed plaques and dry, silvery scale. Scale may extend just beyond the hairline, and itching can lead to broken hairs or shedding in the affected area.

A smooth round patch, broken hairs, pus, tenderness, or a boggy swelling is not explained by psoriasis alone. These findings can occur with other hair or scalp disorders, so appearance and scalp examination matter before treatment is changed.

Use prescribed scalp treatment as directed, part the hair so medicine reaches the skin, and soften scale before gently washing it away. Avoid scraping plaques, picking scale, tight hairstyles, harsh brushing, and very hot water.

Photograph the area in consistent lighting and note whether scale, itch, and shedding improve together. A clinician can adjust the formulation for a hair-bearing area and check whether infection or another form of hair loss is present.

Arrange an appointment if a bald area is new, enlarging, painful, oozing, crusted, or not improving as the psoriasis settles. Seek prompt care for fever with a hot, swollen scalp, rapidly spreading redness, or significant pus, because these signs may indicate infection.

Ask whether the bald area fits inflammation-related shedding or needs testing for another condition; which product should touch the scalp rather than the hair; how to loosen scale safely; and what changes would mean returning sooner.