Hair loss from psoriasis on the scalp

Psoriasis can create thick scale, itch, redness, and soreness on the scalp. Scratching or forcefully lifting attached scale can pull out hairs or break them near the surface. Inflammation and the stress of a flare may also shift hairs into a shedding phase. This is different from a permanently scarred follicle, and the amount of shedding does not show how severe the psoriasis is by itself.

Not every episode of hair loss in someone with psoriasis comes from psoriasis. Smooth round patches may fit Alopecia Areata, while diffuse shedding may be Telogen Effluvium. Infection, inherited pattern loss, medicines, or another inflammatory condition can coexist and should be considered if the pattern is unusual.

Follow the scalp treatment prescribed for your psoriasis and apply it as directed, allowing products intended to soften scale time to work rather than scraping. Wash gently, keep nails short, and avoid tight styles, extensions, harsh dyes, and high heat while the scalp is sore. Do not stop a prescribed medicine because of shedding without discussing it. Photograph the scalp between flares so a clinician can compare scale, redness, and density.

Arrange a review if treatment is not controlling itch or scale, or if hair loss continues after the scalp settles. Seek prompt assessment for pus, spreading redness, severe pain, fever, tender lumps, smooth shiny areas, or rapidly enlarging bald patches. These features can point to infection, a different diagnosis, or a complication needing specific treatment.

Is the shedding consistent with scalp psoriasis or is another cause present? How should I loosen scale without pulling hairs? Which treatment is suitable for my scalp and other medicines? Could a recent flare trigger Telogen Effluvium? What changes should prompt an earlier review?