What should you know about hairline psoriasis?

Psoriasis is an inflammatory skin condition that can affect the scalp and extend onto the forehead, behind the ears or the neck. The hairline may show a clearly outlined red or darker plaque with dry scale, itching, soreness or cracking. Scale can cling to hair, but psoriasis does not result from poor hygiene and is not contagious. Similar-looking rashes include seborrhoeic dermatitis, eczema and contact irritation from hair dye or products. A clinician may examine the scalp, nails and other skin areas before confirming the diagnosis.

Use fragrance-free cleansers and moisturisers, and soften scale rather than scratching or forcibly lifting it. Keep nails short and tell your clinician if the rash reaches the eyelids or ears. Prescribed scalp solutions, foams or creams may be easier to apply along the border than thick ointments; use them only as directed because some medicines are unsuitable for prolonged facial use. Avoid changing several products at once, and rinse hair dye promptly if burning begins. A treatment plan may need adjustment during flares.

Arrange a review if the rash is spreading, cracking, bleeding, affecting sleep or not responding to the prescribed plan. Seek prompt advice for pus, marked warmth, rapidly increasing pain or facial swelling, which may indicate infection or a significant reaction. New joint stiffness or swollen fingers should also be mentioned because psoriasis can occur with joint symptoms.

Is this psoriasis or contact irritation? Which product can I use on the forehead edge, how should I separate it from the eyes, and what should I do during a flare?