Psoriasis spots on the scalp: what to know

Scalp psoriasis is an inflammatory form of Psoriasis that may appear as small areas or thicker plaques. Flakes can resemble dandruff, but psoriasis scale is often more noticeable and the skin underneath may look red or darker than nearby skin. Scratching can loosen scale, irritate the skin and contribute to temporary hair shedding; it does not mean the hair follicle has been permanently damaged. A clinician may compare the scalp with the ears, elbows, knees and nails because psoriasis can affect several sites.

Arrange a dermatology assessment if the spots persist, spread or interfere with sleep. Treatment may include a medicated scalp product, a leave-on medicine, or another option chosen for the thickness and location of the plaques. Apply products to the scalp rather than only to the hair, following the prescribed schedule. Soften scale as directed, wash gently, and avoid forcefully picking it off. Keep nails short and pause hair treatments that sting or inflame the area.

Seek prompt medical advice for rapidly worsening redness, marked pain, pus, crusting, fever, or widespread blistering. Contact a clinician if the scalp becomes difficult to open, the skin cracks and bleeds repeatedly, or hair loss is sudden or patchy. New scalp scaling can have causes other than psoriasis, so an examination is useful when the appearance is uncertain.

Ask whether the spots fit psoriasis or another scalp condition, how long to leave a product on, and how to protect the hairline. Also ask what to do if burning develops, how to recognise infection, and when persistent itching needs a follow-up.