Psoriasis under hair: what to know

Hair may conceal the edges of a plaque, redness and loose scale. You may notice itching, tightness, flakes on clothing, or soreness before you can see the skin clearly. Psoriasis can also extend from the scalp onto the forehead, behind the ears or the back of the neck. Scratching and vigorous brushing can create small injuries and may increase shedding. A scalp examination can distinguish psoriasis from dandruff, irritation, infection or another cause of scaling.

Part the hair gently in good light to check the skin without scraping it. Apply a prescribed lotion, foam, solution or shampoo to the scalp surface as instructed; ask for help reaching covered areas if needed. Wash with lukewarm water and avoid picking, tight hairstyles, harsh chemicals and heated tools when the scalp is irritated. Keep a simple record of itch, scale, tenderness and shedding to discuss at review.

Arrange care for persistent scalp symptoms, repeated bleeding, painful cracks, sudden patchy hair loss or discharge. Seek prompt advice for fever, pus, rapidly increasing tenderness or widespread blistering. If a product causes intense burning or swelling, rinse as directed on its label and contact the prescribing clinician.

Ask how to part the hair and apply treatment, whether a wash or leave-on product fits your scalp, and how to handle thick scale. Ask which hair-care ingredients to avoid during a flare and whether shedding should be examined.