In short
- Thick silvery plaques, often extending to the forehead, ears and neck.
- First-line: coal tar or salicylic acid shampoo + topical steroid scalp application.
- Second-line: vitamin D analogue (calcipotriol) foam or scalp solution.
- Severe cases benefit from systemic therapies overseen by a dermatologist.
Scalp psoriasis is an immune-driven inflammatory condition — not a hygiene issue and not dandruff. About 60% of people with psoriasis anywhere on the body have scalp involvement, and about 2% of Londoners have psoriasis overall.
How to recognise it
Thick, silvery-white scale on well-defined red patches. Often extends past the hairline onto the forehead, behind the ears, or into the ear canal. Distinguishes from seborrheic dermatitis by thickness and sharp borders.
The London treatment ladder
- Salicylic acid or coal tar shampoo to lift scale (Neutrogena T/Gel, Capasal).
- Topical corticosteroid scalp application (mometasone or clobetasol) — short courses.
- Vitamin D analogue (Dovonex, Enstilar) — long-term maintenance without steroid effects.
- Phototherapy for stubborn cases — available at St John's Institute and NHS dermatology.
- Systemic biologics for severe cases — dermatologist-led.
What not to do
Do not pick or scratch — psoriasis is Koebner-positive (physical trauma triggers new lesions). Do not stop treatment abruptly; taper under guidance. Do not rely on anti-dandruff shampoo alone; it does not treat psoriasis.
Psoriasis rewards steady maintenance and punishes intermittent panic.
Frequently asked
Common questions
Will hair grow back on psoriasis patches?+
Yes, once inflammation is controlled — psoriasis rarely causes permanent hair loss.
Is scalp psoriasis contagious?+
No — it is autoimmune, not infectious.
Can I dye my hair with scalp psoriasis?+
Yes, when inflammation is quiet. Choose PPD-free dyes and patch test.
Keep reading
Related, trichologist-reviewed
Scalp health
Dandruff and seborrheic dermatitis in London: what actually works when shampoo isn't enough
Dandruff is not dryness, does not respond to moisturising shampoos, and rarely fixes itself with a Boots aisle. Here is what actually works, in what order.
Read
Scalp
Itchy scalp: the London differential and treatment paths
Itching is a symptom, not a diagnosis. The wrong product on the wrong cause makes everything worse.
Read
Scalp
Dry scalp: London causes, real fixes, and what not to do
A dry scalp isn't thirsty — it's leaking. Rebuild the barrier and the itch stops.
Read