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Real members of MyPsoriasisTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Tried lots of medicated shampoos, oils, steroids and when I scrape the scales off my scalp is bright red. The scales build up very quickly and it itches like crazy

January 9
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A MyPsoriasisTeam Member

I had moderately severe dandruff dating back to age 22. Now I'm 64. Dandruff is technically called "seborrheic dermatitis," which is related to eczema. If you ask me, eczema and psoriasis are also related, although "they" don't say that.

Then there's also what's called "sebopsoriasis" if you've never heard of it, which is a cross between seborrheic dermatitis and psoriasis. So when I had my major psoriasis outbreak last year, I ended up with what looked like sebopsoriasis on my face, neck, behind the ears, and also parts of the scalp (mainly the sides of the head and at the hairline of the forehead).

When I started my regimen in February of this year, not only did the scalp psoriasis clear up along with the rest of the psoriasis all over my body, but for the first time in over 40 years I no longer have any dandruff. It was a real surprise when the dandruff also cleared up...

January 20
A MyPsoriasisTeam Member

Time to see your dermatologist. I had it badly on my scalp and Clobetasol solution worked great. Them diagnosed with Psoriatic arthritis and mocked on to other solutions that treat both but the clobetasol was amazing.

January 20
A MyPsoriasisTeam Member

I am sorry you are suffering. In my experience, everything that I found that worked with my scalp, I was allergic to. They all had tea and euculypus extracts. Plant based relief and I are not compatable. For me it cleared up once I started medication. Currently I am on tremfya and that is currently working for me, but its only been about 6 months. I hope you find something that works for you,.

January 12
MyPsoriasisTeam

How can you manage stubborn scalp psoriasis that hasn't responded to typical treatments?

Dealing with scalp psoriasis for 40 years with limited relief is incredibly frustrating. The bright red scalp and rapid scale buildup you're experiencing suggests your condition may need a different treatment approach.

Since topical Show Full Answer

How can you manage stubborn scalp psoriasis that hasn't responded to typical treatments?

Dealing with scalp psoriasis for 40 years with limited relief is incredibly frustrating. The bright red scalp and rapid scale buildup you're experiencing suggests your condition may need a different treatment approach.

Since topical treatments haven't been effective, it might be time to discuss systemic medications with your doctor. These include:

- Biologics (medications that target specific parts of the immune system)
- Immunosuppressants like methotrexate
- Phototherapy with specialized devices

A MyPsoriasisTeam member shared: "I don't have a problem at all now, since I have been on immunosuppressant medication for 10 years."

It's important to avoid picking or scraping the scales, even though it's tempting. This can trigger the Koebner phenomenon, where new psoriasis lesions appear in injured areas of your scalp that were previously clear. Some members have found relief with scale-softening approaches before washing:

- Coconut oil applied overnight (wash hair twice to remove)
- Extra-virgin olive oil dabbed on plaques
- Salicylic acid products to help loosen scales

One member noted: "Extra-virgin olive oil worked miracles on the plaques. I would dab them, and they would dissolve within an hour. Relief would last a week."

Given your 40-year history without adequate relief, a conversation with your dermatologist about adjusting your treatment plan to include systemic therapy may be your best path forward. Your current treatments clearly aren't managing the severity of your symptoms.

January 9

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