Though psoriasis is primarily a skin condition, it can cause a number of different symptoms and show up in a wide variety of ways. This often leaves people diagnosed with the condition wondering if a particular symptom is caused by their psoriasis or something else. When it comes to alopecia (hair loss), psoriasis may be the culprit. Hair loss can have a number of causes, some of which are related to the condition.
Here’s what you need to know if you’re living with psoriasis and hair loss. As with any psoriasis symptom, talk to your dermatologist if you notice new or worsening hair loss. They can determine the cause and work with you to find the best way of managing it.
A number of MyPsoriasisTeam members have experienced hair loss — particularly from scalp psoriasis. “My hair was progressively thinning out,” wrote one member, “and then it started falling out in clumps at the plaque psoriasis places on my scalp.” This can come on quickly, as it did for one member who wrote, “All of a sudden, I’m losing massive amounts of hair.”
Sometimes, people lose their hair only when they tug on it with a brush or comb. As one member explained, “My hair was falling out ‘big time’ every time I combed it. I always had thick hair, but there was so much hair loss that on the back of my head, you could see a large area of my scalp.”
In some cases, people lose a significant amount of hair, which can lead to some difficult choices. “My hair is falling out like crazy. I might shave my head due to scalp psoriasis,” one member lamented. Another wrote, “My hair has been falling out since March, and the thickness of my hair is down by 50 percent.”
Hair loss from psoriasis can show up in a wide variety of ways. One study found that for about half of the people who experience hair loss, it’s acute (short-term) — it shows up as part of psoriasis flares and goes away when the flare-ups pass. Others experience it chronically, having hair loss regardless of whether or not their psoriasis is flaring.
Most of the time, hair loss occurs where a person already has psoriasis plaques or lesions. A few people experience more widespread hair loss. Although living with psoriasis does increase your risk of developing long-term alopecia, the vast majority of people with psoriasis experience only temporary hair loss and will regrow their hair once the psoriasis is under control. Some products are available to speed up hair growth, but doctors don’t always recommend them.
Psoriasis on the scalp can lead to scarring, so treating the condition is important. Hair may not grow back in areas that have been scarred. This is rare, but it can occur.
There are several ways that psoriatic disease may result in hair loss.
Psoriasis is an inflammatory disease of the immune system. Scalp psoriasis can affect both the skin cells and hair follicles. This can cause the follicles to weaken and make the hair they produce brittle. Although brittle hair may not necessarily fall out, it usually breaks more easily than healthy hair does. Simply brushing brittle hair or pulling it back into a tight hairstyle may cause breakage.
The inflammation from psoriasis causes plaques to build up on the skin. Removing these scales without sufficient care can break off any hair in the affected area.
Psoriasis plaques are often itchy. This itchiness can be accompanied by dry skin, flaking, and dandruff, which can worsen the problem. Many people with psoriasis find themselves scratching their scalp, even if they don’t intend to. This scratching can break weak hair, causing even more hair loss.
For some people, stress is a trigger for plaque psoriasis. Since hair loss itself can cause stress, people can find themselves in a negative feedback loop — stress can worsen psoriasis, which can lead to hair loss, which can cause more stress, and so on. Finding healthy ways to manage the stress that causes and is caused by psoriasis could be key to minimizing or preventing hair loss.
Some of the oral medications or injected medications used to treat psoriatic disease — such as biologics — can cause hair loss as a side effect. If you start losing your hair after taking a new medication, talk to your rheumatologist or dermatologist about its side effects. In consultation with your doctor, you may choose to try a different medication.
There are a few things you can do to prevent or minimize hair loss associated with psoriasis or scalp psoriasis.
Talk to your dermatology team about getting a medicated shampoo or other topical scalp treatment (like a topical steroid cream) for the affected area or for your whole head. These can help get your psoriasis under control, which can help stop or minimize the hair loss you experience. Shampoos for scalp psoriasis can have a wide variety of effective ingredients, including coal tar, salicylic acid, and corticosteroids.
Don’t pick at the plaques on your scalp. Instead, start by making sure your shampoo has a scale softener. Use the shampoo as directed, then see if you can very gently peel any of the scaly patches off your scalp. You may need to let the shampoo soak in or use it multiple times before you can remove the plaques without taking hair along with it.
You will have to use your hands to rub your shampoo or topical treatment in, but keeping your nails short can minimize the damage you do to your hair while applying the product. It can also help minimize damage if you accidentally scratch your scalp or if you scratch while you’re asleep.
A moisturizing conditioner can prevent some of the dryness you might experience on your scalp, which will minimize itching and, therefore, hair loss. Test your conditioner, along with all of your hair care products, to make sure it’s not adding to your scalp difficulties.
Let your hair air-dry, and don’t use a curling iron or flat iron or other heated styling implements on your hair while you are dealing with scalp psoriasis. Doing so will help your scalp heal faster and help you lose the least possible amount of hair while it’s healing.
If you are experiencing hair loss related to psoriasis, talk to your health care provider right away. They can provide medical advice and help you find an effective treatment option, so you can minimize both the amount of discomfort and the hair loss that you experience.
Are you or a loved one living with psoriasis? Consider joining MyPsoriasisTeam today. Here, on the online social network for people living with psoriatic disease, you can share your story, meet others who live with the same issues, make friends, and more. It won’t be long before you find yourself surrounded by a team of people who will be there no matter what psoriatic disease throws at you.
Are you struggling with hair loss due to scalp psoriasis? Have you found a way to treat your scalp psoriasis and related hair loss and you’d like to share it? Share your thoughts or tips in the comments below or by posting on MyPsoriasisTeam.