If you have psoriasis on your scalp or near your hairline, your symptoms and treatment may affect how you style your hair. According to the National Psoriasis Foundation, between 45 percent and 56 percent of people living with psoriasis have scalp psoriasis. This type of psoriasis can cause symptoms like dryness, plaques, flaking, and irritation and itching on the scalp itself, as well as on the hairline, forehead, back of the neck, and skin around the ears.
The following dermatologist-recommended tips for hairstyling with psoriasis can help you avoid flares, make the most of treatment, and disguise plaques or hair loss.
Be as gentle as possible when combing or brushing your hair. Injuring the skin by scratching or scraping can cause scalp psoriasis to flare. In fact, in a response known as the Koebner phenomenon, skin injury can cause psoriasis plaques to develop on previously clear areas of skin.
Harsh brushing or combing can sometimes have another frustrating impact: temporary hair loss. Whether a person with psoriasis accidentally scratches their dry scalp or forcibly removes itchy plaques, they may lose hair in the affected areas. The hair usually will grow back unless the hair follicles are damaged.
Watch as MyPsoriasisTeam member Katya Meltaus discusses how she manages psoriasis plaques on her scalp.
Pulling too tightly on the hair may cause scalp irritation, potentially leading to a psoriasis flare-up. Constant tension from tightly pulled hairstyles may also cause hair strands or follicles to break or fall out, leading to a form of scarring, irreversible hair loss known as traction alopecia.
To prevent irritating the scalp and losing hair, avoid styles that constantly pull on the hair, including:
Some styling tools, like rollers, straightening irons, and curling irons, use high heat to achieve a long-lasting style. The heat may burn or irritate the scalp, potentially leading to a psoriasis flare. Limit how often you use these tools, and when you do use them, take extra care to prevent them from touching your scalp.
Coloring your hair with dye or relaxing your hair with chemical treatments can cause scalp irritation and psoriasis flares. Some people using hair dye may also have an allergic reaction known as contact dermatitis, which can cause the skin to be discolored, dry, and irritated on top of existing psoriasis symptoms. Like scalp psoriasis, contact dermatitis is initially treated with topical steroids.
If you would like to color your hair, some strategies can help limit irritation from hair dye.
Cleveland Clinic notes that plant-based dyes and other all-natural hair colorants are a good option if you want to avoid exposing your skin to the chemicals found in most artificial hair dyes. One MyPsoriasisTeam member offered an alternative to chemical-based hair color: henna dye. Henna dye is a plant-based product made from the leaves of the henna tree (Lawsonia inermis). As this member wrote, “I stopped using chemical hair dye years ago because I found henna dye. It is all natural and does not burn, even when the scales are horrible.”
Before trying any new hair dye, treatment, or styling product, perform an allergy test known as a patch test. Dab a small amount of the product on a discreet area of skin, such as behind your ear or on your inner elbow, and allow it to dry. If you experience any irritation after applying the product, do not use it further.
Although a patch test can help gauge your short-term response to a hair product, research has shown that people with psoriasis may have delayed reactions to irritating substances. One 2014 study found that it took seven days for reactions to reach maximum intensity in people with psoriasis versus three to five days in people without psoriasis. Be careful even after doing a patch test.
Before you sit down in the salon chair, let your stylist know about your psoriasis. Having psoriasis can influence the cut or hairstyle a person decides to wear, depending on their goals. There’s a good chance your stylist has worked with other clients who have psoriasis. If not, let them know that psoriasis is not contagious and is not an infection. As some MyPsoriasisTeam members have noted, you may also want to tell them that harsh combing, brushing, or heat styling could aggravate your psoriasis.
“I went to the hairdresser’s today,” wrote one member, “and it aggravated my psoriasis on my scalp! I have a lovely hairstyle that’s now ruined by my itching.”
Topical treatments are currently used as first-line treatment in many people with scalp psoriasis. However, hair can complicate treatment. As one research team described in a report for Psoriasis, hair affects not only the application and penetration of medications but also how likely a person is to stick to their treatment plan — topical treatments may make hair greasy or can be difficult to remove. Some MyPsoriasisTeam members have shared that keeping their hair short is helpful for treatment. Ask your doctor about topical solutions and foams that won’t get caught as easily in your hair.
Psoriasis treatment isn’t the only factor taken into account when deciding on a haircut. Some MyPsoriasisTeam members have shared that psoriasis-related hair loss has also made them consider changing their hairstyles.
“I’ve been thinking about my hairstyle here lately,” wrote one member. “My entire life, I’ve always had long, pretty hair. Now that I’m practically bald, I’m wondering if I should let my hair grow back out or look for a cute, short hairstyle. I’m wondering if I should get a short hairstyle to help keep the psoriasis maintained, as well.”
In addition to camouflaging hair loss, some hairstyles can cover psoriasis — a preference of some MyPsoriasisTeam members. Some share frustration with feeling that they need to keep hair long to cover their plaques. As one member with psoriasis on their neck and behind their ears wrote, “Sometimes, I feel like chopping my hair. I do not wear short hair due to my psoriasis.” Another shared that their hairstyle depends on their psoriasis symptoms: “I cover mine up as much as possible with my hair. I also have psoriasis on my forehead, as well as on my scalp and behind my ears, so my hairstyle is always chosen by how I cover it all up.”
Other members get creative with their haircuts to help hide psoriasis lesions. “I cut my hair at a small salon,” one member wrote, “so now I have a bang. It helps me to cover my scalp psoriasis that is now below my hairline. Sometimes, it is red, thick, and flaky, and no amount of makeup can hide it.”
MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, members ask questions, offer advice and support, and share their experiences living with psoriasis. Hairstyling for psoriasis is one of the most frequently discussed topics.
How do you style your hair with psoriasis? Share your tips with members in the comments below or by posting on your Activities page.