Scalp Psoriasis: The Dandruff Problem that Never Ends?

What is scalp psoriasis?
According to the National Psoriasis Foundation (NSP), psoriasis is a "chronic, autoimmune disease that appears on the skin" and "occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells." Psoriasis, then, is simply the overactive shedding of skin cells. Psoriasis can occur anywhere on the body (knees, torso, elbows being common areas). In psoriasis of the scalp, scalp skin cells shed at a ridiculously fast rate. The National Institutes of Health estimate that psoriasis affects 7.5 million Americans and 125 million people worldwide. Half of all people with psoriasis have it on the scalp.

Causes/ Symptoms
Scientists have not been able to pinpoint the exact cause of scalp psoriasis or what causes the immune system to shift into high gear out of the blue. Some research seems to suggest that there is a genetic predisposition at play. Typically, skin cells grow, mature, then shed once a month (or about every 28-30 days). Psoriasis-driven skin cells will mature in 3-4 days, and then WON'T shed at all. They just sit there and pile up with the rest of the "matured" cells on the surface of the skin.

What's the difference between dandruff and scalp psoriasis?
Psoriasis and dandruff both present with flakes and itching, but psoriasis flakes tend to be much larger than standard dandruff flakes and are not limited to the scalp area. Also psoriasis, unlike some forms of dandruff, is not contagious. But it can still be rather annoying. This pesky scalp problem laughs at your attempts to wash the hair by producing even more layers of dry, scaly scalp skin. Rather than flakes rinsing away nicely with your shampoo, wet psoriasis simply lingers on the scalp and becomes a gummy, gunky unwanted white skin cap. It is truly the dandruff problem that never ends. When dry, the scalp appears white, and scratching it away only reveals more layers of this stuff. Because scalps often appear somewhat white anyway on their own, you might have psoriasis without even knowing it. It is often once you scratch that top layer while parting the hair where you realize, "Hey... there is actually scalp under this!"

Wondering what scalp psoriasis looks like on a typical, healthy scalp? Picture what your scalp would look like if you found the thickest deep conditioner possible and just let it sit on your hair and scalp. Now rinse your hair only. Welcome to the world of scalp psoriasis. This scaling can be thick, or light, and may be in patches or spread throughout the scalp. Either way, the condition is quite stubborn to treat.

Treatment
Unfortunately, there is no cure for psoriasis. Several over-the -counter and prescription options exist. In some individuals, the scaling can spontaneously clear up on its own. Nizoral shampoo is one effective, topical treatment against psoriasis and a host of other scalp ailments. It is now available in most drug stores without a prescription. Unfortunately psoriasis can return once treatment ends and shampoo is no longer regularly used. The shampoo is also quite drying and tangles the hair terribly, so most would find it difficult to use for each and every wash.

See your dermatologist
Think you may have psoriasis? See your dermatologist. Sometimes psoriasis can look like other ailments such as your typical dandruff or seborrheic dermatitis flare ups. It is important to know whether you have psoriasis because it can often be an indicator of other co-morbidities, or serious health problems, like diabetes or heart disease.

References
National Psoriasis Foundation. http://www.psoriasis.org/netcommunity/about_psoriasis
Mayo Clinic: Scalp Psoriasis vs. Seborrheic Dermatitis: What's the Difference?