This week, Marion Kerrlooks at psoriasis of the scalp:
I have developed severe dandruff which has been unresponsive to a range of anti-dandruff preparations. Someone has suggested that it could be psoriasis. Can psoriasis affect the scalp?
Psoriasis is estimated to affect up to 3 per cent of the Irish population and is therefore a common condition. It can take several different forms and present in a wide range of ways.
Psoriasis of the scalp affects up to half of all patients with the condition. It can also affect the elbows, knees and other parts of the body such as under the toe and finger nails, in the creases of the skin and the lower back.
Classically, psoriasis develops as red, non-itchy plaques, the top surface of which tends to be silvery in colour. However, many patients present with atypical rashes, making the diagnosis difficult.
In cases of psoriasis of the scalp, when the scales detach they can give the appearance of severe dandruff. You should see your doctor for a definitive diagnosis.
I never had psoriasis before and there is no sign of it anywhere else on my body. Could it have anything to do with the medication I have started to take for high blood pressure?
Some medications are known to exacerbate existing psoriasis or cause it to happen for the first time. These include ACE inhibitors and beta blockers which are often used in the treatment of cardiac and blood pressure problems.
Anti-malaria drugs, non-steroidal anti-inflammatory drugs and lithium are all known to be associated with a flare-up of psoriasis. The sudden withdrawal of steroid treatment may also precipitate the condition.
Can it be easily treated?
There are a wide range of scalp preparations specifically developed to treat psoriasis of the scalp. These are available in shampoo, ointment, lotion and oil formulas. Tar-based shampoos are most effective if left on the scalp for a period of time before washing out.
Applying lotions, foams and ointments to your own head can be difficult so you may need some assistance to remove the loose plaques and apply the preparations onto the affected areas of the scalp.
Some sufferers experience hair loss but this is usually temporary and tends to return to normal with treatment.
In most cases, psoriasis of the scalp responds well to treatment but you do have to persist with the regime.
For further information and support contact the Psoriasis Association of Ireland at www.psoriasisireland.ie