Conditioner for scalp psoriasis

Smart Ways to Manage Scalp Psoriasis

An annoying itchy, flaky scalp is an everyday occurrence for many people with psoriasis. In fact, between 50 and 75 percent of all people with plaque psoriasis wrestle with it on the scalp. “Some people have only scalp psoriasis,” says Jerry Bagel, MD, a dermatologist in East Windsor, N.J., and a member of the National Psoriasis Foundation board.

Scalp psoriasis runs the gamut from mild, with thin scales or plaques that are hardly noticeable, to severe, covering not only the scalp but also the forehead, the back of the neck, and the skin around the ears. Severe scalp psoriasis can be extremely itchy, highly visible, and challenging to treat, because hair gets in the way.

Chances are that your doctor will have you try topical treatments for scalp psoriasis first. Products include shampoos, gels, oils, lotions, creams, and foams, some over-the-counter and others prescription-strength. “While they work in most people, getting them in and out of your hair can be cumbersome,” Dr. Bagel says.

Caring for Scalp Psoriasis

Here’s how you can maximize topical treatments for scalp psoriasis while minimizing the effects on your tresses:

  • Pretreat. Apply scale-softening agents or oils to psoriasis patches to help remove them before you apply your scalp medication. This makes your medication more effective.
  • Move your hair out of the way. When applying a product, part your hair to expose your scalp, says Fran Klapow, 50, a hairstylist from Long Island, N.Y., who has scalp psoriasis. That way you can target your scalp directly. Repeat this sectioning to treat your scalp with minimal hair involvement.
  • Apply the five-minute rule. Leave the topical treatment on for five minutes before the next step. Then rinse it out and follow that with shampoo, advises Klapow. “It isn’t easy to do, but if you use a better shampoo and lather your hair without touching your scalp, your hair won’t smell like medicine or be weighed down by the medication,” she says. A moisturizing conditioner can leave your hair looking glossier too.
  • Be gentle. Don’t rub or scrub when shampooing. Rubbing, scrubbing, and scratching tend to exacerbate scalp psoriasis.
  • Avoid mint. Mint has become a popular ingredient in many shampoos. “But if your plaques are raw and you use a mint shampoo, it could irritate them,” Bagel says. The best shampoos for scalp psoriasis have the fewest additives. One possible exception is tea tree oil. A study by Iranian researchers published in the journal Skin Pharmacology and Physiology found that tea tree oil can be effective in treating scalp psoriasis.
  • Go easy with steroids. Start with the least powerful topical steroid that works for you, and use it just three to four times a week. If you overuse these medications, your body may stop making its own steroids and your scalp psoriasis can get worse, not better.
  • Cover your ears. Some scalp medications can irritate the ears. To keep out the meds, put a little petroleum jelly on cotton balls and place the cotton balls gently into your ears before using a medicated shampoo.
  • Be patient. It can take eight weeks or more for scalp skin care treatments to have an effect. Also, don’t stop your treatment abruptly once your scalp is clear. Use a tar or medicated shampoo once or twice a week for maintenance.
  • Use conditioner. If you have scalp psoriasis, itching can be a real problem. Your dry scalp is what’s causing the itch, so look for over-the-counter products developed specifically to ease the itch. Klapow says that if you use conditioner every time you shampoo, your scalp will stay moisturized.
  • Don’t blow it. Your blow dryer can worsen your dry scalp, so let your hair air dry. If you must use a blow dryer, use the lowest setting.
  • Hide the evidence. While your psoriasis is flaring, be sure to wear light-colored clothing. Klapow says she always wore lighter-colored tops when her scalp psoriasis was severe because that made it easier to hide the skin flakes.

Talk With Your Doctor

If your scalp psoriasis is still no better, talk with your doctor about new treatment options. Recently published research from the University of Utah found that people with stubborn hairline psoriasis improved rapidly when they were given high-powered ultraviolet laser therapy in addition to traditional topical treatments. Biological agents can also help, says Bagel.

Treating scalp psoriasis presents challenges, but with persistence, you will see results.

How to treat and manage scalp psoriasis

The range of available topicals, the most commonly used treatment for scalp psoriasis, has expanded greatly, although in most cases, the ingredients aren’t new. (Typically, topicals contain a potent steroid, though synthetic forms of vitamin D, retinoids and salicylic acid are also used.) Instead, the “vehicles,” or formats in which the active ingredients are delivered, are more user-friendly, says Hsu. Rather than lotions alone, people can now choose, for instance, a spray, shampoos, oil or foam.

More good news: Scalp psoriasis doesn’t have to mean ruling out salon services. “In general, blow-drying and other types of mechanical hairstyling are safe for people with scalp psoriasis, as are processes, like coloring, that bring chemicals in contact with psoriatic lesions — as long as people don’t have sensitivities to the ingredients, which can happen with or without psoriasis,” Hsu says.

At the salon

While a trip to the salon likely won’t exacerbate scalp psoriasis, visible symptoms can impact your confidence. To ease embarrassment or anxiety, communicate openly with your stylist before and during the appointment. If you’re looking for a new stylist, call salons and ask if they have someone on staff who is familiar with scalp psoriasis. Most experienced stylists are educated about the disease. If yours isn’t, use the consultation time to explain that psoriasis is not a contagious disease or fungal infection and provide general information from the National Psoriasis Foundation, if helpful. Then go over your individual scalp and hair issues, and discuss any known sensitivities to styling products.

And keep in mind that chemicals used in coloring, perming, or straightening services can irritate anyone, with or without scalp psoriasis, who has a sensitivity to the ingredients, says Kristina Callis Duffin, M.D., associate professor of dermatology at the University of Utah in Salt Lake City, and a member of NPF’s medical board. “It’s hard to predict which products will cause a reaction in an individual because there are so many different products, and they all have different formulations,” she says.

Talk with your stylist about the potential for irritation with specific treatments and services before going forward. If you still have questions or concerns, check with your dermatologist. “If something burns during the process, or causes irritation later, ask your stylist to try a different product,” Duffin says. “Hair dyes marketed as organic or natural may be less irritating for some individuals, although it’s important to remember that people can be sensitive to anything, whether it’s ‘natural’ or not.”

Chemicals can also cause stinging pain if your scalp psoriasis includes open, bleeding areas from cracking or scratching, Hsu says. “Applying chemicals or products with alcohol to any open wound is going to sting, though it’s not otherwise dangerous and won’t generally worsen psoriatic scalp issues,” she adds.

Picking and scratching at scalp psoriasis can, however, make it worse, in a trauma-triggered process known as the Koebner effect. “Scratching and picking doesn’t spread psoriasis in a contagious process, but rather, traumatizing the skin , triggering the inflammatory process that underlies psoriatic disease,” Hsu says.

“Gentle” should be the watchword in the care of scalp psoriasis. Use caution while grooming your hair, and remind your stylist to do so, as well. Avoid burns from hot irons and trauma from firm brushes and combs, which should not rub against the scalp.

Clearing scalp psoriasis

Scalp psoriasis, along with psoriasis of the nails, genitals, palms of the hands or soles of the feet, can greatly affect your life, which is why appropriate treatment is critical.

“Scalp psoriasis impacts quality of life, including appearance where plaques are visible,” says Kiran Motaparthi, M.D., assistant professor of dermatology at the University of Florida College of Medicine in Gainesville. “Patients may feel self-conscious or distressed about scale, redness, visibility to others and even hair loss.”

Severe or undertreated scalp psoriasis can cause hair loss, which is most often temporary.

“Typically, hair loss due to psoriasis, called psoriatic alopecia, is chronic, patchy, occurs within pre-existing plaques of psoriasis and does not result in scarring or permanent hair loss,” Motaparthi says. “However, while psoriatic alopecia responds well to topical and systemic therapies, it may occasionally result in scarring or permanent hair loss if the underlying psoriasis is not adequately treated. Additionally, in some patients, psoriatic alopecia is the initial manifestation of psoriasis. Thus, patients who think their hair loss is due to psoriasis should seek prompt treatment from a dermatologist.”

Topicals work well for many people with scalp psoriasis. But they don’t always work effectively enough to give everyone the significant clearing of lesions, which should be the goal, Hsu says.

“Scalp psoriasis can affect your ability to function in your daily life,” she says. “For that reason, I am aggressive in treating it. If you aren’t being helped by the most potent topical steroid, for example, I usually move to a biologic or other systemic medication.”

Hsu says she considers treating stubborn moderate-to-severe scalp psoriasis with systemic medications even when someone’s psoriasis is mild elsewhere on the body.

“Some dermatologists stick closely to the 10 percent rule,” she says, noting many insurance companies require at least 10 percent of a person’s body surface area be affected by psoriasis before covering a biologic.

“In some cases, however, dermatologists can work with the insurance companies to prove there is a need and get the drug covered,” Hsu says. “If patients are still suffering from scalp psoriasis symptoms despite getting treatment with topicals, they should ask their dermatologist about the possibility of moving to biologics or another systemic medication.”

Motaparthi agrees. “If satisfactory improvement is not achieved within several weeks to a few months, then systemic medications should be considered,” he says. “Many effective systemic therapeutic options are available for psoriasis, including scalp psoriasis.”

Finding a physician with specialized training in psoriasis — and one who is up-to-date with the current range of available therapies — is key to successful treatment, Hsu adds.

Don’t fear your flakes

Enjoy your hair and learn tips on managing your scalp psoriasis with our free quick guide.

Psoriasis brings a myriad of pains. First, there’s the blunt physical pain: Our hands and elbows and knees and scalps itch and burn and ache; thick red plaques of inflamed skin calcify over with rough, silver scales. Then, there is the shame of trying to avoid the stares, pitying and disgusted alike.

What is scalp psoriasis?

Roughly 7.5 million Americans have been diagnosed with psoriasis, in which skin cells multiply 10 times faster than usual; these cells eventually break the surface of our skin, and when they die, they simply pile up on top of each other, creating those dense, dry and unruly patches of sore skin.

More: How Pregnancy Affected My Psoriasis and What I Did to Deal With It

In some cases, these lesions meld with each other to menace broader swathes of the body — like the scalp. People with scalp psoriasis face a unique set of challenges, like finding over-the-counter hair products that won’t agitate our already angry skin or wondering if pulling our hair into ponytails will cause our scales to crack and bleed.

Washing your hair with scalp psoriasis

Your instinct may be to leave your hair alone as much as possible to avoid irritating your scalp, but according to experts, that’s not the right move.

Washing our hair semi-regularly — about two or three times a week — refreshes our scalps. “Washing away the scaliness,” is how Dr. Lindsey Bordone, dermatologist at Columbia Doctors and assistant professor of dermatology at Columbia University Medical Center, describes the process. “If hair is unwashed for longer periods of time, the scaliness can build up so patients balance scalp care with dryness of hair,” she says. That’s why she cautions patients against over-drying our hair — since dryness, particularly the heat blast of a hair dryer, can irritate psoriasis.

More: How Psoriasis Changed My Life… for the Better

Choosing your products

Though anyone with scalp psoriasis should seek out a dermatologist, we can still use many of the common shampoos and conditioners found at the local grocery store. “Most shampoos are safe for psoriasis,” says Dr. Andrea Hui, board-certified dermatologist of Bay Area Cosmetic Dermatology in San Francisco, California. “I recommend occasionally using over-the-counter shampoos with ingredients such as zinc pyrithione (helps with itching), salicylic acid (helps with flaking) and coal tar (helps with itching).” However, in some more severe cases, a doctor will prescribe a steroid shampoo that should be used about three times a week.

We must treat our scalps tenderly, explains Dr. Bobby Buka, a dermatologist in New York City and section chief for the Mt. Sinai school of medicine. “Any irritation of the scalp makes scalp psoriasis worse… we ask that patients use only gentle products on the hair and scalp.”

More: How to Get Rid of Varicose Veins and Feel Confident With Your Legs Again

Buka says there’s been some promising data about the healing effect that omega-3s in fish oil can have on scalp psoriasis; currently, he recommends products with salicylic acid to remove “excess scale from the scalp.”

Dying your hair with scalp psoriasis

We’ve covered the basics of hair hygiene, but what do we do when we want to prettify our locks? There’s hope for those of us who’ve toyed with going Monroe blond or even Elvira black — if we’re careful. “I would recommend hair dyes that are free of harsh ingredients such as paraphenylenediamine or ammonia, which may cause irritation to the scalp,” says Hui.

Still, we’d probably do best to let a trained colorist, who will be trained to know the best products for each hair and skin type, baby our tresses.

Styling options

Once we’ve got our new shade of honeyed brown or those beach-ready highlights, we also have options about how to do our ‘do — the old wives’ tale that wearing ponytails or updos exacerbates inflammation isn’t true. “Wear all the ponytails you want,” jokes Bordone.

Of course, we should take care not to accidentally knock against scaly patches of skin while combing our hair, pull our hair up too tightly or use harsh hairsprays that can dry out our scalps.

Feeling better, inside and out

One of the worst aspects of psoriasis — beyond the bodily pain it causes — is the way it can steal our sense of poise and beauty. So knowing that we can give our hair a good wash and a fabulous new color and that we can play with some styles (or simply deploy the on-the-go ponytail like everyone else) heals more than the body. It’s good for the soul.

This post was part of a sponsored advertising collaboration.

What Ingredients in Psoriasis Shampoo Make It Effective?

Many varieties of scalp psoriasis shampoo are available over the counter. Here are some to purchase online.

If you have severe scalp psoriasis, you may be able to get a stronger, prescription-strength shampoo from a dermatologist.

These shampoos contain special ingredients that work quickly to reduce the itching, scaling, swelling, and redness caused by scalp psoriasis. Some shampoos contain one main ingredient, while others may include several. Each main ingredient can help reduce specific scalp psoriasis symptoms.

Coconut oil and coal tar, for example, are good at moisturizing and reducing itchiness. Salicylic acid can soften hard scales, while clobetasol propionate is good for severe scalp psoriasis.

Coal tar

Coal tar is a dark, thick liquid that can reduce the itchiness of scalp psoriasis. It may help to use coal tar shampoo as often as once a day and as little as once a week.

The frequency depends on the severity of your psoriasis and the strength of the shampoo. A doctor can suggest how often you should use it.

Coal tar is a powerful ingredient. You should not use coal tar on infants. Avoid direct sunlight after applying coal tar, and avoid using a sunlamp for 72 hours to prevent possible skin damage.

Do not apply coal tar shampoo to parts of the skin that appear infected, blistered, raw, or oozing. Keep coal tar shampoo away from your eyes.

Coconut oil

Coconut oil is not a proven treatment of scalp psoriasis. However, it can help reduce the symptoms of itchiness, dryness, and inflammation caused by this condition. Coconut oil contains healthy fats that can restore moisture to skin and improve its appearance.

Sulfur

Sulfur is an ingredient that can help slough off the scales associated with scalp psoriasis. This can make it easier for other chemicals and moisture to access the skin and helps reduce symptoms.

When using scalp psoriasis shampoo to remove scales from your scalp, be gentle. Do not rub, scrub or scratch your scalp, as this can worsen your symptoms.

Clobetasol propionate

Clobetasol propionate can be found in prescription-strength scalp psoriasis shampoos. This ingredient is a topical steroid that can reduce all the symptoms of scalp psoriasis, including redness, dryness, and swelling. It can also help you more easily remove some of the scaling from your scalp, face or neck.

Salicylic acid

Sometimes the scaly buildup of scalp psoriasis can become quite thick. This can make it hard for your scalp psoriasis treatment to be absorbed into your skin and reduces its effectiveness.

Salicylic acid can soften thick patches of skin, making treatment easier.

Ketoconazole

Shampoos containing ketoconazole are most often used to treat dandruff, another condition that can cause skin flaking on the scalp. It also appears effective in reducing the inflammation caused by scalp psoriasis, and may also prevent infection.

Blue lagoon algae

Blue Lagoon algae is a small plant that grows in seawater in Iceland. According to research, it appears that algae may have an anti-inflammatory effect on the skin.

Using shampoos that contain algae may reduce the redness, swelling and irritation caused by scalp psoriasis.

Zinc pyrithione

Zinc pyrithione is an ingredient commonly found in dandruff shampoos. While it’s considered very effective at treating dandruff, there’s also evidence that it may effectively treat scalp psoriasis.

Zinc pyrithione can help normalize the way skin cells grow and work, and also moisturize the scalp. This can reduce flaking and scale buildup.

Scalp psoriasis: Shampoos, scale softeners, and other treatments

Scalp psoriasis: About 50% of the people who have plaque psoriasis will experience a flare up that causes psoriasis to appear on the scalp. There are many treatments for scalp psoriasis. Some people get relief from a medicated shampoo or other treatment that you can buy without a prescription.

If scalp psoriasis remains after using this type of treatment, a dermatologist can help. With a dermatologist’s assistance, it’s unusual for anyone to struggle to control scalp psoriasis for long, even when the psoriasis is severe. Dermatologists can help people who have itching, scaling, hair loss, and bleeding due to scalp psoriasis.

When you see a dermatologist, you receive a treatment plan tailored to your individual needs. Often a treatment plan will include more than one treatment. You may need to treat your scalp differently in the morning and evening. This can make treatment more effective and help reduce side effects.

The following may be part of your treatment plan for scalp psoriasis.

Medicine you apply to the scalp

This is the most commonly prescribed treatment. Your plan may include one or more of the following medicines.

Corticosteroids: This is the #1-prescribed treatment for scalp psoriasis in children and adults. Corticosteroids work quickly to reduce redness, swelling, itch, and scale. This makes it more effective than any other treatment that you apply to the scalp.

When used as directed, this medicine is safe. Because side effects can occur with long-term use, your dermatologist may recommend another treatment to use with the corticosteroid. This reduces possible side effects.

Medicated shampoos: This is often part of a treatment plan.

If you have stubborn scalp psoriasis, your dermatologist may prescribe a shampoo that contains clobetasol propionate. This can be quite effective when used in a shampoo. Studies show that patients can safely use this shampoo every day for up to four weeks. It’s also safe to use it once or twice a week to maintain results.

Gently shampoo

Rubbing, scrubbing, and scratching your scalp can worsen existing psoriasis.

Scale softeners: If the psoriasis on your scalp is thick, it can be hard for the treatment you apply to work. A product that contains salicylic acid can soften thick, stubborn patches. Other ingredients can also help.

Calcipotriene: Most people apply this manmade form of vitamin D to the scalp before going to bed. Your dermatologist may also recommend covering your scalp with a shower cap after applying the medicine. This helps the medicine penetrate the thick patches of psoriasis.

If you need stronger medicine, your dermatologist may prescribe a medicine that combines calcipotriene with a strong corticosteroid. This combination can also help reduce scalp irritation. Most people apply the medicine once a day for two weeks. It can be used longer if necessary.

Tazarotene: Most people apply a thin layer of this medicine to their scalp before going to bed. When they wake up, they shower it off. As with calcipotriene, a strong corticosteroid may be added to your treatment plan. This can help you have better clearing.

Tip for applying medicine

Lift your hair up and away when applying medicine to your scalp.

Coal tar: Used less often today, coal tar may be recommended if your scalp itches. If you shop for a psoriasis shampoo, you’ll find that some contain coal tar. The ones that contain a weaker concentration of coal tar, you can buy without a prescription.

Treatment you receive at a dermatologist’s office or clinic

If the psoriasis fails to clear with treatment applied to the scalp or you have thick psoriasis on your scalp, your dermatologist may recommend the following.

Injections of corticosteroids: Your dermatologist can inject a corticosteroid directly into the scalp psoriasis. While this can be effective, its use is limited to a few times.

Excimer laser and other light treatments: This laser can treat psoriasis in difficult-to-treat areas like the scalp, feet, and hands. When used to treat the scalp, your dermatologist may use a device that looks like a blow dryer. A benefit of using this to treat scalp psoriasis is that this laser treats only the areas that need it.

The drawback to this treatment is that you will need to travel to your dermatologist’s office or a psoriasis clinic two or three times per week. Each treatment session takes about 10 minutes. Most patients need to continue these visits for several weeks. If your schedule won’t permit this, be sure to tell your dermatologist.

While getting these treatments, you may also need to use another treatment at home.

Excimer laser treatment is usually painless, but possible side effects include redness and sunburn-like pain.

Strong psoriasis medicine

Scalp psoriasis can be stubborn. If you are following your treatment plan and not seeing results, your dermatologist may prescribe stronger medicine. This treatment attacks psoriasis where it starts, in your immune system.

Before treating scalp psoriasis with a biologic

This patient had an unbearably itchy scalp psoriasis, which failed to clear with medicine applied to the skin.

After treating scalp psoriasis with a biologic*

A biologic may be an option for some patients.

*Results may vary from patient to patient.

If this is an option, your dermatologist may prescribe one of the following:

  • Apremilast

  • Oral (taken by mouth) retinoid

  • Methotrexate

  • Cyclosporine

  • A biologic

Following your treatment plan is key to getting results

When working with a dermatologist, it is important to use the treatment exactly as prescribed and for as long as recommended. Many patients fail to see clearing because they stop following their treatment plan.

Images
Before and after treating scalp psoriasis: Photographs used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol 2008;58:614.

Al-Mutairi N, Al-Haddad A. “Targeted phototherapy using 308 nm Xecl monochromatic excimer laser for psoriasis at difficult to treat sites.” Lasers Med Sci. 2013;28(4):1119-24.

Bagel J, Lynde C, et al. “Moderate to severe plaque psoriasis with scalp involvement: A randomized, double-blind, placebo-controlled study of etanercept.” J Am Acad Dermatol 2012;67:86-92.

Chan CS, Van Voorhees AS, et al. “Treatment of severe scalp psoriasis: from the Medical Board of the National Psoriasis Foundation.” J Am Acad Dermatol. 2009;60(6):962-71.

Guenther L. “Current management of scalp psoriasis.” Skin Therapy Lett. 2015;20(3):5-7.

Paghdal KV, Schwartz RA. “Topical tar: Back to the future.” J Am Acad Dermatol. 2009 Aug;61(2):294-302.

Renton C. “Diagnosis and treatment of adults with scalp psoriasis.” Nurs Stand. 2014 Feb 26-Mar 4;28(26):35-9.

Wong, JW, Kamangar F, et al. “Excimer Laser Therapy for Hairline Psoriasis: A Useful Addition to the Scalp Psoriasis Treatment Algorithm.” Skin Therapy Letter. 2012;17(5)6-9.

Supported in part by Novartis.

The Best Shampoos for Psoriasis, According to Dermatologists

If you suffer from scalp psoriasis—which affects nearly 80 percent of patients with psoriasis—reaching for a garden-variety drugstore shampoo to wash your hair won’t help improve the itching, scaling, and crusting on your scalp.

“Psoriasis presents as a build-up of skin cells which create scaly, patches that can itch, hurt, crust up and bleed,” says Dendy Engelman, MD, a board-certified dermatologist in New York City. This buildup, according to Dr. Engleman, can range from mild scalp psoriasis, which appears as fine scaling, to severe scalp psoriasis, which looks like thick, crusted plaques.

Because there’s no cure for psoriasis, “management is key,” says Dr. Engleman—which is why it’s so important to look for the right product to keep your symptoms at bay. Here, dermatologists weigh in on the best shampoos for psoriasis—and why they’re essential to your routine.

RELATED: 4 Things To Know About Scalp Psoriasis, According To Dermatologists

Which shampoos should you use for psoriasis?

The most effective first-line shampoo for scalp psoriasis patients, especially when the scalp is acutely itchy and red, is called clobetasol solution or topical treatment, a prescription-only treatment which can be applied as a foam, shampoo, cream, gel or lotion, says Mitchell Lewis, MD, a clinical assistant professor of dermatology at Stanford University.

But there are downsides to clobetasol’s effectiveness: “It’s a very strong corticosteroid so there’s a potential for side effects,” Dr. Lewis says. Those side effects include burning, itching, and even changes in skin color, according to the US National Library of Medicine.

Still, as a first-line treatment, clobetasol can usually bring scalp psoriasis under control within two to four weeks, says Erum Ilyas, MD, a dermatologist in Philadelphia. “Once you take that, your scalp psoriasis can be maintained with prescription topical calcipotriene (IE dovonex solution) and shampoos that contain coal tar, like Neutrogena T-Gel shampoo ($7.98, Amazon.com) and salicylic acid, like Neutrogena T-Sal shampoo ($9.96, Amazon.com).

RELATED: What is Inverse Psoriasis—and What’s the Best Way to Treat It?

But it’s important to remember that there’s no one-size-fits-all treatment plan. “Everyone has a different kind of hair, scalp and different oil production and will have different requirements in a shampoo,” says Dr. Lewis. “It takes a lot of trial and error to find the right balance.”

According to Richard Torbeck, a board-certified dermatologist with Advanced Dermatology PC in New York City, the best way to do this is to match your treatment plan to what’s going on at that exact moment on your scalp: “For flake reduction, I recommend patients use Neutrogena’s T-Sal shampoo and for inflammation and flake reduction, I recommend they use Neutrogena T-Gel coal tar shampoo,” says Dr. Torbeck. “Then, for maintenance, I recommend that my patients use prescription ketoconazole shampoo, an antifungal shampoo that also has anti-inflammatory properties.”

And one more tip that has nothing to do with your shampoo: Dermatologists urge psoriasis patients to skip the long, hot showers, avoid picking or peeling the scales from your scalp, and always be gentle when you wash your hair as your psoriasis can worsen if you scrub your scalp with too much vigor.

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