1. Medicated Shampoos — The First Line of Defense

Medicated shampoos are often the starting point for managing scalp psoriasis. They target inflammation, reduce scaling, and calm itching.

Key active ingredients:

Coal tar: Slows skin cell growth and eases inflammation.

Salicylic acid: Helps remove thick scales so other treatments can penetrate.

Ketoconazole: Antifungal agent that reduces yeast overgrowth contributing to irritation.

Corticosteroid shampoos: Short-term use for severe inflammation.

Usage tip:

Massage into the scalp for 5–10 minutes before rinsing to maximize absorption. Rotate between formulas to prevent tolerance.

💡 Pro tip: Combine medicated shampoos with a gentle moisturizing conditioner to prevent dryness.

2. Topical Corticosteroids — Fast Relief for Flare-Ups

For moderate to severe inflammation, topical steroids remain highly effective.

They come in foams, gels, lotions, and sprays — perfect for navigating thick hair.

Common examples:

Clobetasol propionate (super-potent)

Betamethasone dipropionate

Fluocinolone acetonide oil (often used overnight under a shower cap)

Use carefully:

Steroids are for short-term control, not daily maintenance. Overuse can cause skin thinning or reduced effectiveness.

3. Vitamin D Analogues — Targeting Overactive Skin Cells

Calcipotriol (calcipotriene) and calcitriol are vitamin D analogues that regulate cell turnover, helping reduce plaques without steroid side effects.

Combination therapies — like calcipotriol + betamethasone — balance inflammation control with long-term safety.

Best for:

Maintenance therapy

Reducing scaling after steroid tapers

Sensitive scalps needing non-steroidal options

These formulas are available as foams, ointments, or scalp lotions and can be used daily or every other day.

4. Phototherapy (Light Treatment)

For widespread or resistant scalp psoriasis, UV light therapy can make a significant difference.

Types of light therapy:

Narrowband UVB: Most common and safe for repeated sessions.

Excimer laser (308 nm): Targets localized plaques precisely.

Challenges:

Hair can block light penetration, so clinicians often use combs with UV-emitting teeth to reach the scalp surface.

Treatment schedule:

2–3 times weekly for several weeks under a dermatologist’s supervision.

5. Systemic Medications — For Moderate to Severe Cases

If topical treatments aren’t enough, doctors may prescribe oral or injectable medications that address the immune system directly.

Common options include:

Methotrexate: Reduces immune overactivity; used long-term under supervision.

Cyclosporine: Fast-acting for acute flares, though not for chronic use.

Apremilast (Otezla®): An oral medication that regulates inflammation with fewer side effects.

These drugs require:

Regular blood tests for liver and kidney function

Monitoring for potential side effects (fatigue, nausea, immune suppression)

6. Biologic Therapies — Targeted Immunotherapy

Biologics are one of the biggest breakthroughs in psoriasis treatment. They target specific immune pathways that cause inflammation — offering deep, sustained remission for many patients.

Leading biologics for scalp psoriasis include:

Adalimumab (Humira®) – TNF-alpha inhibitor

Secukinumab (Cosentyx®) – IL-17A inhibitor

Ustekinumab (Stelara®) – IL-12/23 inhibitor

Risankizumab (Skyrizi®) – IL-23 inhibitor

Advantages:

High effectiveness (70–90% clearance rates in trials)

Less frequent dosing (every 4–12 weeks)

Improves both scalp and body psoriasis

💡 Note: Biologics are prescription-only and typically covered under specialty insurance plans for chronic or severe cases.

7. Natural and Supportive Therapies

While not replacements for medical treatments, some natural remedies can complement therapy and soothe irritation.

Helpful options:

Aloe vera gel: Cooling, anti-inflammatory, and moisturizing.

Coconut oil: Softens scales; can be used overnight under a shower cap.

Tea tree oil (diluted): Antimicrobial properties, but patch test first to avoid irritation.

Omega-3 supplements: May reduce inflammation internally.

Consistent stress management, sleep, and hydration also play a major role in reducing flare frequency.

8. Lifestyle and Daily Care Tips

Avoid scratching: It worsens inflammation and infection risk.

Keep the scalp hydrated: Use fragrance-free emollients or oils.

Watch triggers: Cold weather, stress, and certain hair dyes can aggravate symptoms.

Stay consistent: Psoriasis management is about routine, not quick fixes.