Treatments for scalp psoriasis may include over-the-counter products like shampoos, as well as light therapy and topical, oral, and injectable medications.

Psoriasis is a chronic skin condition that causes skin cells to build up on different parts of the body, such as your knees, back, elbows, and scalp — where it’s known as scalp psoriasis.

The build-up of skin cells may dry and scaly and they may flake, itch, or bleed. The majority of people who have psoriasis experience these patches on their scalp.

Scalp psoriasis can be caused by an overactive immune system, genetics, and environmental factors. There is no definitive cure for psoriasis. There are several types of treatments for the condition. The goal is to limit symptoms and prevent flare-ups. This article covers topical, oral, and injectable medications.

There are several types of topical medications for psoriasis, which come in the forms of ointments, creams, and lotions.

Topical corticosteroids

Topical corticosteroids are often a first-line treatment for various kinds of psoriasis. They have anti-inflammatory effects that slow or stop skin inflammation and its symptoms like:

  • skin tone changes
  • itching
  • swelling

They also suppress your immune system’s ability to over-produce skin cells and can be helpful at halting flare-ups.

Topical corticosteroids come in numerous formulations and strengths, based on the severity of your condition. Examples include:

Finally, some corticosteroids are found in specialized psoriasis shampoos over the counter.

Topical calcineurin inhibitors

Calcineurin inhibitors are another class of medications used to treat psoriasis. They work by preventing the activity of calcineurin, a protein that activates certain immune cells involved in inflammation. This:

  • decreases inflammation
  • suppresses your immune system from causing psoriasis symptoms
  • reduces skin cells from over-growing

They are a preferred treatment on sensitive areas of your skin and for longer-term treatment.

Examples include tacrolimus (Protopic) and pimecrolimus (Elidel).

Topical retinoids

Retinoids, which are compounds derived from vitamin A, work by slowing down the overproduction of skin cells.

They also have anti-inflammatory properties that can help reduce inflammation, swelling, and irritation caused by psoriasis.

Retinoids also promote the shedding of dead skin cells and encourage healthy skin growth.

Like calcineurin inhibitors, they can be used long term. And they are sometimes used in combination with other treatments like topical corticosteroids or phototherapy.

Examples include tazarotene (Tazorac), which is used for mild to moderate scalp psoriasis.

Coal tar preparations

Coal tar is one of the oldest treatment methods for psoriasis. It has anti-inflammatory and soothing properties. Additionally, it also may slow the rapid growth of new skin cells, prevention the formation of thick scales and patches. Products with coal tar may be effective at loosening and removing existing scales, as well as moisturize your skin.

Products containing coal tar are often sold over the counter in the form of coal tar shampoos and tar soaps.

Salicylic acid

Products containing salicylic acid are used to loosen and remove scales, making other treatments more effective. This is because salicylic acid is an exfoliant.

Salicylic acid may also:

  • reach the pores, helping to unclog them and promoting healthy skin
  • decrease mild inflammation
  • smoothen your skin

It can be found in shampoos, facial scrubs and other topical products.

Vitamin D analogs

Vitamin D analogs are synthetic compounds designed to mimic the effects of vitamin D in the body. They’re used to treat various conditions. In people with psoriasis, topical medications containing vitamin D analogs are used to help:

  • regulate skin cell growth
  • reduce inflammation
  • improve the appearance of skin rashes, scales, and thickened skin

Examples include:

Anthralin

Anthralin, also known as dithranol, is a synthetic compound derived from the natural compound chrysarobin. It has

anti-inflammatory properties and slows and disrupts the ability of skin cells to grow and divide.

It’s typically used as a short-contact therapy, where it’s applied to the affected areas for a specific period of time and then washed off. This helps to minimize skin irritation, one of several potential side effects.

Anthralin comes in various forms, including shampoos and ointments.

Systemic medications are taken either orally or by injection. They’re absorbed into the bloodstream and distributed throughout your body.

For psoriasis, they’re typically used when topical medications are not effective.

Oral retinoids

Oral retinoids work similarly to topical retinoids. They slow down the overproduction of skin cells, calm inflamed skin, and promote the shedding of dead skin cells.

Additionally, they can help your body regulate sebum (oil) production, which can be beneficial if you have overly dry or oily skin.

Types used to treat psoriasis include:

Biologics and biosimilars

Biologics are derived from living organisms, such as proteins, antibodies, or nucleic acids. In psoriasis, they target specific parts of the immune system used in the condition’s development. They’re used for more severe cases, including those affecting the scalp, and are usually taken long term.

Like many of the medications listed here, they reduce:

  • inflammation
  • over-production of skin cells
  • scaling

Examples include:

In addition to biologics, there is a category of drugs called biosimilars. These are highly similar versions of approved biologic medications but are usually cheaper.

Disease-modifying antirheumatic drugs (DMARDs)

DMARDs are used primarily to treat autoimmune diseases by suppressing your immune system to reduce inflammation and slow down skin cell growth.

Examples used for psoriasis include methotrexate (Rheumatrex, Trexall, Otrexup) and cyclosporine (Neoral).

Corticosteroid injections

Corticosteroid injections are sometimes used in the treatment of specific areas of psoriasis, including the scalp. A dermatologist, a medical professional specializing in conditions of the skin and hair, administers the injections.

Injections can:

  • decrease redness, swelling, and itching by suppressing your body’s immune system
  • reduce itching
  • slow the over-growth of skin cells

However, injections are only administered on a short-term basis. They’re sometimes administered alongside other medications.

It’s recommended to speak with a medical professional before starting any treatment regimen for scalp psoriasis, including over-the-counter remedies like shampoos or scrubs. Side effects are possible, including worsened symptoms or psoriasis flare-ups.

Once you begin treatment, it’s also recommended you follow up with your medical professional if your symptoms change or get worse, or if you experience other side effects.

A medical professional can tailor a treatment plan specific to your condition.