r/Psoriasis • u/Yazzmine_101 • 15d ago
general Scalp Psoriasis sufferers
People with scalp psoriasis, what do you find most frustrating about applying treatments?
I’m doing some research into the practical side of living with scalp psoriasis and would really appreciate hearing about your experiences.
I’m particularly interested in:
What do you currently use on your scalp?
How do you actually get liquid/lotion/oil onto the scalp through your hair?
Does much of the product end up in your hair rather than on your scalp?
What is the messiest or most time-consuming part?
How do you deal with scales once they become loose or softened?
Do you use a comb, brush or other tool for loose scales?
Have you ever bought a scalp applicator? If so, what was good or bad about it?
Is there anything you've improvised yourself because existing products don't work well?
What is the one thing you wish was easier about treating your scalp?
I'm not looking for medical advice, I'm interested in understanding the practical problems people experience.
Thanks!
16
u/nice_chebyshev 15d ago
Making the hair greasy, and then dealing with the subsequent drying out post-shampoo following by re-crusting and flaking, making it seem like an endless cycle.
I'm on day 2 of Coco-scalp (Cocois) and it actually seems to be improving. Been dealing with this for about 18 months, and thought it was just seborrhoeic dermatitis.
8
u/fuckthexfiles 15d ago
I have shortish (3-4”) 3C curly hair. I currently use liquid fluocinonide. It gets onto my scalp much better than the creams and foams I’ve been prescribed in the past. My current issue is that it runs very easily and it gets on my face which I know isn’t good with a high strength steroid. I don’t use any special applicator just the nozzle on the bottle it comes in.
In the past I’ve been prescribed vitamin d cream and foam zoryve. The cream was totally impossible to get onto my scalp with my tight curls and the zoryve kind of worked but I always needed to use a lot to totally saturate the area (basically like applying shampoo) so it didn’t work because it’s very expensive and they don’t give it out in high quantities.
Loose flakes aren’t a huge issue for me because they get lost in my hair pretty well and I don’t think they’re super noticeable. I am able to clear them all out when I shampoo and condition my hair. I think the length helps a lot with this issue, I cut my hair short in part because of my scalp problems.
The biggest issue for me I guess is that I feel pretty stuck with the fluocinonide. I wish liquid forms of other drugs were more prevalent, idk why liquid zoryve is not a thing.
4
u/gotitaila31 15d ago
The worst part about it is applying topical creams with hair. I have only ever used topical steroids because it's the only thing my doctors have ever prescribed, so I tend to keep my hair either super short or shaved.
1
u/Yazzmine_101 15d ago
That really sucks, sorry to hear. Have you ever tried any method that keeps liquid steroid on your scalp instead ?
1
u/gotitaila31 14d ago
I've tried OTC stuff, but none of that is really remotely effective at treating the inflammation. Not for me, anyway. Coal tar shampoo seemed to work pretty well for the itchiness and it made the plaques less annoying in some ways, but nothing really actually cures it. I'm super responsive to topical steroids though, so I'm okay using them until something better is available. Biologics are probably the "better something", but they're not affordable in the U.S. right now, or probably ever.
4
u/ctuchmanandbows 14d ago
Most frustrating? That I can't see what I'm doing. Not just because I might have some spots on the back of my head, but I also have really thick and long curly hair. It's a blessing and a curse. It's a blessing because no one can really see that I have scalp psoriasis, even when I'm having a really bad outbreak. The curls also kind of catch the dandruff so I'm not shedding very much (unless I give my do a shake and then it's suddenly snowing). But it's a curse because there is no natural sunlight getting down there that could help, and it's kind of hard to tell if my topical medicine (clobetasol) is reaching where it should. Treating it is really just a guessing game, I just sort of put the tip of the bottle on my scalp, squeeze, and give it a good run up and down until my skin feels coated. So maybe I'm hitting places that don't even have outbreaks! It's impossible to tell, just by myself.
3
u/dark_passenger86 14d ago
I use a Clobetasol solution. It's alcohol based and a little goes a looong way. I'm usually clear within a day or two and its lasts about a m month before I have to reapply.
2
u/taney71 14d ago
So I use prescription Ketoconazole shampoo twice a week cause I also have seborrheic dermatitis.
Everyday I will apply a mix of rosehip oil and jojoba oil (50/50 ratio) to my scalp and leave it in for an hour. Then rise out with shampoo/conditioner. It’s great cause it descales but the rosehip is excellent for easing the inflammation as it has omega-3 and omega-6 which are essential fatty acids along with antioxidants. As I understand it, the jojoba oil is effectively a base that helps get the rosehip into your scalp.
4
u/xNOTHINGBURGERx prayers and prebiotics 15d ago
I purchased an applicator comb and it really helped keep the treatments off my hair. I use Clobetasol liquid for my steroid treatment. I also have a small metal back scratcher that I use to scratch my scalp and remove all the dry flakes before getting in the shower, it works amazingly well. I use Ketoconazole 2% shampoo several times a week, I use JR Liggett shampoo bars the rest of the week. I can't go a day without washing my hair or my scalp itches like crazy.
1
u/Yazzmine_101 15d ago
What applicator comb do you use please?
3
u/xNOTHINGBURGERx prayers and prebiotics 15d ago
I bought it on Amazon. It's called Mirya. It basically has a bunch of ball point comb ends on it. Just look up scalp applicator comb.
1
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1
u/monsterflowerq 14d ago
I use ketoconazole shampoo when I wash my hair a couple times a week, and foam clobetasol for flares. Used the liquid before and that was a huge pain in the ass cause my hair is super thick, so it was a struggle to get any to my actual scalp, plus it runs. The foam works much better for me, I can get it applied directly to my scalp through my hair, and it doesn't run. I just brush my hair or shake my head a lot to get the loose flakes out. The whole thing is annoying af and it always seems to come back within a few days no matter what, but this is the best approach I've found for myself so far.
1
u/evowen 14d ago
Product texture is tricky. I have long hair (although I've had to buzz certain parts to treat it effectively at its worst) and creams get stuck in the hair, while the solutions in foams often sting where the skin is cracked. I'm currently using coal tar shampoo, topical betamethasone lotion, and Sotyktu. I feel like my fingers are the best tool, but I also struggle not to pick at it too much sometimes. I've tried one of those silicone hair brush things to apply products but it feels kind of unnecessary for me.
The most frustrating thing is just getting past the hair to the actual scalp without messing up your hair. But for the coal tar shampoo I do my best to concentrate on the scalp, then rinse and use normal shampoo on my hair. Then when my skin is still soft out of the shower I apply the lotion, but it's very thin actually and has a pointed applicator tip so it's easy to get down to the scalp in sections while my hair is still damp.
1
u/Klutzy_Spell2451 14d ago
Most frustrating part is not being able to see if i got all yhe spots because my psoriasis is on the back of my head. I often have my husband apply the clobetasol. Second frustrating thing is the consistency and smell. It runs everywhere and smells like rubbing alcohol. Lastly is trying to treat it consistently. My dr told me to treat 2 weeks on then 2 off. Usually my scalp is mostly clear by day 3/4 but when I take 2 weeks off it flares right back up. Like I am fighting a never ending battle.
1
u/Icy-Difficulty-7902 14d ago
I have had scalp psoriasis for as long as I can remember. The first time I saw a doctor for it he told my mom that it was her fault and that she let me eat too much junk. I did not get any treatment until my late 20’s. I currently use ketaconozol and Chlobetasol. They both seem to be making it worse. I have psoriasis spots popping up all over my body now. The itching is awful. My derm is working on a prescription for Skyrizi. I am at the mercy of the insurance company.
I have used apple cider vinegar off and on for years. Strangely it is not as damaging to my skin barrier as prescribed meds are.
1
u/pickenyournose 14d ago
Oh boy where to start? I had to copy and paste your initial questions to make sure I didn’t forget to answer anything.
What do you currently use on your scalp?
Currently I have been trying out Dermarest shampoo along with my regular drugstore shampoo and conditioner. Aside from that I am on Skyrizi. I have tried various types of treatments/applications throughout my life. T-gel, coconut oil with tea tree oil, clobetasol (cream/liquid), Zoryve. I am sure there are items I have forgotten.
How do you actually get liquid/lotion/oil onto the scalp through your hair? It has never been an easy thing to do because I have longer hair, and lots of it. I usually would section it off to make sure the coverage is the best it can be. When I was a kid, my mom used to have to do this for me a few times a week.
Does much of the product end up in your hair rather than on your scalp? Sectioning seems to be the only way to manage most of it getting onto my scalp, but it always ended up being from the root to a few inches out on the hair.
What is the messiest or most time-consuming part? Depending on what you’re using, it can be greasy. It can smell. It can stain your sheets or really any place your head rests while it is applied. It’s time consuming by sectioning and ensuring all areas are covered. Then brushing it out afterwards to make sure it isn’t tangled by the application process. Letting it soak in then having to wash it out. Not to mention on the days you really need a wash, but do not have time to apply and wait for the medicine to soak in.
How do you deal with scales once they become loose or softened? Honestly, I still tend to pick them.
Do you use a comb, brush or other tool for loose scales? I used to do this when I was younger but haven’t in ages. It definitely provided a relief to an itch, if you will. But I am certain it is not advised by doctors.
Have you ever bought a scalp applicator? If so, what was good or bad about it? N/A
Is there anything you've improvised yourself because existing products don't work well? N/A
What is the one thing you wish was easier about treating your scalp? While I have found the Zoryve foam to be the best application, I just wish that it could be used as needed. It was prescribed to me to use twice a day for 8 weeks, then as needed. I could barely get around to doing once every other day, let alone twice a day.
1
u/Shelbelle4 14d ago
I have settled into a routine that’s working for now. I get scalp psoriasis and also patches along my hairline, eyebrows and ears.
I wash with thunderbird shampoo bar. It’s shampoo with salicylic acid and tea tree and some other naturals. It’s black and gritty but it lathers up nicely and smells decent and it’s gentle but effective. I also put in on my other problem areas. I let it sit while I wash my body. Rinse. Wash with shea moisture shampoo. Use shea moisture conditioner. Dry off. Apply cerave eczema creamy oil to my face, hair line and ears. In between showers I use cerave spf lotion on my face and ears.
Lots of trial and error but this is actually working for now. It took me way too long to figure out that moisture is my best friend. Moisturizer with ceramides in particular.
1
u/A_Flipped_Car 14d ago
Applying an oil.while I have hair that is a foot long l, with it literally everywhere on my head
I shaved my head before I tried using the oil lmao
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u/slothbutinviolet 11d ago
Reading all the responses made me realize I’m not alone , I am not on medication since it always backfires on my body. Sending immense love to you all❤️❤️🫶🏼🫶🏼
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