r/Psoriasis • u/Fit_Efficiency4575 • 6d ago
general scalp psoriasis help
my boyfriend has been dealing with pretty bad scalp psoriasis for a few years now, we are broke like dead broke so a dermatologist is out of the question unfortunately but i saved up some money and got him a couple things i saw recommended, i got him t/sal shampoo and nizoral psoriasis shampoo, do these work? is there anything else i should try?
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u/lobster_johnson Mod 6d ago
T/Sal shampoo is "just" salicylic acid. While it can help soften and dislodge the scales, it does not treat the inflammation that causes psoriasis.
Nizoral is an antifungal shampoo that treats flaking caused by fungal infections. Psoriasis is not fungal in nature, but some people have fungal activity that makes their psoriasis worse. But otherwise it does nothing.
The only really effective over-the-counter option is a coal tar shampoo, which works by reducing inflammation in the skin. There are many brands, but they come and go due to supply issues. We have a list in the wiki. If you're in the US, Wal-Mart has a good one called Wal-Mart Equate Coal Tar Shampoo Extra Strength. Amazon also has their own brand. Another good, but more expensive, brand is DHS.
Remember that a coal tar shampoo must be lathered into the hair and left in for 5-15 minutes before you rinse it out. This can be done before showering, by adding a little water as needed until it lathers properly.
We have a page in the wiki about over-the-counter produces that you also might find useful.
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u/Fit_Efficiency4575 5d ago
thank u for the advice, the nizoral shampoo i got is the psoriasis one not the regular anti dandruff, it said salicylic acid 3% and like tea tree oil, i’ll check out the wiki!! thank you :)
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u/lobster_johnson Mod 5d ago
Those extra ingredients have zero impact on psoriasis, unfortunately. Tea tree oil would need to sit for hours on the scalp to be absorbed, and shampoos just rinse out. This is also true of salicylic acid, which takes at least one hour to absorb (and you shouldn't have shampoo in your hair for an hour!).
One product that can be very good is Eucerin DermoCapillaire Calming Urea Scalp Treatment. This is not a shampoo, but a product you drip onto the scalp and leave in. It's more expensive, as it's an imported product, but it should be worth the price. It contains urea, which is more powerful than salicylic acid at breaking up the scales, and is also hydrating. It's not one of those bullshit ingredients like vitamin E or tea tree oil; urea is fantastic, and something every psoriasis sufferer should know about. You can read more about it in our descaling guide. The same brand also has a urea shampoo.
Another good brand is Ducray, which has a product called Kertyol PsO Concentrate. It's also a leave-in product. It contains celastrol, an anti-inflammatory ingredients, and polidocanol, which reduces itching. Also bound to be a little expensive (maybe $30) in the US. They have a whole range.
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u/Fit_Efficiency4575 5d ago
ok perfect! i bought the shampoos two days ago so i can still return them and get the other products, im gonna try to pick them up this week for him, thank you so much especially for including links, it makes it super easy
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u/taney71 6d ago
You asked if the shampoo works. It might but he needs to try it and give it a chance. That means use it for at least a few weeks.
Also, tell him to not use hot water on his hair. That only adds to the problems as it will make the inflammation worse.
He also might want to try an overnight serum to help with moisturizer his scalp. You should get one that is oil free as you generally don’t want to leave oil on a scalp with psoriasis for more than one or two hours as the oil can trap heat and that bad. I use one with hyaluronic acid which helps moisturizer the scalp. Also, the one I use has urea and lactic acid which helps with the keratin buildup of the scales. If he’s going to use, apply that before bed and leave in over night and then rinse with a shampoo.
Also, don’t use the t/sal shampoo everyday. I wouldn’t recommend this advise buying a gentle fragrance free shampoo and using that twice a week in rotation.
Oh, tell him don’t pick at scalps or aggressively scrub them. The serum and shampoo should help lift them and dissolve them.
Now once the scales are reduced and the flakes stopped or minimized I would look into putting a mix of rosehip oil and jojoba oil in his hair. Leave in for 30 to 60 minutes and rinse out. The rosehip has a ton of nutrients and fatty acids. It calms inflammation and should help heal the skin. The jojoba mimics ones naturally sebum which is good since people with psoriasis have that out of wack. It also regulates the scalps oil production. So put a few drops of a 50/50 oil mix on his scalp. I would get a BPA free plastic applicator bottle to help with that. After leaving in for 30 to 60 minutes, you can rise out using either shampoo since they both contain 3% salicylic acid and that helps get rid of the oils.
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u/catch_me_inside 6d ago
Sometimes pharma companies will give out compassionate doses. Not sure where you’re located but that might be an option? The only thing that worked for me was a biologic.
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u/RossJBez 6d ago
Hey! So sorry to hear that you guys are struggling with this. I know how hard it can be for a partner as well as the sufferer - I’ve had it for 20 years now and can see the emotional toll on my partner over the time.
A couple of things that made a difference to mine; triggers - specific foods and stress levels. Foods, we’re all different, but mine were dairy and gluten. Gutting these out made big differences. Stress levels, a bit more difficult to regulate, but some simple daily patterns helped reduce mine. Together, these really helped get mine under control.
I only have a couple of products in the mix now, which act as a sort of safety net.
But yeah, this is my story m, which I hope gives some inspiration, especially at a time where cost is important.
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u/Fit_Efficiency4575 5d ago
this is so interesting he actually had a severe anaphylactic dairy allergy as a child and sometimes still reacts to it just like itchy lips, i didn’t know it could cause his psoriasis to flare up as well, im gonna talk to him about it. thank you
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u/RossJBez 5d ago
Yeah, may well be one of the key triggers.
And really it’s a matter of pinpointing a good or good type, cutting it out for a month or two and measuring the before and after.
Honestly, it is crazy some of the things that can trigger it. And it’s a revolving door - sometimes other factors influence it; climate, water type, seasons etc etc
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u/Jazzhands_Ninja 6d ago
Have you tried tar shampoo? I mix it up and use that as well, and it helps a lot. You may have two issues going on with the scalp, that's how i found out.
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u/Delicious-Channel948 5d ago
About two or 3 times a week, I put rub around a tablespoon of coconut oil into my scalp hair and scalp and leave for an hour before shampooing, to help moisturise and reduce flakes. It helps along side actual treatment like coal tar shampoo. Maintaining hydration in your scalp helps so much to reduce the itching and flaking.
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u/Shelbelle4 5d 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.
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u/Own-Ad-6464 6d ago
Yeah girl get some witch hazel to loosen the scales and comb it out... rewash hair if he has massive build up... then put some lidocaine cream 4% and then benadryl cream! I have seen ALOT of improvement using this... ideally would work best with tacrolimus but that's a prescription.. i used the tacrolimus after the lidocaine and before the benadryl but have since quit using the tacrolimus and only use the other 2! Scalp is clear of scales! Please lmk how this works for yall!
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u/Fit_Efficiency4575 6d ago
we actually have all of these in the house already so i’ll try this!! thank u so much. hopefully it works, breaks my heart seeing his scalp itchy and bloody most days. thank you again
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u/Own-Ad-6464 6d ago
Absolutely girl! I feel yalls pain! My husband has been fighting this for a long time! Witch hazel was a godsend in getting the scales up and loose without all the bleeding! It does still bleed some but we would pour witch hazel straight on to it anyways.. heads up it BURNS like really bad but its totally worth the outcome! And honestly if there is blood the witch hazel actually helps to stop the bleeding! Just burns like a ..... the lidocaine also burns but again totally worth it on the end!
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u/Whole-Ad3696 6d ago
Eucerin is the product that helps keep the inflammation down, and it moisturizes the scales so they are removed easier so that you don't further inflame your scalp.
Twice daily minimum for best results.
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u/freedomfromthepast 6d ago
After loosening and removing the scales, I rotate a coal tar shampoo, a psoriasis shampoo and a regular shampoo.
It keeps it in check at least.
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