Scalp Psoriasis: Symptoms, Hair Loss and Treatment
How scalp psoriasis looks, how it differs from dandruff and seborrheic dermatitis, what each treatment step does, whether your hair grows back, and when a transplant can be planned.
48sources
48in PubMed
12min read
Written by Nazmi Güldeş, Certified Trichologist · Medically reviewed by Dr. Teuku Adifitrian, Sp.BP-RE (Dr. Tompi), Plastic, Reconstructive and Aesthetic Surgeon · Last reviewed 30 October 2026
Reading level
Scalp psoriasis is psoriasis on the scalp: sharply edged, red plaques under silver-white scale that often run past the hairline and usually itch.[1][2][3] It is a chronic immune disease, not an infection, so you cannot catch it or pass it on.[4] There is no cure, but treatment can clear the scalp for long stretches.[5][6]
Hair loss is what worries most people. It can happen, yet it is almost always temporary.[7] Below: how to tell it from dandruff, what each treatment does, and why a transplant must wait for a calm scalp.
1Quick answerThe short answer, in a few sentences
What Is Scalp Psoriasis?
Scalp psoriasis is the same immune-driven skin disease as psoriasis elsewhere, showing on the scalp as well-defined, scaly plaques. Up to 80% of people with psoriasis get it there at some point. It is not contagious, it tends to come and go, and a topical steroid is the usual first treatment.[8][9][4][10]
Estimates range from 50 to almost 80% of people with psoriasis, and the scalp is often where psoriasis first appears.[11][12]
2Complete guideFrom symptoms and treatment to hair loss and surgery
Scalp Psoriasis Symptoms, Causes and Look-Alikes
What Scalp Psoriasis Looks Like
The plaques have sharp edges and often cross the natural hairline, unlike the blurred redness of seborrheic eczema.[1] On the body, psoriasis favors the outer elbows and knees, so a doctor will usually check those too.[13]
Itch: reported at some point by all 32 people with scalp psoriasis in one study, and stronger with worse plaques[3]
Plaques past the scalp margin onto nearby skin[13]
Plaque psoriasis on the elbow, a site doctors check when the scalp is scaly. Photo: Jacopo188, CC BY-SA 3.0, via Wikimedia Commons, cropped.
In 1,593 people with psoriasis, scalp lesions were linked to psoriatic arthritis (hazard ratio 3.89), though under 10% developed it over 30 years.[14] Mention any joint pain at your appointment.
What Causes Scalp Psoriasis?
The immune pathways in scalp plaques match those in psoriasis elsewhere on the skin.[8] Genes carry much of the risk.[15]
Triggers and risk factors in the research:
Smoking: a 67% higher risk across 30 studies; former smokers still had a raised risk[16]
Stress: a systematic review found a probable link with onset, flare-ups and severity[17]
Skin injury: trauma, chemical irritation and infection can raise new plaques, called the Koebner response[18], and itch may worsen psoriasis the same way[19]
If your scalp itches without clear plaques, our itchy scalp entry covers the other causes.
Scalp Psoriasis vs Dandruff, Seborrheic Dermatitis and Ringworm
Seborrheic dermatitisGlossarySeborrheic dermatitis causes an itchy, flaky, scaly rash on oily areas such as the scalp. It is the Malassezia-linked condition most people mean by a scalp yeast infection. Open in the glossary → is the condition most often confused with scalp psoriasis, and the two can overlap.[1] Dandruff sits at the mild end of the same spectrum: itchy flaking without visible inflammation.[20]
Condition
What you see
What sets it apart
Usual first step
Scalp psoriasis
Sharp-edged plaques with silver-white scale, often across the hairline[1][2]
Examination plus trichoscopy, a magnified look at the scalp, is often enough; a biopsy is kept for doubtful cases.[2][9]
The vessels give it away more than the flakes: in 96 Korean patients, red dots, globules and twisted red loops marked psoriasis, branching vessels marked seborrheic dermatitis, and the scale looked alike.[21]
What a scalp magnifier shows in each condition. Not to scale. Illustration: Turkey Hair Center.
Scalp Psoriasis in Children, Men and Darker Skin
Children. Among 146 children with psoriasis in Colombia, the scalp was the most often affected site (55.5%).[26] A UK study counted scale at the hairline, scaly redness inside the ear canal and a family history among the seven best clues in children.[27]
Men. Three young men with mild scalp psoriasis and a family history of pattern baldness avoided removing scales that held hairs, fearing faster hair loss.[28] Pattern baldness has its own cause, covered in DHT and hair loss.
Darker skin and textured hair. Hair texture and care practices change how scalp psoriasis looks and is treated.[29] Cleared plaques can leave darker or lighter skin for months or years, more often and more severely in skin of color.[30]
Hair Loss and Treatment for Scalp Psoriasis
Does Scalp Psoriasis Cause Hair Loss?
It can, but most people with scalp psoriasis do not lose hair.[7] When they do, one review says the loss most often sits on the plaques[31], another that most cases are diffuse shedding called telogen effluvium.[7] In most cases the hair grows back.[31]
Sources disagree on how often it happens: a German review calls it rare[1], a 2025 review calls psoriatic alopecia underrecognized and sometimes scarring.[32]
Biologic drugs, mostly TNF-alpha inhibitors, can also set it off; in a review of 96 such cases, most went into remission.[33]
Scalp Psoriasis Treatment, Step by Step
Hair makes the scalp hard to treat, so the form (shampoo, gel or lotion) matters as much as the drug.[34][10]
Works better than whole-body light on hair-bearing skin[12]
Tablets and injections
Methotrexate, cyclosporine, deucravacitinib, IL-17, IL-23 and TNF blockers[9][38]
Severe disease, or when quality of life suffers[10]
In a Cochrane review of 59 trials, strong steroids beat vitamin D alone, and adding vitamin D to a steroid gave only a small extra benefit.[34]
Roflumilast foam cleared or almost cleared the scalp in 66.4% of 432 patients aged 12 and over at week 8, against 27.8% on the base foam.[37] Deucravacitinib, a daily tablet, did so in 48.5% at week 16, against 13.7% on placebo.[38]
A 2026 network meta-analysis of 16 trials ranked the IL-17 blockers ixekizumab and brodalumab highest for scalp clearance, with no rise in serious side effects for any agent.[39]
Lifting Scale and Caring for Your Hair
Should you soften the scale first? A 2026 Spanish consensus backs a keratolytic plus a steroid for heavy scaling[10], but a 2014 review found only a marginal gain and warned that extra steps hurt adherence.[35]
Day to day:
Do not pick or scratch. Injury can raise new plaques[18], and itch may worsen psoriasis the same way.[19]
Apply gently. Friction from rubbing in treatments can pull hair out.[31]
Colored or light hair: a coal tar solution did not discolor naturally light or color-treated hair in a lab test.[11]
Haircuts, shaving and bleach: physical trauma and chemical irritation are both Koebner triggers[18], so avoid nicks and chemical burns while plaques are active.
Scalp Psoriasis and Hair Transplant Surgery
Can You Have a Hair Transplant With Scalp Psoriasis?
We found no trials of hair transplantation in people with psoriasis, so this section rests on how psoriatic skin reacts to injury.
A transplant moves follicles; it does not treat psoriasis. Hair lost to the plaques usually regrows once they settle[31], so grafting it is the wrong answer. A transplant can fit pattern hair loss once psoriasis is controlled; we found no study of transplants into the rare scarring form.
The Koebner Response: Why Timing Matters
In psoriasis, injury to healthy skin can raise new plaques at that spot, and skin incisions are a known trigger.[40][18] A transplant takes follicles from the back of the head and implants them, roots and all, in the thinning area[41]: small wounds in the donor areaGlossaryThe donor area is the back and sides of the head, where follicles resist DHT. An extracted follicle does not grow back in that spot, so extractions are spread out, and the donor supply is the limit of every plan. Open in the glossary → and many more where the graftsGlossaryA graft is a follicular unit taken from the donor area and placed in the thinning area. It holds one to four hairs, rarely more, so 2,000 grafts is roughly 3,600 to 4,600 hairs. Open in the glossary → go.
The evidence is indirect:
In 8 of 27 people with psoriasis, tape stripping and a punch biopsy of unaffected skin raised plaques[42]
Plaques have appeared along incision scars, and some people with psoriasis have been refused surgery over this risk[43]
In a 24-year-old man with no history of psoriasis, plaques appeared over both a skin flap and its donor site 6 months after surgery[44]
Yet none of 38 patients treated with lasers on the face, neck or scalp developed new plaques[45]
Disease activity seems to matter most. After laser hair removal in 99 people with skin diseases, psoriasis included, flares were linked to active disease, and the authors advise waiting until it is controlled.[46]
Before and After Surgery
Have the whole scalp examined first. After 10 patients developed inflammatory scalp disease following a transplant, the authors recommended a routine dermoscopic check at the pre-operative visit.[41]
After surgery, follow the washing steps in our post-operative hair wash guide. In the flap case, new plaques at the surgical sites cleared with a topical steroid.[44] Shedding in the first weeks has its own cause, shock lossGlossaryShock loss is a temporary shedding phase after a hair transplant, triggered by surgical stress to the scalp and typically starting 2 to 4 weeks after the procedure. The follicles remain healthy beneath the skin, and new growth resumes within 4 to 6 months. Open in the glossary →, covered in shock loss after a hair transplant.
Frequently Asked Questions
Is scalp psoriasis contagious?
No. Psoriasis is a non-contagious, immune-driven disease.[4] The myth persists: in a survey of 333 secondary school students, 14.5% believed psoriasis was contagious.[5] Ringworm of the scalp, which can look similar, is contagious.[23]
Can scalp psoriasis be cured?
There is no cure; psoriasis is a chronic disease.[5] Treatment can still clear the scalp: on guselkumab, 68.4% of trial participants with skin of color had a clear or almost clear scalp at week 16, against 11.5% on placebo.[29]
Does scalp psoriasis ever go away?
It can clear, but it tends to return. Six months after starting maintenance, 40.3% of people using clobetasol shampoo twice a week were still relapse-free, against 11.6% on a dummy shampoo.[6]
Is scalp psoriasis an autoimmune disease?
It is described as a chronic autoimmune disease[4], with the same immune pathways on the scalp as elsewhere.[8]
Is scalp psoriasis genetic?
Partly. In a study of 10,725 twin pairs, genes explained 68% of the variation in psoriasis risk and environmental factors explained the rest.[15]
Can scalp psoriasis spread to the face?
Plaques often extend beyond the scalp margin.[13] In 282 patients, facial psoriasis marked more severe disease, with more itch and more Koebner reactions.[47]
Can hair dye cause scalp psoriasis?
We found no study showing that hair dye causes psoriasis. Para-phenylenediamine (PPD), a common hair dye ingredient, is a growing cause of allergic contact dermatitis[48], and scalp contact dermatitis can mimic psoriasis; patch testing sorts it out.[25]
Treat the Scalp First, Then Weigh a Transplant
Scalp psoriasis is a long-term condition for a dermatologist to manage, and the hair it takes usually returns as plaques settle.[31] A transplant does not suit active psoriasis or hair lost to it; it can suit pattern hair loss once the scalp has been calm, planned with the Koebner response in mind.[18][46]
Not sure whether your thinning is psoriasis or pattern hair loss? Send three photos for a free hair analysis; the medical team will tell you which it looks like and whether to see a dermatologist first. You can also message us on WhatsApp.
About the Author
Written by: Nazmi Güldeş, Certified Trichologist. Nazmi Güldeş focuses on patient education around androgenetic alopecia, evaluating miniaturization through dermoscopy, and assessing candidates for medical treatments and hair transplants.
Editorial Policy & Trust
This entry was drafted with the help of AI writing tools and edited by our team, then medically reviewed by Dr. Teuku Adifitrian, Sp.BP-RE (Dr. Tompi) on 30 October 2026. AI is never used as a source: every study cited here was checked against PubMed on 30 October 2026, and each claim sits next to the study that supports it. Read how we work in our editorial policy.
3 questions
Test yourself
Check what you remember from this entry. Each answer links back to the section that explains it.
Which trichoscopy sign points to scalp psoriasis rather than seborrheic dermatitis?
Red dots, globules and twisted red loops marked psoriasis; branching vessels marked seborrheic dermatitis, and the scale looked much the same in both. Read the section
Does hair lost to scalp psoriasis usually grow back?
Reviews describe hair loss in psoriasis as almost always non-scarring and reversible; scarring is rare. Read the section
Why does timing matter for a hair transplant in someone with psoriasis?
Through the Koebner response, incisions and other injuries can raise new plaques, and complications after skin procedures were linked to active disease. Read the section
3Scientific evidenceStudy types, references and how to cite this entry
48sources
Evidence behind this entry: 48 publications indexed in PubMed (1988 to 2026): 16 reviews, 14 clinical studies, 5 randomized trials, 5 systematic reviews, 5 case reports, 2 guidelines and 1 lab study. 24 sources have free full text. 1 article has a published correction, shown in the references.
Randomized trialpeople assigned to treatments by chance
Reviewsummarises many studies
Clinical studya study in people without random groups
Lab studytested on cells or hair follicles in the lab
Guideline or labela professional body, or the official drug label
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Waśkiel-Burnat A, Czuwara J, Blicharz L, et al. Differential diagnosis of red scalp: the importance of trichoscopy. Clinical and Experimental Dermatology. 2024;49(9):961-968.ReviewPubMedDOI
Jaworecka K, Kwiatkowska D, Marek-Józefowicz L, et al. Characteristics of pruritus in various clinical variants of psoriasis: Final report of the binational, multicentre, cross-sectional study. Journal of the European Academy of Dermatology and Venereology. 2023;37(4):787-795.Clinical studyPubMedDOI
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Kuchnicka A, Fałkowska U, Konopelski P, et al. Application of Trichoscopy and Novel Non-Invasive Imaging Techniques in the Diagnosis and Management of Patients with Scalp Psoriasis. Psoriasis (Auckland, N.Z.). 2026;16:549372.ReviewPubMedDOIFree full text
González Cantero Á, Ferrán M, Pérez Barrio S, et al. Management of scalp psoriasis: Updated treatment recommendations from a Delphi consensus of 53 dermatologists from AEDV Psoriasis Working Group. Actas Dermo-Sifiliograficas. 2026.GuidelinePubMedDOI
Johnson C, Edison B, Brouda I, et al. A novel LCD (coal tar) solution for psoriasis does not discolor naturally light or color-processed hair in an exaggerated exposure test model. Journal of Cosmetic Dermatology. 2009;8(3):211-215.Lab studyPubMedDOI
Wang TS, Tsai TF. Managing Scalp Psoriasis: An Evidence-Based Review. American Journal of Clinical Dermatology. 2017;18(1):17-43.ReviewPubMedDOI
Geng RSQ, Sibbald RG. Cutaneous Psoriasis: Clinical Aspects and Treatments. Advances in Skin & Wound Care. 2025;38(4):176-182.ReviewPubMedDOI
Wilson FC, Icen M, Crowson CS, et al. Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis and Rheumatism. 2009;61(2):233-239.Clinical studyPubMedDOIFree full textA correction to this article was published: Arthritis Rheum. 2010 Apr;62(4):574.
Lønnberg AS, Skov L, Skytthe A, et al. Heritability of psoriasis in a large twin sample. The British Journal of Dermatology. 2013;169(2):412-416.Clinical studyPubMedDOI
Chen D, Ye G, Yang J, et al. Smoking, alcohol consumption, and psoriasis risk: a systematic review and dose-response meta-analysis of observational studies. Frontiers in Public Health. 2026;14:1840932.Systematic reviewPubMedDOIFree full text
Stewart TJ, Tong W, Whitfeld MJ. The associations between psychological stress and psoriasis: a systematic review. International Journal of Dermatology. 2018;57(11):1275-1282.Systematic reviewPubMedDOI
Zhang X, Lei L, Jiang L, et al. Characteristics and pathogenesis of Koebner phenomenon. Experimental Dermatology. 2023;32(4):310-323.ReviewPubMedDOI
Bahali AG, Onsun N, Su O, et al. The relationship between pruritus and clinical variables in patients with psoriasis. Anais Brasileiros de Dermatologia. 2017;92(4):470-473.Clinical studyPubMedDOIFree full text
Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. Journal of Clinical and Investigative Dermatology. 2015;3(2).ReviewPubMedDOIFree full text
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Torres M, Flórez J, Páez MS, et al. Pediatric psoriasis: A descriptive, retrospective and multicenter study in Colombia. Biomedica. 2025;45(2):310-320.Clinical studyPubMedDOIFree full text
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George SM, Taylor MR, Farrant PB. Psoriatic alopecia. Clinical and Experimental Dermatology. 2015;40(7):717-721.ReviewPubMedDOI
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Duffin KC, Griffiths CEM, Hoffmann M, et al. Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 (TYK2) inhibitor, in patients with moderate to severe scalp psoriasis: Efficacy and safety results through week 16 in a phase 3b/4, multicenter, randomized, double-blinded, placebo-controlled trial (PSORIATYK SCALP). JAAD International. 2026;25:28-40.Randomized trialPubMedDOIFree full text
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Güldeş, N. (2026, October 30). Scalp psoriasis: Symptoms, hair loss and treatment. Turkey Hair Center Hair Library. https://turkeyhaircenter.com/scalp-psoriasis/
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