Psoriasis and Hair Loss: Why It Happens and How to Stop It

Key Takeaways

• Psoriasis can trigger hair loss through inflammation, scalp plaque buildup, and stress‑related shedding.
• Identifying the specific pattern (scalp psoriasis, alopecia areata, telogen effluvium) guides effective treatment.
• Topical steroids, vitamin D analogues, and newer biologic drugs target the root cause, not just the symptoms.
• Gentle hair‑care habits, a balanced diet, and stress control reduce flare‑ups and protect hair follicles.
• Seek a dermatologist if you notice sudden thinning, persistent scalp plaques, or scalp pain.

Understanding Psoriasis

When dealing with skin conditions, Psoriasis is a chronic autoimmune disease that accelerates skin cell turnover, producing red, scaly patches that can appear anywhere on the body. The immune system mistakenly attacks healthy skin, releasing cytokines such as TNF‑α and IL‑17 that inflame the dermis. About 2‑3% of the global population lives with psoriasis, and roughly 30% of those patients experience scalp involvement at some point.

How Psoriasis Can Lead to Hair Loss

The link between Hair Loss also called alopecia, refers to the shedding or thinning of hair from the scalp or other body areas and psoriasis is multifactorial:

1. Inflammation: Cytokine storms damage hair follicles, pushing them into the resting (telogen) phase.
2. Physical blockage: Thick plaques on the scalp trap sebum and debris, creating an unhealthy environment for hair growth.
3. Medication side‑effects: Some systemic treatments (e.g., methotrexate) can temporarily thin hair.
4. Stress response: The psychological burden of visible skin lesions often precipitates stress‑induced shedding (telogen effluvium).

Common Types of Hair Loss Linked to Psoriasis

Not every case of thinning is the same. Recognising the pattern helps you pick the right cure.

• Scalp Psoriasis‑Induced Shedding Hair loss directly caused by plaque buildup and chronic inflammation on the scalp. Hair often appears broken around the edges of red, silvery scales.
• Alopecia Areata An autoimmune condition that creates smooth, round bald patches and can coexist with psoriasis in up to 10% of patients. The two diseases share similar immune pathways, making co‑occurrence plausible.
• Telogen Effluvium A diffuse, temporary shedding that follows a stressful event, severe flare‑up, or a sudden change in medication. You’ll notice more hairs on your pillow or in the shower drain.

Diagnosis: Spotting the Signs

Before you start a treatment plan, get a clear picture of what’s happening:

1. Examine the scalp for raised, silvery plaques that itch or bleed.
2. Note the pattern of hair loss-patchy, diffuse, or hair breaking at the scalp line.
3. Ask your doctor for a dermatoscopic exam; a handheld microscope reveals inflammation around follicular openings.
4. If alopecia areata is suspected, a simple punch biopsy can confirm the autoimmune attack on hair roots.

Effective Solutions: Treatment Options

Addressing hair loss means tackling both the skin inflammation and the follicle health. Below are the most common approaches, organized from mild to systemic.

• Topical Steroids Prescription creams or solutions that suppress local inflammation, reducing plaque thickness and itch. Potency ranges from low (hydrocortisone 1%) to very high (clobetasol propionate 0.05%).
• Vitamin D Analogues Synthetic forms of vitamin D (e.g., calcipotriene) that slow skin cell proliferation and improve plaque clearance. Often combined with steroids for a “steroid‑sparing” effect.
• Phototherapy Controlled exposure to ultraviolet B (UVB) light that modulates immune activity in the skin. Narrow‑band UVB sessions (2‑3 times per week) are effective for scalp disease when combined with a medicated shampoo.
• Biologics Targeted injectable drugs (e.g., secukinumab, ixekizumab) that block specific cytokines like IL‑17 or IL‑23, offering rapid plaque clearance. They have the highest success rate for severe psoriasis and often reverse associated hair loss.
• Natural adjuncts: aloe vera gel, tea tree oil, and omega‑3 rich fish oil can soothe the scalp and lower systemic inflammation.

Comparison of Popular Treatments

Everyday Care Tips to Protect Your Hair

Even with medication, the daily routine matters. Follow these simple habits:

• Use a gentle, sulfate‑free shampoo formulated for sensitive scalps; avoid harsh antiseptic shampoos that strip natural oils.
• Apply a medicated scalp solution (your dermatologist’s prescription) after shampooing while the skin is still damp; this improves absorption.
• Limit heat styling - excessive blow‑drying or flat‑ironing can aggravate inflammation.
• Consume omega‑3 rich foods (salmon, walnuts, flaxseeds) and maintain adequate vitamin D levels, both of which support skin immune regulation.
• Practice stress‑relief techniques (mindful breathing, yoga, or short walks). Reducing cortisol helps curb telogen effluvium.

When to See a Dermatologist

If you notice any of the following, book an appointment promptly:

• Rapid progression of scalp plaques that cover more than 10% of the scalp surface.
• Sudden, patchy hair loss that doesn’t improve with over‑the‑counter moisturisers.
• Persistent itching, burning, or bleeding from the scalp.
• Signs of infection (red streaks, pus, fever).

Early intervention can prevent permanent follicle damage and keep your hair looking its best.