Over-the-Counter Help: Is There a Shampoo for Psoriasis?

An expert weighs in.

If you spend as much time vegging out in front of the TV as we do (hey, times are stressful!), you’ve probably come across more than your fair share of drug and pharmaceutical commercials. One such ubiquitous spot advertises for relief from psoriasis, a common skin disorder said to affect almost 7.5 million Americans. Curiously enough, it’s also a disease that’s been gaining traction in the media, due to more and more celebrities speaking up about their struggles with the condition.

Psoriasis is an auto-immune disorder that shows up as a scaly, raised rash on skin, and is typically found on the elbows, torso, knees, palms, soles of the feet and the scalp. It is usually treated with topical steroids on the body, but for scalp rashes, some people have turned to look for specific kinds of shampoo for psoriasis to get relief.

We spoke with Unilever R&D expert Leon van Gorkom for more insight into this chronic skin condition, and whether or not a shampoo for psoriasis is really the most effective form of treatment there is. Read on:

All Things Hair: Hi Leon! First off, can you tell us what psoriasis really is?

Leon Van Gorkom: “Psoriasis is a hyper-proliferation of your skin cells, which means that your skin grows too quickly. It’s usually genetic, and is also an immune response.”

What are its symptoms?

“Psoriasis looks like it always has redness around it. It has elevated scales; it’s like your skin is slack, then all of a sudden you have a raised area with redness around it.”

Is it itchy?

“It usually doesn’t feel too itchy, but it can feel itchy. Normally, the skin exfoliates within a certain time period. This means that the top of the skin will come off in very small flakes, because it has time to disintegrate; there are enzymes on top of skin that cut the little bonds in the skin cells, so they come off in very small parts you don’t see (and it ends up as dust in your house!). However, if you have psoriasis, your skin starts to turn over very quickly, which means that the natural process wherein skin disintegrates into small pieces doesn’t happen anymore in the same amount of time. So the flakes end up becoming really big.”

Which parts of the body are affected, and how is it usually treated?

“Psoriasis can be everywhere on your body, or it can be in one spot. It can spread. Nowadays, people normally use topical steroids prescribed by doctors. But you always have to be careful with the long-term use of steroids, because they can thin your skin.”

How about scalp psoriasis then? Is there a shampoo for psoriasis relief?

“From a shampoo point of view, since psoriasis is a medical condition, there are two clear active ingredients that are cleared by the FDA for the treatment of psoriasis on your scalp: salicylic acid and cold tar. Nobody these days uses cold tar shampoos because of the smell, but salicylic acid shampoos are quite nice. The way salicylic acid works is that it’s an acid that breaks the bonds between the individual skin cells [and turns them into] flakes. So the flakes become smaller, and they come off in smaller parts.”

Wait—is this the same salicylic acid that we commonly use to treat acne?

“Correct. It’s also the same salicylic acid that you treat dandruff with, but don’t think salicylic acid is as effective in treating dandruff as, for example, pyrithione zinc. The same active ingredient can have different benefits for different diseases.”

So how do you know what you’re really afflicted with? Is there a way to tell if what you have is just a regular case of dandruff, or if it’s something else?

“Sometimes not easy for an individual to determine what he or she has. Is it a dry scalp? Is it psoriasis? Dandruff? Seborrheic dermatitis? We don’t know at first. And I don’t recommend self-diagnosis, but the first thing to do if you see flakes is to buy an anti-dandruff shampoo with pyrithione zinc, like Dove Dermacare (Ed’s note: We like Dove Dermacare Dryness & Itch Relief Anti-Dandruff Shampoo and Conditioner). If you don’t see improvements, after a considerable time of use—say two or three weeks—go see your doctor.

“He or she then might ask you how you use your shampoo because some people use shampoo on their hair, but dandruff is a scalp disease, so you really have to rub it into your scalp. If you don’t give the right answer, then your doctor might have a further look to see if it is psoriasis, or whether it is seborrheic dermatitis.”

But is there any way you can tell right off the bat? Are there any telltale signs that can alert us that we might have psoriasis instead of just dandruff?

“Psoriasis is more pronounced than dandruff; it feels dry, scaly and lumpy. Psoriasis tends to have very high-raised scales. It almost feels like a wart, but dry. If you go along the skin, you would feel a bump where the psoriasis patch is. It comes in patches. Dandruff is not raised—it’s just flakes. Seborrheic dermatitis, which is a form of eczema, is also scaly, but the flakes tend to be oily and yellow.

“So if you use a product, only two active ingredients are in a shampoo for psoriasis: cold tar and salicylic acid-containing shampoos.

Are these over-the-counter (OTC) or prescription-only?

“Those are available over the counter. If you have a severe case of psoriasis on your scalp, I would recommend going to a doctor to be prescribed a topical steroid. OTC drugs are not necessarily efficient. Your doctor might recommend the use of shampoo as a first step. If you see improvements, that’s great, but if you don’t see improvements, then he or she might recommend a topical steroid, usually in the form of a cream.”

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