Quality of Life with Scalp Psoriasis

You wake up intending to go to your family picnic. But then you look in the mirror, and your courage disappears. Your scalp psoriasis is in full view. There are several plaques, behind your ear and on your neck. The top of your head looks like you shook powder all over it.

Maybe the picnic is not such a good idea. You stay home. Avoidance is so much better than embarrassment, you think.

Who lives with scalp psoriasis?

Psoriasis affects about 8 million people in the United States. Scalp psoriasis affects about 45 to 56 percent of them. Six out of 10 reports that psoriasis has a negative impact on their social life. Three in 10 say it impacts their work life.

Many people report that if they are not battling a flare, they are worrying about when the next one will occur.^1-4 Social difficulties, low self-esteem, shame, depression, and anxiety are all common in people with psoriasis.⁴

Let's break it down

Psoriasis, including scalp psoriasis, is an autoimmune disease. It causes rapid reproduction of skin cells which pile on top of each other, creating plaques. When psoriasis plaques are located on the scalp, hairline, forehead, back of the neck, and the skin around the ears, it is called scalp psoriasis. Symptoms include:³

1. Scaling that looks like dandruff
2. Red patches
3. Thick, crusted plaques on and around the scalp that appear powdery with a silver sheen
4. Itching
5. Burning sensation
6. Bleeding

Removal of the plaques along with scratching can lead to temporary, patchy hair loss.

The emotional strain of scalp psoriasis

The physical symptoms of psoriasis are difficult. But the emotional ones are just as challenging. Embarrassment and shame can stop you from socializing with friends and family. There is also a stigma in having a disfiguring condition. Even though psoriasis is common, many people do not understand it.

Some might think the plaques are contagious or caused by poor personal hygiene. They might avoid you or exclude you from group activities. People with scalp psoriasis face rejection in their work-life too. If you have plaques at a job interview, it can affect whether you get the job. It can affect earning potential throughout your life.

The impact on self-esteem

Taken together, this negative feedback can lead to low self-esteem, negative body image, social avoidance, depression, anxiety, or substance over-use. One study found the level of depressive symptoms was not directly tied to the severity of the disease but to the amount of stigma and rejection someone faced.⁴

That is why people living with scalp psoriasis are encouraged to develop a robust social support system. Surrounding yourself with support can be a great boost to self-esteem and a stress reliever. If you feel depressed, talk to your doctor or someone you trust. There are many effective treatments that can help you feel better.

Stress as a trigger

Flares are when your psoriasis acts up and symptoms either appear or get worse. Stress can be a common trigger of flares. That is why stress-reduction techniques are an important tool to manage psoriasis. Some popular stress relievers include:⁶

• Deep breathing
• Exercise
• Yoga
• Meditation

What can you do when you are feeling alone and isolated?

One of the most challenging aspects of scalp psoriasis is feeling alone. When you are in the middle of a flare, you want someone to be there and listen. But not just anyone. You want someone who understands exactly how you feel. Support groups can help. Today, many support groups are online, such as our own PlaquePsoriasis.com community. The National Psoriasis Foundation also offers support programs.

If you feel hopeless, it may be time to seek the help of a therapist. As difficult as it sometimes is, you need to be around other people and build your support network. Explain what you need to feel better. And then, when you feel alone, reach out to people in your network.