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Scalp psoriasis advice?

I've been battling the itchy scalp and dandruff for about 20 years. (I'm 66 now.) In the last 50 to 10 years, I've developed plaques. In addition to all that, I constantly feel like I'm wearing a hat or headphones. I'm guessing that's because my scalp is stretched tight because of the psoriasis.

I've tried oral, and they worked for a bit and then stopped. I used one biologic for a while until I ended up in the ER with chest pain. They determined it was pericarditis, and I had to stop. It was helping, but now I'm on nothing. My doctor told me there was nothing else we could try. She also told me that my thinning hair was due to age because psoriasis doesn't cause hair loss. I'm looking for a new dermatologist because she obviously doesn't know her stuff.

Anyway, I am a picker. I pick at scabs. I pick at the dead skin around my nails. I think you know what's next. I pick at the plaques. Even when my scalp isn't itching (Since developing the plaques, the itching isn't as bad as it was.), my hand is still on my head, picking or scratching. I think it's become a habit. My hands always have to have something to do, so they go to my head.

How do I break this habit and keep my hands off my head? I've actually drawn blood, and I worry that I'm going to cause an infection.

  1. Hello I am glad to hear you are looking for another dermatologist. If you hadn't mentioned that I was sure going to suggest it. She obviously doesn't know what she is talking about. I have a friend that has scalp psoriasis really bad and she has lost her hair multiple times because of the psoriasis. For some reason I am not being able to search for stories on our site but if you put scalp psoriasis up in search engine it will give you a list of stories on that topic. Maybe it will give you a suggestion on the scratching. Vickie W., Team Member

    1. Thank you so much for your questions and for sharing a part of your journey with us. It does sound like a second opinion could be a good idea for you. Picking is a hard habit to break, I also cannot leave a plaque alone, if the skin even looks slightly loose, I get hold of it. I am sharing some articles with you about scalp psoriasis that I think you will find informative. There may even be one or two ideas that you could try.
      https://plaquepsoriasis.com/living/home-scalp-therapy-routine

      https://plaquepsoriasis.com/living/home-diy-scalp-treatment



      You could also ask about medicated shampoo, there are a few options that might be helpful.


      - Clair ( Team Member)

      1. Thank you. I meant to also ask for suggestions on questions to ask when making an appointment with a new doctor. There are several in the area and I'm sure that if I ask the appointment clerk if the doctor is experienced in psoriasis, they will all say yes.

        1. Scheduled for March 28.

        2. glad to hear you are calling a doctor. Please keep us updated if you want. Vickie W., Team Member

      2. Hi , nice to see your username pop up again! I'm so glad you reached out here. I can relate to so much of what you have shared, from feeling like you're wearing a helmet to constantly picking at the scalp.


        I used to pick at my head all the time. I still do it very rarely (nowhere near as much as I used to). As you've found yourself, for me, the picking wasn't the start of the issue, it was the touching my head in the first place and searching for things to pick at. If I know something is there to be picked then I will pick at it, so it's better if I just don't know that it exists. If I remember correctly, I think I just removed my hand from my head every time I found it there. Over time, it became less difficult to not touch my head. I also keep my nails very short which makes it harder to pick at anything. Have you thought about trying a fidget toy or similar? Perhaps that would help with keeping your hands busy. Something else that might help is wearing gloves - you can still touch your scalp but it would be very hard to pick at it with gloves on.


        With regards to an appointment with a new dermatologist, Alisha has written a very helpful article on this topic, where she lists a few questions that are worth asking: https://plaquepsoriasis.com/living/appointment-guide-newly-diagnosed I hope this is helpful and that you'll get more input from the community here. Please keep us updated on how you're doing if you can. Warmest wishes, -Catherine, Community Moderator

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