Adult female with scalp psoriasis and dandruff is getting her hair combed with a nit comb to check for lice.

Treating Lice With Scalp Psoriasis

First off-I apologize in advance for making your poor scalps itch even more than normal by the sheer mention of lice.

The dreaded lice outbreak

My kid’s school had a lice outbreak recently. Just reading the email made my scalp tingle in the worst possible way. As soon as my wife read the letter, she insisted on mandatory checks of everyone’s hair to make sure the little buggers didn’t come home.

All three kids successfully passed the inspection, and then it was time for me to get my head picked through like a monkey. Before diving in, my wife innocently asked if lice could live on my scalp. After all, the plaques on my scalp are so thick, it would be a wonder for a louse to be able to reach what he was looking for.

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I had never really thought about it, but we both awkwardly laughed and she went ahead with the check. She didn’t get too far in before determining her eye wasn’t trained enough to distinguish lice eggs (nits) from my psoriasis.

Understanding treatment options

Our next step was to get on our phones and Google “lice and psoriasis” to see if we could find anything. Thankfully our embarrassment was subsided as we discovered that many others had wondered the same thing! I have decided to share what we found so that no one else has to shamefully google in the middle of the night.

Specific symptoms

Allow me to start by saying that lice can, in fact, live on a psoriatic scalp. So, if you notice any of these symptoms, and know you have been exposed recently—look into it a little deeper.

The first and most obvious sign of lice on most people is itching. This is clearly a lot tougher to pinpoint when you have psoriasis because your scalp ALWAYS itches. Lice itch seems to be a little different due to it being described as a “crawling itch”.

Certain challenges

Since itch can be subjective, the definitive test for lice comes from seeing nits or live lice on the scalp. Live lice look like little brown sesame seeds, but they are tough to see. This is especially true against a plaque terrain.

The best way to get a glimpse is to wet the hair because this slows them down. If you are still not able to see the actual bugs, move on to the final step. The next thing to look for is the nits.

This is where my wife felt uncertain because my hair had so many flakes in it, that determining what was a piece of skin or product buildup and what was an egg was hard. The biggest difference is that nits are “glued” to the hair. By design, they do not come off easily. They also have an egg shape and encompass the entire hair shaft.

Avoiding scalp psoriasis triggers

If you haven’t been able to identify eggs or live lice, chances are you are lice-free (hooray!). You may just need some extra moisturizer for that itchy scalp.

However, if you did see signs that more than just an annoying disease inhabits the top of your head, it’s time to evict those little suckers. Traditional prescription and over-the-counter insecticides for lice are very harsh.

This means that if you are flaring and have a buildup of plaques and cracks, you need to use caution. If you do decide to go this route, only use the treatment once. Repeated use raises the risk of further irritation to your scalp.

Additional products and final thoughts

Luckily, there are some natural ways to treat lice. Invest in a nit comb, which is a metal comb with very fine, tight-fitting teeth. One way to remove the eggs is to put conditioner on your dry hair, and then use the comb throughout the entire head every day for 12 days.

In addition, you can warm up some coconut oil and slather your head, wrap it up, and sleep on it to help smother the live lice. Just be sure it is on there all night (lice can hold their breath up to 8 hours!)

Tea tree oil for scalp psoriasis & lice

Just like the oil is good for killing the lice AND softening your plaques, the prevention is dually beneficial as well. In fact, most of us already have it in our cabinet: tea tree oil.

Lice hate it, and scalps love it. I put a few drops to a spray bottle and apply before any kiddo functions. Win-win!

Thankfully our house was unscathed by lice, but I now feel prepared for the future. One thing I have figured out about this disease is that there are many adjustments I am going to have to make, but persistence pays off!

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