How to Treat Psoriasis in Afro Hair
Scalp psoriasis on Black Afro hair is more common than you think and it’s a minefield to access accurate and helpful solution driven information. It was this video that prompted us to speak to leading experts on the causes, treatments, triggers and importantly how to treat it.
There is a reason the term ‘crown’ is often associated with Black hair, and that’s because it’s treasured and has been for generations. It was a way to signify community in African tribes. It was used for communication during slavery, but it is now a symbol of identity and exploring our self-expression. Yet, efficient care can go amiss between the hairstyle switch-ups and its delicate DNA – often prone to dryness, moisture loss and breakage – especially regarding the scalp. In these instances, you may experience dryness, itchiness, irritation, flakiness and itchy patches and, under a more serious lens, a scalp condition.
A particular condition not often spoken about is scalp psoriasis and its impact on those with curly, coily and Afro-textured hair. A condition not widely explored or discussed… until now. Busting all myths and misconceptions, we’ve enlisted the expertise of BSD practitioner Dr Ingrid Wilson, Trichologist and Director at Crewe Hair and Skin Clinic, Dr Sharon Wong, Consultant Dermatologist and Hair Specialist and a personal experience in dealing with scalp psoriasis from facialist Alicia Lartey.
The hardest thing about dealing with scalp psoriasis and having Afro hair is that no dedicated products on the shelf can treat it.
Alicia Lartey
Unpacking Psoriasis
Firstly, it’s essential to understand what scalp psoriasis is. “Psoriasis is a chronic inflammatory skin condition resulting in well-defined inflamed plaques of skin covered with a thick silvery scale that can appear on any part of the body but most commonly on elbows, knees and the scalp,” explains Dr Wong, who also highlights that while the plaques can appear anywhere on the scalp, it is most commonly seen along the hairline and is thicker, more silvery and coarser compared to dandruff. But as these conditions go, it has been difficult to see how scalp psoriasis appears on Black skin and affects Afro hair.
Speaking to Dr Wilson, she explains the visceral differences. “On other skin types, scalp psoriasis is described and pictured as being red, but on darker skin tones, the area will look violet in colour with a grey or whitish scale and post-inflammatory hyperpigmentation.” This then impacts the health and maintenance of Afro hair because those experiencing scalp psoriasis also can expect itchiness, hair loss and hair breakage (and the cycle to maintain moisture transitions twofold), emphasising the need to retain moisture for hair and introduce soothing treatments for the scalp.
Insights and Causes
According to Dr Wilson and Dr Wong, it’s an immune condition (sometimes running in the family) where the skin’s renewal process accelerates. What typically takes 21-28 days for most, takes a few days for those with psoriasis. Despite being immune, scalp psoriasis also has triggers that can heighten the condition and worsen the symptoms. These look like “stress, smoking, trauma, drugs, pregnancy, sunlight and certain injections such as streptococcal (a treatment given to those who experience strep throat) are the most prevalent to note,” according to Dr Wilson.
However, for most with scalp psoriasis, it has been experienced from childhood. “I’ve had issues with psoriasis since I was a child, and my mum noticed clumps of scalp scales each time she would wash my hair,” says Lartey. “I dislike the feeling of not having a smooth and debris-free scalp; I would often worry that the clumps would detach from my scalp, appear as dandruff, and make other people think I wasn’t clean. Or I was nervous when styling my hair in case of a flare-up. The hardest thing about dealing with scalp psoriasis and having Afro hair is that no dedicated products on the shelf can treat it” she explains.
Personal accounts such as Alicia’s aren’t a drop in the ocean; scalp psoriasis on Afro hair isn’t as easy to treat due to the nature of our hair, and because so many of us often are under or misdiagnosed. According to Dr Wilson, it can go untreated for so long without knowledge or awareness. Not to say treating scalp psoriasis on Black scalps is impossible, but more so that it needs to be tailored to each person depending on their severity. “It isn't permanently curable, but treatments can certainly keep it under control or in remission.”
Combination Treatments
Depending on the severity, the scalp can be treated with prescription topicals containing varying strengths of anti-inflammatory medication and descaling actives such as tar and salicylic acid. The aim is to use the steroids only in the short term. Once the inflammation has settled, long-term and regular use of an anti-scaling shampoo is important to keep the flakes in check,” shares Dr Wong.
For that reason, frequently washing your hair is recommended, and while tossing the coin between the hours needed to wash Afro hair, it’s vital to wash hair with scalp psoriasis at least once a week. “During flare-ups, it may be necessary to do this 2-3 times per week in the short term so the products have enough contact with the scalp to work. In very severe cases, scalp psoriasis may require much stronger tablets to keep under control,” adds Dr Wong.
Other ways to treat scalp psoriasis:
Avoid picking or scratching off the scales, as psoriasis attracts more of the condition.
Avoid hair styles like locs and braids that restrict access to your scalp.
During a flare of psoriasis, it is best to soften the scales overnight using a coconut oil/salicylic acid preparation such as Sebco and then using an anti-scaling shampoo the following day to wash this out (e.g. Capasal, Vichy Dercos DS, Exorex, T Gel) followed by an excellent conditioning product for the hair strands.
Once weekly, use an anti-scaling shampoo, and use prescription corticosteroids for flares only.
With long-term use of an anti-dandruff shampoo, choosing one that is kind to the hair and scalp is essential.
Avoid or minimise chemical processed treatments and heat to reduce the chances of inflammation.
Minimising combing and brushing as this can cause hair damage. Finger detangle wherever possible.
Finally, research tells us that psoriasis affects roughly 1.8 million people in the UK, 7.4 million in the US and globally 125 million people, so you aren’t alone. Find a treatment plan that works for you with advice and product recommendations - check out our Black Skin Directory clinics today.
Try adding these recommended favourites to your next wash day:
