Psoriasis on the head is one of the most common forms of psoriasis.It can be an independent variant of the disease, when psoriatic rashes are located only on the head (regional psoriasis of the scalp), or may relate to the manifestations of generalized, diffuse forms, when pathological changes capture the entire surface of the skin.
Causes of the disease
The causes of psoriasis on the head are the same as that of psoriasis of other localizations.However, none of the many theories of psoriasis is universally recognized, and, despite the huge number of studies, the true causes of the disease are still unknown.Nevertheless, factors are distinguished, the role of which is proved in the development of the disease.
- Heredity.In about a third of patients, psoriasis is inherited according to the classical laws of genetics: from parents to offspring, according to the autosomal dominant mechanism.In other cases, psoriasis refers to multifactorial to diseases, when hereditary factors increase the risk of disease in the presence of other significant effects.
- Immune, endocrine, metabolic disorders.
- Epidermal disorders: various kinds of changes in the vital cycle of skin cells, among which the greatest value is attached to the abnormal proliferation of keratinocytes (acceleration of skin division of skin) and a slowdown of morphological differentiation (ripening and division into different types of cells).
The main symptoms
The main local symptom of the psoriasis of the head is the thickened, clearly delimited papule and plaques of pinkish or bright red color with a characteristic silver-white peeling on their surface.Typical localization - the forehead and the freezing area on the border of the hair growth zone.At the beginning of the disease, there are usually few plaques, they are pale and, as it were, erased, long preserved in the same places.After exposure to provoking factors (trauma, infection, pregnancy, diet, nervous shock, etc.), the rash progresses.Plains increase in size, merge, become brighter, itching.Hair with psoriasis does not fall out, even in the case of severe course and extensive lesions of the scalp.
When the surface of the plaques is displayed, you can determine the characteristic triad of symptoms:
- The phenomenon of the stearine spot is an increase in peeling with a slight props.
- The phenomenon of the terminal film - after removing the scales, the surface of the plaque becomes wet, thin, shiny.
- Auspitz symptom, or a phenomenon of bloody dew - with carefully propagating the terminal film, point bleeding occurs in the form of small non -merging blood drops.
In addition to local symptoms, some of the patients develop nail lesions and psoriatic arthritis.
Treatment
Treatment of psoriasis on the head should be complex, including the correction of possible causes and eliminating provoking factors, diet therapy, and general and local funds.Specific recommendations for skin care and the choice of drugs in each case are individual, and they should give them a dermatologist.
Unfortunately, today it is not known how to cure psoriasis completely - the disease is chronic, prone to frequent relapses.However, the thorough fulfillment of all appointments can provide a long persistent remission, when skin symptoms become inconspicuous or completely disappear.
Diet
The diet of patients with psoriasis is similar to the diet of patients with allergies, since it is precisely allergy mediators (histamine and others) that support acutely vicious changes in the skin.Thus, they are excluded from the diet:
- Extractive substances (rich meat and fish broths, smoked meats).
- Spices, seasonings.
- Products with a large number of artificial flavors, dyes.
- Marinades, sauerry and salty vegetables, canned food.
- Mushrooms.
- Alcohol.
- Exotic fruits (mango, kiwi, etc.).
Fatty and fried dishes are limited, easily digestible carbohydrates (sweets, pasta, butter baking), table salt.Against the background of exacerbation, it is recommended to conduct unloading days, with intense itching rashes - one -day starvation twice a week.
Skin care
Even with severe itching, combing the skin should be avoided, since injury to plaques often contributes to the appearance of new rashes (Kobner phenomenon).To relieve itching and removing scales, they wash their heads daily, alternating the use of special shampoos and decoctions of anti -inflammatory herbs.Shampoo from psoriasis of the head may contain:
- tar;
- Selena sulfide;
- zinc.
Shampoos are used no more than three times a week, and between these procedures it is recommended to wash the head with a decoction of chamomile, calendula, sage, pine extract, and tea leaves.
Medication
Treatment of psoriasis on the head in case of severe exacerbations can be carried out in a hospital, with the prescription of systemic corticosteroids (orally or intramuscularly), desensitizing therapy (antihistamines inside and intramuscularly).Detoxication is carried out, intravenous administration of sodium thiosulfate, calcium chloride, intramuscular injections of calcium gluconate (or prescribed inside).
In addition, with severe and moderate psoriasis, it is possible to prescribe the following groups of drugs (strictly according to indications and individually!):
- Cytostatics (methotrexate, cyclosporin) - to suppress abnormal cell proliferation.
- System retinoids - to regulate the processes of regeneration and differentiation of skin cells.The drug is not combined with cytostatics and other retinoids.
- System biological agents - reduce the activity of the immune system.
Local funds
With extensive skin manifestations, especially with elements of acute inflammation, exudation, in the presence of combs, local funds are used limited and extremely carefully, since the active penetration of the active substance through damaged skin with the development of systemic side effects is possible.They begin to apply in the stage of exacerbation, and during the period of partial remission, local drugs form the basis for the treatment of psoriasis.
In addition to therapeutic shampoos and anti -inflammatory decoctions, pastes, ointments, creams, gels, lotions are used.The following drugs are most often used:
- Local funds containing tar are applied to the scalp twice a day with courses of 1-2 weeks.It is not recommended for them to be treated for a long time without interruptions, as they can cause excessive dry skin.
- Naphthalan ointment.
- Salicylic ointment.Salicylic acid has a keratolytic effect (“dissolves” coarse cells), disinfects the surface of the plaques.
- Means with zinc.
- Local forms of glucocorticosteroids.In order to avoid the development of local skin changes (steroid acne, irritation, thinning, atrophy, allergic dermatitis) and systemic side effects (metabolic, hormonal disorders, etc.) corticosteroids are prescribed courses within two weeks 1 time per month.They should be applied twice a day with a thin layer and only on plaques, the surface of which has no mechanical damage (combs, erosions).In addition to creams, there are hormonal emulsions and lotions on sale, which are easier to wash off from the hair.
- Analogs of vitamin D are applied to the lesions 2 times a day, they can be used in combination with local steroids.
- Local retinoids are applied to plaques every hour daily in courses of 10 days or more, depending on the reaction to treatment (they can cause severe irritation in the area of application).
- Anthralin is used up to 4 times a day.Side effects - irritating effect (itching, redness), yellow skin color in the place of application.
- Combined local remedies are modern and highly effective drugs for the treatment of psoriasis.Most often, combinations of glucocorticoids with tar, salicylic acid are used.Another good combined cure for psoriasis on the head.
A huge number of trade names of local drugs from psoriasis are produced, and only a specialist can understand them.Do not self -medicate, buying on the advice of acquaintances or under the influence of advertising any, even really effective drugs.How to treat psoriasis on the head-only a dermatologist should determine, since local therapy always implies individually selected combinations and alternating drugs.
Non -drug treatment
Psoriasis refers to climat-dependent diseases.Thus, natural sunlight is very beneficial for psoriasis, contributing to a decrease in skin manifestations.Patients are recommended daily, but a short stay in the sun (in the morning, closer to the evening).In the autumn-winter periods, UOF is prescribed.River and sea water have a good effect.A persistent and sufficiently complete remission can be achieved after undergoing a rehabilitation and treatment course in sanatoriums on the Dead Sea.
In the treatment of psoriasis of the head, physiotherapy techniques are widely used: phototherapy of UFV, UFV of a narrow range, bullet-therapy.It should be borne in mind that the frequent stay in the sun and physiotherapeutic methods for treating psoriasis increase the risk of skin cancer, so physiotherapy is not recommended for children, and all other groups of patients need to undergo preventive examinations of the oncologist annually.