$Unique_ID{BRK00446}
$Pretitle{Skin and Subcutaneous Tissue}
$Title{Help for Severe Psoriasis of the Head}
$Subject{psoriasis treatment}
$Volume{L-20}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Help for Severe Psoriasis of the Head


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QUESTION:  My son age 47, has a severe case of psoriasis in his head, which
his doctor says he can't help.  Its getting worse.  I have tried nearly
everything anyone suggests.  Do you know anything that can help us?

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ANSWER:  It is apparent you have a difficult problem, but there is effective
treatment for scalp psoriasis.  About 1 to 2 percent of Americans suffer from
this chronic and distressing skin condition, and about half of them have some
problems with the scalp Psoriasis can strike at any age, but most often starts
in young adulthood.  The lesions in the scalp may extend a few centimeters
beyond the hairline, but they rarely affect areas that are bald.  However, the
condition itself may cause hair loss and hair thinning.  Treatment is always
complicated and may take some time before the proper combination of
medications can be discovered, and there are many preparations to consider.
So my first advice is patience.  Treatment will always include some type of
medication to be applied locally.  It is important to remove the heaped up
scales first, and that may be done by applying mineral oil to the scalp and
combing out the scales with a fined toothed baby comb.  Next we must find a
medicated shampoo to help.  Regular use of coal tar shampoos can often be
useful, particularly when used regularly.  They should be kept on the scalp
for a least five minute to be effective.  We can also use coal tar mixed in
petroleum jelly to be massaged into the scalp and left in place several hours
before shampooing out.  Its messy but is useful in moderate to severe cases.
Other products may contain keratolytics, chemicals such as salicylic acid that
are used to "dissolve" the scales.  Some coal tar shampoos may contain this
medication as well.  When dealing with a truly difficult case, a physician may
employ anthralin, most effective, but be careful to avoid contact with the
eyes and normal skin.  If local treatment fails (and I have had to leave out a
few) we can turn to medications by mouth that include hydroxyurea,
methotrexate etretinate and isotretinoin.  The use of psoralens and
ultraviolet A (PUVA) may be used for balding patients without much hair.
These oral medications are most frequently used when the patient has extensive
lesions, involving other areas of the skin in addition to the scalp.
Applications of corticosteroid preparations to the skin are most helpful, but
this cortisone like material is not recommended as an oral medication for
psoriasis.  Its obvious to me that you may not understand about all of these
medications, but I have included their names to show you that all is not lost,
and that there is much help still available for you son, even if it must come
from another doctor.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
