Psoriasis on scalp and neck

Posted by tcokeefe @tcokeefe, Feb 20, 2021

Almost a year ago I started having itching behind my right ear which I thought was a bug bite. Long story short the entire back of my scalp and nape of my neck have horrible itching. I went to my GP twice and she sent me to my dermatologist who said it looked like psoriasis. She prescribed clobetasol propionate shampoo. I am to use it until the itching stops and then I must stop using it for at least as many days or weeks as I used it and I know there is a maximum of four weeks that you can use it at any one time. My problem is the itching starts up immediately after I stop using it. I have tried coal tar shampoo, and the other kind of shampoo which name I can’t remember right now. Basically I’ve tried everything that I’ve read is recommended for psoriasis of the scalp. Anyone have any good ideas and also, how long has anyone used that steroid shampoo? Thanks for any input!

Interested in more discussions like this? Go to the Skin Health Support Group.

@tcokeefe It sounds like you have an intense and uncomfortable case of psoriasis. Due to the nature of the topic I added this discussion to the Skin Health group as well as Autoimmune. I did this so you could connect with members in both groups like @ske22 @terri672 @oldkarl @destinnana @jobby99 @gardeningjunkie @kewpie8484 @pollyanne.

Below I have linked two previous related discussion. You may wish to scroll through the comments and look for relevant information.
- Scalp and hair problems possibly from discoid lupus https://connect.mayoclinic.org/discussion/scalp-and-hair-problems/
- Undiagnosed and frustrated: RA? Lupus? https://connect.mayoclinic.org/discussion/hi-im-new-to-the-forum-and-want-to-share-my-journey/
- Bronchiectasis and skin problems like psoriasis? Any connection? https://connect.mayoclinic.org/discussion/bronchiectasis-and-skin-problems-like-psoriasis-any-connection/
- I have body and scalp psoriasis. https://connect.mayoclinic.org/discussion/hi-my-name-is-janet-and-i-have-body-and-scalp-psoriasis-my/

Since you have such am intense case of psoriasis, has your provider considered exploring other treatment options and/or an alternative diagnosis? I'm wondering if you have considered getting a second opinion at a specialty or teaching hospital? Could there be another autoimmune or alternative diagnoses that would account for your symptoms?

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Thanks! I appreciate it!!

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I have only seen the dermatologist once and the diagnosis was made by her looking at my scalp. At the same time I had itching on my elbow and lower back which she thought the back was eczema and the elbow was also psoriasis but they have both subsided. But the itching on my scalp never lets up. I think I need to call her and go back for further explanation

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@tcokeefe - I can relate to the itching scalp. I have the same problem with psoriasis on the lower back of my scalp and nape of my neck, as well as one elbow, and it’s driving me mental! I have just started on Stelara 90ml. injection (dosage increased from 45ml as that was not having effect). The Stelara does not seem to have eased the itching, but my nurse says the injection will take several weeks to take effect so I live on hope! If you do not have any liver issues, you could ask your doctor if Methotrexate would work for you. It did for me - cleared all my psoriasis in six months but as soon as dosage was reduced it came back with a vengeance! I also have fatty liver disease so apparently can’t stay on the higher dose of Methotrexate.

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That’s interesting, I’ve been told I have fatty liver is well!

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@tcokeefe

That’s interesting, I’ve been told I have fatty liver is well!

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You might want to ask your doctor/dermatologist to try you on Methotrexate. Your liver enzymes will have to be under observation during this treatment.You may not be able to stay on it long term if titrating down the dosage does not work. Titrating down from full dose of eight 2.5mg pills once a week didn’t work in my case, but because of my history of fatty liver disease my dermatologist didn’t want me to continue at the full dose after three or four years. Stelara injections don’t seem to be working, but the nurse told me it takes some months to see results (it took six months with Methotrexate).

Unfortunately my dermatologist has retired and has transferred me to another dermatologist but because of the Covid lockdown situation in Toronto there is a backlog of appointments with the new dermatologist so I am still waiting to see him.

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Try Nizoral shampoo found on Amazon

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@jamesbmakos

Try Nizoral shampoo found on Amazon

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I’ll look it up, thanks! A friend of mine also told me to try rubbing argon oil into the area. I have to say rubbing tea tree oil into it seem to help better than all the different shampoos, of course with the exception of the ultra strong Cortizone stuff. I want to avoid Biologics if I can

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@tcokeefe

I’ll look it up, thanks! A friend of mine also told me to try rubbing argon oil into the area. I have to say rubbing tea tree oil into it seem to help better than all the different shampoos, of course with the exception of the ultra strong Cortizone stuff. I want to avoid Biologics if I can

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Tea tree oil irritates my scalp and skin - as does an apple cider vinegar rinse! Argon oil doesn’t do anything for my scalp. Nizoral worked initially but doesn’t any more - neither does Denorex. Biologics has become my last resort.

I think the two-pack of Nizoral at Costco is cheaper than Amazon ...?

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@jamesbmakos

Try Nizoral shampoo found on Amazon

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Been using Nizoral for some time now. Worked great initially, but now seems to have no effect. I’ve also tried Denorex because someone mentioned it stops the scalp itch; been using it - scalp still itchy and psoriatic.

I think the two-pack Nizoral is cheaper at Costco, if you have membership there.

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