How to Diagnose Scalp Psoriasis

Medically reviewed by Janice Litza, MD

Last Updated: January 7, 2022 References

Scalp psoriasis is similar to other types of psoriasis, except that it presents on your scalp rather than the rest of your body. You can likely make a general diagnosis at home, although you do need to visit a doctor for a proper diagnosis and for treatment. You'll also need to differentiate it from other conditions, such as dandruff.

Method 1

Method 1 of 3:

Looking for Symptoms

1
Pay attention to red patches. Psoriasis usually presents as red patches with silver or whitish scales on top. Look for patches across your scalp, as that's the first sign that you may have psoriasis. It may cover your whole scalp or only be a few small patches.^{[1]
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- You may also (temporarily) lose some hair.
2
Notice itchiness. Another symptom of psoriasis is itchiness, so if you find yourself scratching red patches on your head, it could be psoriasis. However, don't rule psoriasis out if you're not itching. Not everyone with psoriasis finds it itchy.^{[2]
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National Health Service (UK)
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3
Check for soreness. Psoriasis will often make your scalp sore or painful. Your scalp may also feel like it's burning. It can be painful at any time, though it may become worse when you press on your scalp or run your hands through your hair.^{[3]
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American Academy of Dermatology
Professional organization made of over 20,000 certified dermatologists
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4
Watch for flaking and bleeding. Because psoriasis results in crustiness and scales, you may notice bits of it flaking off into your hair. In addition, you may notice bleeding where you have patches, particularly if you scratch the areas, as you may take off scales that aren't ready to fall off.^{[4]
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- Bleeding can also result from dryness of the scalp.
5
Look for patches elsewhere. If you have psoriasis on your head, you're likely to have it elsewhere, though not always. Look for similar patches on other parts of your body, and check to see if your patches extend past your hairline, as that could indicate it's psoriasis.^{[5]
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DermNet NZ
Online clinical resource website written and run by dermatologists providing evidence-based information about dermatology and skin health
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6
Identify your triggers. Stress, cold, and dry air can all trigger flareups in different people. Keep a journal of common triggers and note when you have flareups to see which ones bother you. That way, you can take steps to avoid them when possible, or at least have treatments ready on hand.^{[6]
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American Academy of Dermatology
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Method 2

Method 2 of 3:

Seeing a Doctor

1
Visit a doctor. A general doctor will likely be able to diagnose scalp psoriasis, though they may also send you to a dermatologist if they're not sure whether it's psoriasis or another condition. Either way, you need a solid diagnosis so you know how to move forward with treatment.^{[7]
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American Academy of Dermatology
Professional organization made of over 20,000 certified dermatologists
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2
Expect a physical examination. The main way a doctor diagnoses scalp psoriasis is through physical examination. The doctor will ask you questions about your medical history, and then they will take a look at the skin condition on your scalp to determine if it really is psoriasis.^{[8]
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American Academy of Dermatology
Professional organization made of over 20,000 certified dermatologists
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3
Know when a biopsy is done. Occasionally, your doctor may take a skin biopsy. However, that is generally rare when diagnosing scalp psoriasis. It's usually done when there's some question about what condition you have. In that case, a small sample of skin is taken from your head and sent to be tested in a lab to help determine your condition.^{[9]
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- Your doctor will use a local anesthetic to prevent pain when performing the biopsy.
4
Follow your treatment plan. Your doctor will recommend a treatment plan. They may start you out on shampoos designed to treat psoriasis, usually tar shampoos or ones with salicyclic acid. You'll also likely use creams or other topical treatments, both in steroid and non-steroid forms.^{[10]
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- Be sure to use the shampoos just on your scalp, not all over your hair.
- Your doctor may also inject steroids into some of your lesions to help slow down the reaction.
- Other treatments can include things like ultraviolet light, oral retinoids (a form of synthetic vitamin A), and antimicrobial medications (if you develop a yeast infection).

Method 3

Method 3 of 3:

Distinguishing It From Dandruff

1
Look for a yellowish color for dandruff. Dandruff, clinically referred to as seborrheic dermatitis, often presents in a yellowish-whitish color.^{[11]
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Cleveland Clinic
Educational website from one of the world's leading hospitals
Go to source} Therefore, try examining the patches on your head. If it's more silvery white, it's likely psoriasis. If it's more yellowish, it's more likely dandruff.^{[12]
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2
See if it's greasy or dry. Psoriasis often presents as fairly powdery or dry, so check the patches on your head for greasiness. If it seems greasy, it's more likely dandruff than psoriasis.^{[13]
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Cleveland Clinic
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Go to source} You may even be able to tell just from looking at it whether it seems greasy or dry.^{[14]
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3
Notice where your patches end. Dandruff usually stays just on the scalp rather than moving past the hairline. Therefore, if you notice patches that move past the hairline, that's more likely to be psoriasis than dandruff. If it stays just on your head, it could still be either psoriasis or dandruff.^{[15]
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Cleveland Clinic
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4
Check to see if it might be ringworm. Ringworm may be mistaken for psoriasis or dandruff as well. Ringworm causes bald patches on your head that are itchy and scaly, which may seem like a dandruff problem or psoriasis. However, ringworm is a fungal infection, which requires treatment with antifungal medications.^{[16]
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- See your doctor to be sure about what is causing the flaking on your head.