Skip to main content
SpringerLink
Log in

Shampoo in the treatment of scalp psoriasis

  • Chapter
Handbook of hair in health and disease

Part of the book series: Human Health Handbooks no. 1 ((HHH,volume 1))

  • 1576 Accesses

Abstract

Psoriasis, one of the most common chronic skin disease, is thought to have an immunemediated pathogenesis whereby activated T cells infiltrate the dermis and stimulate cytokines, thus promoting keratinocyte proliferation. Psoriasis affects 1–3% of the world’s population. The scalp is the site of predilection for psoriasis, as 50–75% of all psoriasis individuals have scalp psoriasis sometime during their disease. Scalp psoriasis can be associated with psoriasis vulgaris (types I and II), guttate psoriasis, pustular psoriasis or erythroderma. Scalp psoriasis is characterized by sharply demarcated erythematosquamous lesions with silver-white scaling; plaques often advancing beyond the hair border onto the face and retroauricular area. Several authors have reported that chronic plaque psoriasis may impair hair growth and even result in scarring. Patients with scalp psoriasis frequently complain of pruritus and scaling. Scalp psoriasis can severely impair patient quality of life, restricting lifestyle and daily functioning. Furthermore, it is embarrassing in social settings and associated with psychological distress in many patients. Despite a vast number of therapies, scalp psoriasis remains difficult to treat. The scalp is an area relatively inaccessible because of thick scales, hair density and proximity of the sensitive facial skin. Furthermore, many topical therapy options are unpleasant to apply, resulting in decreased adherence and efficacy. Current topical treatment modalities are based on new formulations - shampoos, lotions and foams. Shampoos are safe, well-tolerated, efficacious and preferable by the patients. Active ingredients include keratolytics (e.g. salicylic acid, sulfur), tars and corticosteroids. Topical corticosteroids (e.g. clobetasol propionate shampoo) and vitamin D analogues (not available in shampoo formulation) are the drugs of choice during the induction phase, and tar-blend shampoos (and vitamin D analogues) continue to be drugs of choice for maintenance therapy. None of the preparations evaluated stands out over the others in all clinical situations and their use must therefore be individualized in each patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 179.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AP-1:

Activator protein 1

CALEPSO study:

Canada Long Exposure PSOriasis study

ELAM-1:

Endothelium leukocyte adhesion molecule 1

FDA:

US Food and Drug Administration

GCs:

Glucocorticosteroids

GM-CSF:

Granulocyte-macrophage colony stimulating factor

GR:

Glucocorticosteroid receptor

HPA:

Hypothalamic-pituitary-adrenal

ICAM-1:

Inter-cellular adhesion molecule 1

IL-1:

Interleukin-1

IL-8:

Interleukin-8

NF-AT:

Nuclear factor of activated T-cells

NF-κB:

Nuclear factor kappa-light-chain-enhancer of activated B cells

PAHs:

Polycyclic aromatic hydrocarbons

PASI:

Psoriasis Area and Severity Index

TNF-α:

Tumor necrosis factor α

References

  • Andres, P., Poncet, M. and Farzaneh, S., 2006. Short-term safety assessment of clobetasol propionate 0.05% shampoo: hypothalamic-pituitary-adrenal axis suppression, atrophogenicity, and ocular safety in subjects with scalp psoriasis. Journal of Drugs in Dermatology 5, 328–332.

    PubMed  Google Scholar 

  • Belvisi, M.G., Wicks, S.L. and Battram, C.H., 2001. Therapeutic benefit of dissociated glucocorticoid and the relevance of in vitro separation of transrepression from transactivation activity. The Journal of Immunology 166, 1975–1982.

    PubMed  CAS  Google Scholar 

  • Bovenschen, H.J. and Van de Kerkhof, P.M.C., 2010. Treatment of scalp psoriasis with clobetasol-17 propionate 0.05% shampoo: a study on daily clinical practice. Journal of the European Academy of Dermatology and Venerology 24, 439–444.

    Article  CAS  Google Scholar 

  • Chan, S.C., Van Voorhees, A.S. and Lebwohl, M.G., 2009. Treatment of severe scalp psoriasis: from the Medical Board of the National Psoriasis Foundation. Journal of the American Academy of Dermatology 60, 962–971.

    Article  PubMed  Google Scholar 

  • Crowley, J., 2010. Scalp psoriasis: an overview of the disease and available therapies. Journal of Drugs in Dermatology 9, 912–918.

    PubMed  Google Scholar 

  • Going, S.M., Guyer, B.M. and Jarvie, D.R., 1986. Salicylic acid gel for scalp psoriasis. Clinical and Experimental Dermatology 11, 260–262.

    Article  PubMed  CAS  Google Scholar 

  • Gottfried, W., 2008. Psoriasis treatment in difficult localizations: scalp, nails, and intertriginous area. Clinics in Dermatology 26, 448–459.

    Article  Google Scholar 

  • Griffiths, C.E.M., Finlay, A.Y. and Fleming, C.J., 2006. A randomized, investigator-masked clinical evaluation of the efficacy and safety of clobetasol propionate 0.05% shampoo and tar blend 1% shampoo in the treatment of moderate to severe scalp psoriasis. Journal of Dermatological Treatment 17, 90–95.

    Article  PubMed  CAS  Google Scholar 

  • Grupper, C., 1971. The chemistry, pharmacology and use of tar in treatment of psoriasis. In: Farber, E.M. and Cox, A.J. (eds.) Psoriasis: Proceedings of the International Symposium. Stanford University, Stanford, CA, USA, pp. 47–356.

    Google Scholar 

  • Guenther, L., Cambazard, F. and Van de Kerkhof, P.C.M., 2002. Efficacy and safety of a new combination of calcipotriol and betamethasone dipropionate (once or twice daily) compared to calcipotriol (twice daily) in the treatment of psoriasis vulgaris: a randomized, double-blind, vehicle-controlled clinical trial. British Journal of Dermatology 147, 316–323.

    Article  PubMed  CAS  Google Scholar 

  • Jabarah, A., Gilead, L.T. and Zlotogorski, A., 1997. Salicylate intoxication from topically applied salicylic acid. Journal of the European Academy of Dermatology and Venerology 8, 41–42.

    Article  Google Scholar 

  • Kaszuba, A., Schwartz, R.A. and Seneczko, F., 2001. Diagnosis, clinical types and treatment of psoriasis. Nowa Klinika 8, 762–768.

    Google Scholar 

  • Kircik, L.H. and Kumar, S., 2010. Scalp psoriasis. Journal of Drugs in Dermatology 9, 101–105.

    Google Scholar 

  • Koo, J., 2002. Vitamin D and scalp psoriasis. Cutis 70, 21–24.

    PubMed  Google Scholar 

  • Langner, A., Wolska, H. and Hebborn, P., 1983. Treatment of psoriasis of the scalp with coal tar gel and shampoo preparations. Cutis 32, 290–296.

    PubMed  CAS  Google Scholar 

  • Lebwohl, M. and Suad, A., 2001. Treatment of psoriasis, part 1: topical therapy and phototherapy. Journal of the American Academy of Dermatology 45, 487–498.

    Article  PubMed  CAS  Google Scholar 

  • Luger, T.A., Cambazard, F. and Larsen, F.G., 2008. A study of the safety and efficacy of calcipotriol and betamethasone dipropionate scalp formulation in the long-term management of scalp psoriasis. Dermatology 217, 321–328.

    Article  PubMed  CAS  Google Scholar 

  • Mason, J., Mason, A.R. and Cork, M.J., 2002. Topical preparations for the treatment of psoriasis: a systemic review. British Journal of Dermatology 146, 351–364.

    Article  PubMed  CAS  Google Scholar 

  • Ortonne, J.P., Chimenti, S. and Luger, T., 2009. Scalp psoriasis: European consensus on grading and treatment algorithm. European Academy of Dermatology and Venerology 23, 1435–1444.

    Article  Google Scholar 

  • Paghdal, K.V and Schwartz, R.A., 2009. Topical tar: back to the future. Journal of the American Academy of Dermatology 61, 294–302.

    Article  PubMed  CAS  Google Scholar 

  • Papp, K., Berth-Jones, J. and Kragballe, K., 2007. Scalp psoriasis: a review of current topical treatment options. Academy of Dermatology and Venerology 21, 1151–1160.

    Article  CAS  Google Scholar 

  • Puig, L., Ribera, M. and Hernanz, J.M., 2010. Treatment of scalp psoriasis: review of the evidence and Delphi consensus of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. Actas Dermo-Sifiliografices 101, 827–846.

    Article  CAS  Google Scholar 

  • Scott, L.J., Dunn, C.J. and Goa, K.L., 2001. Calcipotriol ointment: a review of its use in management of psoriasis. American Journal of Clinical Dermatology 2, 95–120.

    Article  PubMed  CAS  Google Scholar 

  • Seité, S., Paries, J. and Reygagne, P., 2009. A lipohydroxyacid-containing shampoo improves scalp condition and quality of life in patients with seborrheic dermatitis and light-to-moderate scalp psoriasis. Journal of Cosmetic Dermatology 8, 108–113.

    Article  PubMed  Google Scholar 

  • Thami, G.P. and Sarkar, R., 2002. Coal tar: past, present and future. Clinical and Experimental Dermatology 27, 99–103.

    Article  PubMed  Google Scholar 

  • Van de Kerkhof, P.C.M. and Franssen, M.E.J., 2001. Psoriasis of the scalp. American Journal of Clinical Dermatology 2, 159–165.

    Article  PubMed  Google Scholar 

  • Van de Kerkhof, P.C.M., de Hoop, D. and de Korte, J., 1998. Scalp psoriasis, clinical presentations and therapeutic management. Dermatology 197, 326–334.

    Article  PubMed  Google Scholar 

  • Van Schooten, F.J., Moonen, E.J. and Rhijnsburger, E., 1994. Dermal uptake of polycyclic aromatic hydrocarbons after hairwash with coal-tar shampoo. Lancet 344, 1505–1506.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, Kniaziewicza 1/5, 91-347, Lodz, Poland

    A. Kaszuba & M. Pastuszka

Authors
  1. A. Kaszuba
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Pastuszka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Kaszuba .

Editor information

Victor R. Preedy PhD DSc FRSPH FIBiol FRCPath

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Wageningen Academic Publishers

About this chapter

Cite this chapter

Kaszuba, A., Pastuszka, M. (2012). Shampoo in the treatment of scalp psoriasis. In: Preedy, V.R. (eds) Handbook of hair in health and disease. Human Health Handbooks no. 1, vol 1. Wageningen Academic Publishers. https://doi.org/10.3920/978-90-8686-728-8_23

Download citation

Publish with us

Policies and ethics

Societies and partnerships

Search

Navigation