Itchy, flaky scalp: More than just dandruff

MANILA, Philippines -  Romuel B., 37, a call center agent for five years, has been suffering from scalp problem since his early 30s. He is married with two children at their elementary years.

At first he thought he was just having problems choosing the right shampoo. He tried different brands, from the cheapest to the most expensive ones, and still he got the same results.

After two months of experimenting what could be the best shampoo, he tried anti-dandruff medications and still nothing happened. He was so depressed and could not work normally due to his condition.

With the demand of his work, driven by a night-shift schedule, consulting a doctor was the least of his priority. Due to this, his condition became worse. His scalp was itchy, flaky and scratchy.

Finally, after three months of self-medication, he took a day off to see a dermatologist. And then he was diagnosed to have scalp psoriasis, a condition often be mistaken as dandruff.

New research reveals how thousands of people with terribly itchy, flaky scalps delay going to the doctor and rely on anti-dandruff shampoos that may not work, unaware of new fast-acting and pleasant-to-use medicine now available on prescription.

Some mistakenly think that they have dandruff, while up to 50 percent of those who have been diagnosed with scalp psoriasis are so nervous of side effects and sick of messy, time-consuming and unpleasant treatments that they have stopped using them.

It seems that some people are worried about potential side effects, while others just don’t think that treatments are worth continuing with because nothing seems to work.

Scalp psoriasis is thought to occur when faulty signals in the immune system cause skin cells to grow too quickly. Cells are replaced every three to five days, rather than the usual 28 to 30 days for healthy skin, causing the excess skin to accumulate on the surface in red, raised patches of silvery scales.

One in 50 people has psoriasis and 50 to 80 percent of them have scalp psoriasis. The condition is not contagious, but other people’s tendency to stare can make sufferers feel unclean, stigmatized and socially excluded.

Scalp psoriasis can also be physically debilitating — people complain of burning, tightness and such extreme itching that they cannot sleep or function at work. The desire to scratch all the time can make people feel anxious, embarrassed, frustrated and angry.

It is not certain what causes scalp psoriasis but genetics is thought to play a part. It can be triggered by a change of season, an injury to the skin or emotional stress, reaction to certain medicine, smoking and some infectious diseases such as streptococcal infection.

There is no cure for scalp psoriasis and it is a chronic, relapsing skin condition, but it can be effectively managed. Topical treatments — treatments applied to the skin — are usually the first line of defense and are considered to be suitable for 70 to 80 percent of patients with mild to moderate disease.

To help you know your true condition, here is the scalp psoriasis/dandruff test:

• Do you have red, irritated and raised clearly defined patches on your scalp?

• Is there some hair loss around the scaly patches?

• Do you have scaly, silvery patches of skin on other areas like your elbows, knees or lower back?

• Are your nails pitted?

• Have you tried lots of different dandruff treatments that haven’t worked?

• Do your symptoms get worse in the winter and better in the summer?

• Do you have a close relative who suffers from psoriasis?

The difference between dandruff and scalp psoriasis can be difficult to spot as both conditions are characterized by itching and flaking. A health care professional will be able to provide an accurate diagnosis.

Consult PDS-accredited dermatologists, as they will provide more relevant information about scalp psoriasis.