Psoriasis of the head is one of the most common forms of psoriasis.It can be an independent variant of the disease when psoriatic rashes are located only on the head (regional psoriasis of the scalp) or may refer to the manifestations of generalized, diffuse forms when pathological changes capture the entire surface of the skin.
The causes of the disease
The causes of psoriasis of the head are the same as those of psoriasis of other locations.None of the many psoriasis theories is generally recognized, and despite the huge number of studies, the real causes of the disease are not yet known.Nevertheless, the factors are distinguished, the role of which is proven in the development of the disease.
- Heredity.In about one third of patients, psoriasis is inherited according to the classic laws of genetics: from parents to offspring, according to the autosomal dominant mechanism.In other cases, psoriasis refers to multifactorial diseases when hereditary factors increase the risk of disease in the presence of other significant effects.
- Immune, endocrine, metabolic disorders.
- Epidermal disorders: various types of changes in the vital cycle of skin cells, among which the largest value is attached to the abnormal proliferation of keratinocytes (accelerating skin division of the skin) and slowing the morphological differentiation (ripening and division of different types of cells).
The main symptoms
The main local symptom of psoriasis of the head is the thick, clearly distinguished papule and plaques of pink or bright red color with a characteristic silver-white peeling on their surface.Typical localization - the forehead and freezing area at the hair growth area.At the beginning of the disease, there are usually some plaques, they are pale and, as it was, deleted, long preserved in the same places.After exposure to provocative factors (trauma, infection, pregnancy, diet, nervous shock, etc.), the rash progresses.The plains increase the size, the fusion, become more bright, itching.Psoriasis hair does not fall out, even in the case of a severe course and extensive scalp lesions.
When the surface of the plaque is displayed, you can determine the characteristic triad of symptoms:
- The phenomenon of the stearin spot is an increase in peeling with a slight props.
- The phenomenon of the terminal film - after removing the scales, the surface of the plaque becomes wet, thin, shiny.
- Auspitz symptom or phenomenon of bloody dew - with the careful spread of the terminal film, the bleeding of the point occurs in the form of small non -metering blood drops.
In addition to local symptoms, some patients develop nail lesions and psoriatic arthritis.
Treatment
The treatment of psoriasis of the head should be complicated, including the correction of possible causes and the elimination of provocative factors, diet therapy and common and local funds.The specific skin care recommendations and the choice of drugs are in any case individual and they should give them a dermatologist.
Unfortunately, today it is not known how to completely cure psoriasis - the disease is chronic, prone to frequent relapses.However, the in -depth performance of all appointments can ensure a long constant remission when the skin symptoms become imperceptible or completely disappear.
Diet
The diet of patients with psoriasis is similar to the diet of patients with allergies, as precisely allergic mediators (histamine and others) maintain acutely vicious changes in the skin.Thus, they are excluded from the diet:
- Extractive substances (rich meat and fish broths, smoked meats).
- Spices, spices.
- Products with a large number of artificial flavors, dyes.
- Marinadi, saueri and salty vegetables, canned food.
- Mushrooms.
- Alcohol.
- Exotic fruits (mango, kiwi, etc.).
Fat and fried dishes are limited, easily digestible carbohydrates (sweets, pasta, butter), mass for mass.Against the background of exacerbation, it is recommended that unloading days be held, with intense itching rashes - one day fasting twice a week.
Skin care
Even with severe itching, combination of the skin should be avoided as the injury of plaques often contributes to the appearance of new rashes (kobner phenomenon).To relieve itching and removing flakes, they wash their heads daily, alternating the use of special shampoos and decoction of anti -inflammatory herbs.Psoriasis shampoo on the head may contain:
- tar;
- Selena Sulfide;
- Zinc.
Shampoos are used no more than three times a week and it is recommended to wash the head with a decoction of chamomile, calendula, sage, pine and tea leaves.
Medication
The treatment of psoriasis of the head in the case of severe exacerbations can be performed in a hospital, with the prescription of systemic corticosteroids (oral or intramuscular), desensitization therapy (antihistamines inside and intramuscularly).Detoxification is performed, intravenous administration of sodium thiosulfate, calcium chloride, intramuscular injections of calcium gluconate (or prescribed inside).
In addition, with severe and moderate psoriasis it is possible to prescribe the following groups of medicines (strictly according to indications and separately!):
- Cytostatics (methotrexate, cyclosporin) - to suppress abnormal cell proliferation.
- Systemic retinoids - to regulate the regeneration and differentiation of skin cells.The drug is not combined with cytostatics and other retinoids.
- Biological agents of the system - reduce the activity of the immune system.
Local
With extensive skin manifestations, especially with elements of acute inflammation, exudation, in the presence of combs, local funds are used limited and extremely carefully, as the active penetration of the active substance through damaged skin with the development of systemic side effects is possible.They begin to be administered at the stage of exacerbation and during the period of partial remission local drugs form the basis for the treatment of psoriasis.
In addition to therapeutic shampoos and anti -inflammatory decoction, pastes, ointments, creams, gels, lotions.The following medicines are most commonly used:
- Local remedies containing tar are applied to the scalp twice a day with courses of 1-2 weeks.It is not recommended that they be treated for a long time without interruption as they can cause excessive dry skin.
- Naftal ointment.
- Salicylic ointment.Salicylic acid has a keratolytic effect ("dissolves" coarse cells), disinfects the surface of the plaques.
- Means with zinc.
- Local forms of glucocorticosteroids.To avoid the development of local skin changes (steroid acne, irritation, thinning, atrophy, allergic dermatitis) and systemic side effects (metabolic, hormonal disorders, etc.), corticosteroids are prescribed courses within two weeks 1 time a month.They should be applied twice a day with a thin layer and only on plaques, the surface of which there is no mechanical damage (combs, erosion).In addition to the creams, there are hormonal emulsions and lotions on sale, which are easier to wash than the hair.
- Vitamin D's analogues are applied to the lesions 2 times a day, they can be used in combination with topical steroids.
- Local retinoids are applied to plaques every hour every day in courses of 10 days or more, depending on the treatment reaction (they can cause severe irritation in the application).
- Antralan is used up to 4 times a day.Side effects - irritating effect (itching, redness), yellow skin color at the site of application.
- Combined local drugs are modern and highly effective medicines for the treatment of psoriasis.The most commonly used combinations of tar glucocorticoids are used with tar, salicylic acid.Another good combined cure for head psoriasis.
A huge number of commercial names of local psoriasis drugs are produced and only a specialist can understand them.Do not cultivate yourself, buying advice of acquaintances or under the influence of advertising, even really effective medicines.How to treat psoriasis only on the head, the dermatologist should determine, since topical therapy always implies individually selected combinations and alternating drugs.
Without medicine
Psoriasis refers to climate -dependent diseases.In this way, natural sunlight is very useful for psoriasis, contributing to a decrease in skin manifestations.Patients are recommended daily but a short stay in the sun (in the morning, closer to the evening).UOF is prescribed during the autumn winters.The river and seawater have good effect.Sustainable and complete enough remission can be achieved after undergoing a course for rehabilitation and treatment in the Sanatoriums in the Dead Sea.
In the treatment of psoriasis of the head, physiotherapy techniques are widely used: UFV phototherapy, UFV on a narrow range, bullet therapy.It should be borne in mind that frequent stay in the sun and physiotherapy methods for treating psoriasis increases the risk of skin cancer, so physiotherapy is not recommended for children and all other groups of patients should undergo preventative examinations of the oncologist annually.