“I never thought I’d lose my hair from psoriatic disease!”

Hair loss can be another challenging — and often surprising symptom — that comes with the scaly plaques of psoriasis or the joint pain of psoriatic arthritis (PsA), as experienced by the MyPsoriasisTeam member who shared the comment above.

Here’s what you need to know if you’re living with psoriasis or PsA and hair loss, also called alopecia. As with any psoriasis symptom, new or worsening hair loss is a reason to talk with your dermatologist. They can determine the cause and work with you to find the best way of managing it.

MyPsoriasisTeam Members Share About Hair Loss

Several MyPsoriasisTeam members have experienced hair loss, particularly from scalp psoriasis. “My hair was progressively thinning out,” wrote one member, “and then it started falling out in clumps at the plaque psoriasis places on my scalp.” The hair loss can come on quickly: “All of a sudden, I’m losing massive amounts of hair,” said another member.

Sometimes, people lose hair only when they tug on it with a brush or comb. “My hair was falling out ‘big time’ every time I combed it,” shared one member. “I always had thick hair, but there was so much hair loss that on the back of my head, you could see a large area of my scalp.”

People sometimes lose a significant amount of hair, which can lead to difficult choices. “My hair is falling out like crazy. I might shave my head due to scalp psoriasis,” one member shared. Another wrote, “The thickness of my hair is down by 50 percent.”

Here are six details to know if you, too, are experiencing hair loss as a symptom of psoriasis.

1. Hair Loss in Scalp Psoriasis May Be Temporary

Most of the time, hair loss occurs when a person already has psoriasis plaques or lesions. Although some have more widespread hair loss, the majority of people with psoriasis experience only temporary hair loss, and their hair will regrow once the condition is under control.

Most people with psoriasis experience only temporary hair loss, and their hair will regrow once the condition is under control.

Hair loss typically shows up as part of psoriasis flares and goes away when the flare-ups pass. One small study found that about half of the participants with psoriasis experiencing hair loss had acute (short-term) hair loss. Others experienced chronic (long-term) hair loss — it occurred regardless of psoriasis flares.

Can psoriasis cause baldness? Psoriasis on the scalp can lead to scarring, so caring for your scalp safely is important. Rarely, hair may not grow back in scarred areas.

People with PsA can also experience hair loss if they have scalp symptoms. In fact, having scalp psoriasis is considered a risk factor for PsA.

2. Psoriasis-Related Hair Loss Has Various Causes

Psoriasis or PsA may result in hair loss in several ways. The symptom may be related to scalp plaques, damage caused by scratching, or effects of psoriasis treatments.

Psoriasis hair loss can be related to plaques, damage from scratching the skin, or treatments.

Psoriasis is a condition that causes the immune system to overreact, leading to inflammation. Scalp psoriasis can affect both skin cells and hair follicles. The condition can cause follicles to weaken, making hair brittle. The hair may not necessarily fall out, but it usually breaks more easily than healthy hair does. Simply brushing brittle hair or pulling it back into a tight hairstyle may cause breakage. Additionally, constant itching and scratching can damage already delicate hair, increasing the chances of hair loss.

The inflammation from psoriasis causes plaques to build up on the skin. If you don’t remove these scales carefully, they can break off hair in the affected area.

Psoriasis plaques are often itchy. This itchiness can be accompanied by dry skin and flaking, which can make the problem worse. Many people with psoriasis find themselves scratching their scalp even if they don’t intend to. This scratching can break weak hair, causing even more hair loss.

3. Stress Can Trigger Symptoms

For some people, stress can trigger plaque psoriasis or PsA symptoms. Because hair loss can cause stress, people can find themselves in a negative loop — stress can worsen symptoms, which can lead to hair loss, which can cause more stress, and so on. Finding healthy ways to manage stress that’s related to psoriasis or PsA could be key to minimizing or preventing hair loss. Research shows that relaxation and cognitive behavioral therapy (a goal-oriented type of talk therapy) can be beneficial for people who experience stress and psoriasis.

4. Hair Loss May Be a Medication Side Effect

Some topical (applied to skin), injected, or oral medications that are used to treat psoriatic disease can cause hair loss as a side effect. Examples include biologics, methotrexate, and retinoids. Even salicylic acid, which is often used to soften and remove the thick scalp scales, can weaken hair and cause it to fall out.

If you start losing your hair after taking a new medication, talk to your rheumatologist or dermatologist about the drug’s side effects. With your doctor’s guidance, you may choose to try a different medication. Don’t stop your medication without first talking to your doctor.

5. You Have Effective Treatment Options

You can include specific steps in your treatment plan to prevent or reduce hair loss associated with psoriasis, PsA, or scalp psoriasis.

Apply Scalp Treatment

Talk to your dermatology team about getting a medicated shampoo or other topical scalp treatment (like a steroid cream or lotion) for the affected area or your whole head. These products can help get your psoriasis under control, which may help stop or minimize hair loss. Shampoos for scalp psoriasis can have a variety of effective ingredients, including coal tar, salicylic acid, and corticosteroids.

Your health care provider can prescribe a medicated shampoo or other scalp treatments to help manage psoriasis and stop or minimize hair loss.

Remove Scales Gently

Don’t pick at plaques on your scalp. Instead, use a shampoo with ingredients that help soften scales. Use the shampoo as directed, and then see if you can gently peel any scaly patches off your scalp. You may need to let the shampoo soak in or use it multiple times before you can remove the plaques without taking hair along with it. Scrubbing or picking too hard can make psoriasis worse and damage your hair, leading to hair loss.

Scale-softening products contain salicylic acid, urea, or lactic acid to help remove thick plaques. When you use these products, carefully follow the instructions. Using too much salicylic acid can cause skin irritation and hair loss.

Keep Your Fingernails Trimmed

Keep your nails short to avoid accidentally damaging your hair or scalp when you apply shampoo or a topical treatment. Short nails are also less likely to cause harm if you happen to scratch your scalp while awake or asleep. When applying shampoos or a topical treatment, use your fingertips to gently rub it in.

Choose a Hydrating Conditioner

Using a moisturizing conditioner can prevent dry scalp, reduce itching, and help minimize hair loss. Test your conditioner, along with all your hair care products, to make sure it’s not adding to your scalp difficulties. Apply a small amount to your scalp and wait a few hours. If you notice irritation or itching, swap that product for a gentler one.

Minimize Heat Exposure

Let your hair air-dry, and don’t use a curling iron, a flat iron, or other heated styling implements while managing scalp psoriasis. Heat can dry out your hair and irritate your scalp, slowing down healing. Minimizing heat exposure will help your scalp heal faster and may reduce hair loss.

6. Your Doctor Can Help

Psoriasis and other skin conditions may lead to both physical and emotional challenges. Addressing hair loss early can help you manage the symptom and reduce its impact on your well-being. If you’re noticing hair loss related to psoriatic disease, talk to your health care provider for tailored medical advice. They can come up with a personalized treatment plan, which may include specific scalp products and medications. If your hair loss doesn’t improve, let your doctor know. Some other factor, such as a side effect of a medication, might be contributing to your hair loss.

When you speak to your doctor, be open about how hair loss from psoriasis affects you emotionally, socially, and professionally. Feeling self-conscious about your appearance can have an impact on your self-esteem, relationships, and daily life. Tell your health care provider if you’re feeling isolated, anxious, or stressed about your hair loss. Knowing these details can help them better support you and come up with a plan to more effectively help you.

Find Your Team

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 132,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Are you experiencing hair loss related to psoriatic disease? Have you found a way to treat your scalp psoriasis and related hair loss? Share your thoughts or tips in the comments below or by posting on your Activities page.