Why Treating Scalp Psoriasis With Topicals Remains a Challenge

EP: 1.Challenges With Topical Psoriasis Treatments and the Need for Simpler Options

Now Viewing

EP: 2.Why Treating Scalp Psoriasis With Topicals Remains a Challenge

Scalp psoriasis presents unique treatment challenges, often due to limitations in topical formulations. Although the affected body surface area may be relatively small, the scalp’s thick skin and the presence of hair make drug delivery more difficult. Many current topical vehicles—such as ointments, creams, or greasy solutions—are poorly suited for use on the scalp. These products may be hard to apply, uncomfortable, cosmetically unappealing, or simply ineffective due to inadequate penetration. As a result, even patients with limited scalp disease are sometimes escalated to systemic therapy earlier than they or their physicians might prefer.

The cosmetic impact of topicals plays a significant role in patient adherence. Individuals often hesitate to apply products that disrupt their hairstyle, damage hair color, or leave behind unpleasant residues. This is particularly important in populations with diverse hair types, such as those with Afro-textured or tightly coiled hair, where formulation choice becomes critical. For example, alcohol-based solutions, although sometimes effective, can be too drying or irritating, especially if applied to compromised skin. Foams and oils may be more acceptable but still pose problems if they contain harsh excipients such as alcohols or penetration enhancers that cause stinging, burning, or contact dermatitis.

To improve outcomes, new formulations must address both clinical efficacy and patient usability. The ideal topical would penetrate thick scalp skin effectively without compromising hair integrity or comfort. It should be easy to apply, cosmetically elegant, and tailored to accommodate different hair types and sensitivities. Without addressing these real-world barriers, even the most effective medications may go unused. As the treatment landscape continues to evolve, innovations in vehicle technology could empower patients with scalp psoriasis to manage their condition topically—potentially avoiding unnecessary escalation to systemic therapies.