Is Short Hair Better for Scalp Psoriasis?

Read on to find out how different hairstyles might help your symptoms.

If you’re living with Plaque Psoriasis (PsO) you probably already know that it’s an autoimmune, inflammatory condition that causes rapid turnover of skin cells resulting in thick, scaly, silvery plaques that may be itchy, inflamed, or painful. These plaques mainly affect the knees, elbows, and scalp.

PsO lesions on the scalp can be particularly distressing as they can interfere with hygiene, fashion, and confidence — not to mention these particular lesions are very difficult to treat, can be painful, and even bleed.

There’s a lot of buzz about how one wears their hair day-to-day and how it affects PsO scalp plaques. Does haircut, color, and style matter when it comes to the care, maintenance, and prevention of recurring scalp lesions? Don’t shave your head just yet — let’s talk about it.

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How can short hair help scalp psoriasis?

The impact of hair length on scalp PsO can vary from person to person. While there’s no definitive answer supporting whether short hair is better for scalp PsO, it may be easier to manage and can simplify certain aspects of treatment. Here’s how:

1. Convenient for treatment: Shorter hair allows easier and more convenient application of treatments such as topical creams, medicated shampoos, and other prescribed or alternative therapies to the affected areas of the scalp.
2. Visibility: Shorter hair allows direct visualization of the scalp and closer monitoring of lesions. This may allow a more detailed evaluation from medical providers, giving more opportunity for appropriate treatments.
3. Exposure to air: The scalp is exposed to less moisture and increased airflow with shorter hair, and this can avoid making the scalp plaques worse.
4. Less maintenance: Shorter hair is easier to wash and maintain, in general. It typically takes less time and requires fewer products like shampoo, stylers, and medications used to treat scalp PsO. Since scalp hygiene is somewhat easier with shorter styles, there’s also less buildup of dead skin and debris.

However, although shorter hairstyles can help some people manage their PsO plaques better, this may not be the case for everyone. It’s possible that the severity of your scalp plaques will not change in response to your hair length.

Haircuts with scalp psoriasis

Getting a professional haircut may be anxiety-provoking if you have PsO plaques on your scalp, but here are some great tips:

1. Remember that you’re not alone: According to the National Psoriasis Foundation, up to 56% of people living with PsO have scalp lesions. It’s unlikely that you’re their first client with this skin condition.
2. Find an experienced stylist: Finding someone who understands PsO and scalp lesions can be helpful. If they aren’t familiar, and you don’t have a choice, using facts is helpful. Start by telling them that it’s not contagious, as this is likely the first thing they will want to hear.
3. Communicate: If your scalp PsO makes you sensitive to chemicals or heat, let your hairdresser know before they start. Make a plan together to avoid or reduce the use of these during your time together.
4. Provide your preferred products: Bring your favorite PsO scalp products with you to the appointment. Not only does this make telling your stylist what you use easier, but they may even be able to do a thorough application for you during your time together.

Tips for hair maintenance

If you have PsO plaques on your scalp, you should choose products that are free of colors and dyes, made for sensitive skin, and offer gentle cleansing. You may need a combination of sensitive and medicated products, too. This may take some trial and error, but many people with scalp PsO can find a regimen that works for their scalp and their lifestyle.

Avoid harsh chemicals

Try to avoid any chemical processing of the hair, especially close to the scalp. If you can’t avoid that monthly root touch-up, look for organic product options with hemp or vegetable dyes.

Additionally, look for products with more sodium, potassium, and ammonium sulfates, as these are typically less irritating. Avoid products with alcohol as these can dry out the scalp and make PsO plaques worse.

Reduce heat

Heat on the scalp can lead to Koebner’s phenomenon, the triggering of PsO plaques after a trauma to the skin or scalp. If you can avoid heat by air drying your hair, this is the best option, but if you can’t, use low heat settings on your hot tools including flat irons, curling irons, straighteners, and especially blow dryers.

You can also use the “cool shot” button if your hot tool has this feature, especially when you’re closer to your roots and scalp.

Be careful of injury

Any skin injury may contribute to a flare or irritation of PsO. Keep this in mind when using brushes, trimmers, or blades on your scalp.

Tips for hair styling

Style can matter when it comes to managing scalp PsO. If you have plaques on your scalp, you have probably already discovered the magic concealing effect of a low ponytail to cover the nape of the neck or side-swept bangs to cover plaques on the forehead.

Sideburns, or hair pulled in front of your ears, can also camouflage plaques around the ears and hairline. Loosening that ponytail can also help reduce the aggravation of scalp PsO plaques.

If you need eyeglasses for seeing or reading, opt for contact lenses if you can. The skin behind your ears is an extension of the skin on your scalp, and the friction from glasses can worsen plaques in this area.

Don’t forget to include sun protection in your style routine. Barriers, such as hats, hoods, and umbrellas, are great options. There are also a handful of scalp and hair-specific sunscreen products available that are effective at shielding you from harmful ultraviolet (UV) rays.

People of Color and scalp PsO

Plaque psoriasis can present differently across different ethnic groups.

For example, a 2022 review finds that people with darker skin tones can experience thicker plaques and larger surface areas of impacted skin. Additionally, nonwhite groups have reported lower quality of life as a result of these clinical differences.

If you have a darker skin tone and have PsO that affects your scalp, here are some tips that might help:

1. Look for a stylist with expertise: Someone who understands PsO and how to care for your hair type can make a big difference. Sometimes the care required for PsO scalp plaques can be damaging to the hair itself, so it’s important to be aware of these things.
2. Avoid relaxers: If possible, avoid harsh chemicals, especially directly on your scalp. These are known to cause irritation, which can worsen PsO plaques.
3. Ask for alternatives: Explore options with your medical team or dermatologist. For example, if you don’t wash your hair every day, every other day, or every week, ask them to consider alternatives to shampoo treatments.
4. Moisturize your scalp: Whenever possible, use hair oils meant for the scalp. Using oils not meant for hair or scalp might seem OK, but sometimes these can damage the hair itself, further complicating this problem.
5. Minimize friction: Consider using a sleep bonnet and/or satin pillowcase when sleeping.
6. Style loosely: When styling, think loose and gentle. Avoid tight twists and braids, and let your hair rest at every opportunity possible.
7. Explore other options: If your scalp PsO plaques aren’t controlled, and letting your hair rest is not an option for your lifestyle, consider a wig or extensions. These options have the least amount of pulling and tugging and are relatively gentle on the scalp and hair.
8. Follow other PsO advocates: Social media can be a great place for advice. Alicia M. Bridges is an incredible advocate for this specific community. Check out this list of other incredible female advocates, too!

A well-established routine for scalp care is the best way to manage scalp PsO. If you’re still struggling to manage your scalp PsO, be sure to consult with a dermatologist or healthcare professional to review your treatment options.