Which is the best treatment to put on my scalp?

The treatment that you use on your scalp will depend very much on the extent to which it is affected and what you want to achieve.

Coconut oil: This is good if your scalp is dry but not necessarily covered with active psoriasis. It is solid at room temperature but melts on contact with the skin and is therefore quite greasy; it has a very light but not unpleasant smell. Use as much as you need to make your scalp feel comfortable.

Coal tar solution (Cocois): If the psoriasis on your scalp is thick and active, this is the best treatment to use, as it moistens the plaques and encourages them to lift off. Because it has tar in it, though, it tends to be a bit messy and has a distinctive smell. The amount you use will depend on how thick your psoriasis is, but apply enough to turn the scale from white to the colour of the ointment.

Steroid (e.g. Betnovate) scalp application: This is useful for short-term treatment if your scalp is inflamed but the plaques are not particularly thick. (Beware, though: the scalp application is an alcohol- based solution and can sting when applied.) It is relatively clean and odour free.

Vitamin D scalp application: This is useful when the plaques are thin but active. It is clean and odour free. One or two drops are enough to cover an area of your head about the size of a postage stamp.

It is very difficult to apply my scalp treatment Have you any advice?

With scalp treatment, the method of application is almost as important as which treatment you use. Applying the treatment involves parting the hair in sections and rubbing the treatment along the exposed area. It is best to do this in a sequential fashion, starting at the front of the scalp and working your way round. If the scale/plaques are very thick, once they have been moisturised with the treatment (especially Cocois) they can be gently lifted up using a comb.

It is easier to get someone else to do this for you, as it is difficult to see the top of your head and (a) rub the treatment in where it is needed and (b) lift the scale where appropriate. When doing this some hair may come out, but it will grow back so don’t be too perturbed! The best time to do a scalp treatment is before going to bed, because the treatment (especially Cocois and coconut oil) will make your hair look greasy and can smell.

Try wearing a cotton night cap, a shower cap or something similar and cover your pillows with old pillowcases to protect them. (You can buy pillowcase protectors from bed-linen shops/departments, which give useful extra protection to your pillows.) Wash your hair the next morning with an anti-psoriasis shampoo (i.e. tar-based). An advantage of the coconut-based treatments is that they are wonderful conditioners for your hair!