Many hair loss sufferers look towards hair transplant surgery as the ultimate solution to their problem. Slowly losing a part of your identity is painful enough. However, to think that after losing your hair, there is no way of growing it back again is just excruciating.
People who suffer from certain illnesses come across various hurdles when they’re looking for a hair restoration solution. There are certain cases in which surgery is not possible. Does having scalp psoriasis fall in that category?
There are some skin conditions, such as folliculitis and psoriasis, which make it difficult for the surgeon to perform the surgery. Hair transplant surgery with scalp psoriasis is certainly complicated.
There are no exact causes for psoriasis. Still, there are treatments available for it. This should instil hope in you that you can get a hair transplant if you have psoriasis, although it might not always be the case.
What Is Psoriasis?
Psoriasis is a skin disorder in which red, flaky patches form on the body of the person with a scaly, silvery appearance. The size of the patches doesn’t always have to be large. They can be small and appear on the elbows, scalp, knees, low back, torso, legs and other areas of the body.
A person can develop these patches in their childhood. However, it usually develops when the age is less than 35. The condition doesn’t always persist. It can come and go from time to time.
What happens in psoriasis is that there is a buildup of skin cells. Skin cells turnover takes around 28-40 days. However, in the case of psoriasis, skin cell turnover takes 7 days. This results in the formation of crusty, red patches. The disorder can run in the family.
The exact cause of psoriasis is unknown. It may be an autoimmune disorder in which the body’s immune cells start attacking the healthy cells.
Many things can make psoriasis worse, such as showering. Bathing can further dry and irritate the skin that’s already dry and irritated because of psoriasis. Cold weather has the same effect.
Other than that, stressful conditions, skin injuries (cuts, scrapes), sunburns, insect bites, throat infections can all act as psoriasis triggers. This is called the Koebner phenomenon.
Are there Different Types of Psoriasis?
Yes, and these are as follows:
There is a type of psoriasis that occurs more commonly on the scalp. According to the American Academy of Dermatology (AAD), almost 80% of people who have psoriasis suffer from “plaque psoriasis.”
In this condition, the person experiences redness, inflammation accompanied by whitish, silvery scales. This is more commonly seen on the scalp, elbows and knees. Inverse psoriasis generally appears in the skinfolds such as the groin area, armpits, and the skin underneath the breasts.
In pustular psoriasis, the patient forms white or yellow pus-filled pustules. This type usually appears on the hands and the feet. According to the Psoriasis and Psoriatic Arthritis Alliance, around 5% of people suffer from this type of psoriasis.
It is likely to develop in those people who smoke, are under stress or had an infection.
Pustular Psoriasis of Pregnancy
Rare pustular psoriasis of pregnancy (PPP) can also develop in women who are in their third trimester of pregnancy. It is dangerous for the health of both mother and the baby. It needs immediate treatment.
Although uncommon, there’s another very aggressive, even fatal type of psoriasis, called erythrodermic psoriasis. It can take months for pre-existing psoriasis to turn into erythroderma. People who already have plaque psoriasis are at a greater risk of developing this.
The condition can affect the whole body as the skin peels in large sheets. It can be extremely itchy; the heart rate of the person increases with changes in the body temperature. It can result in heart failure. Infection, certain medicines and even sunburn can trigger this.
Does Scalp Psoriasis Cause Hair Loss?
The itchiness resulting from the condition and the consequent scratching can result in hair loss. Fortunately, this is only temporary, so you’ll grow your hair back once you get the treatment.
However, keep in mind that the condition can also lead to permanent hair loss due to the scarring resulting from psoriasis. In that case, a hair transplant may not be possible.
Is There a Treatment for Psoriasis?
Before treatment comes the diagnosis. For that, you’d need to go to a doctor for a physical examination. You might get a diagnosis through a physical exam, or the doctor might send a small piece of your skin, in a medical test called a biopsy, for testing in a laboratory. This can help the doctor determine the type of psoriasis that the person is suffering from.
Psoriasis is a chronic, lifelong condition. It has no cure. However, there are treatments available for it. Topical treatments include:
- Topical corticosteroids
- Salicylic acid
- Vitamin D analogues
These are part of the treatment for many people with psoriasis. Some people also need to get injections or take oral medications.
Phototherapy or light therapy is also used when a person has moderate to severe psoriasis. The way it works is that it slows down the excessive growth of skin cells.
Psoriasis can significantly impact the quality of life of a person. The appearance of the skin can also become a cause for low confidence among individuals with psoriasis. Different treatments can help them better manage their condition.
Moreover, there are some tips suggested for scalp psoriasis. To make sure that the scalp doesn’t get dry, a conditioner can help. Similarly, avoid any products that can dry out the scalp. This includes various hair-styling products. Ice packs can also help with irritation on the scalp.
What Are the Different Phases of Psoriasis?
Psoriasis can come and go. There’s no fixed timeline for this. At one time, psoriasis can flare up, and at another, it can completely go away and clear up, leaving no symptoms behind. This is what’s known as psoriasis remission. You might not experience any symptoms for as long years. However, it can come back at any time.
For instance, some women notice that their psoriasis goes away while they’re pregnant. However, it can come back after childbirth. For some, the experience is different, where their psoriasis gets worse while they’re pregnant.
Having an idea of the triggers of your psoriasis can increase the psoriasis remission time. Smoking, skin injuries, infections, cold weather, prolonged exposure to the sun, and stress can all trigger this skin disorder. Unfortunately, there’s no way to predict how long remission will last.
Hair Transplant With Psoriasis: Is That Possible?
Due to psoriasis remission, a hair transplant becomes a possibility for people who have this chronic condition. Psoriasis can cause people to temporarily lose their hair, especially as they scratch their heads due to itching. Trying to remove the scales can also lead to the breakdown of the hair.
The appearance of the patches can lower the self-esteem of many people. Those who have androgenetic alopecia or are losing their hair due to any other condition find it difficult to cover the different areas of the scalp with red, inflamed patches.
Fortunately, a hair transplant with psoriasis is possible if you’re losing your hair permanently. Only it can take place in the passive phase when the patches have cleared up; you’re not experiencing any symptoms.
One research in which hair transplant surgery was performed on patients with psoriasis found that with proper “dermatological treatment”, psoriasis will not negatively impact the results of the surgery. On its own, a hair transplant cannot treat psoriasis since it is an autoimmune disease that’s inherited.
What Is The Hair Transplant Aftercare For Those With Scalp Psoriasis?
In general, follow the aftercare instructions that your surgeon provides following a hair transplant. You have to be extra careful in avoiding all those things that can trigger scalp psoriasis, such as infection, itching, smoking, stress, prolonged sun exposure, etc. Other than that, the surgeon may prescribe you some corticosteroids to avoid a flare-up.
You should also wear sunblock. You might need to use a special shampoo, the usage of which you can discuss with your surgeon. We’ll closely follow your recovery. If any flare-up occurs, you should inform us. Make sure that you keep your scalp clean at all times.
You’ll be requested to share your pictures with our Aftercare team during your recovery. Our hair transplant surgeons can suggest you see your dermatologist if any flare-ups occur after a hair transplant. Looking after your transplanted areas well if you suffer from psoriasis is important in maintaining good results.
A hair transplant with psoriasis is challenging, but it isn’t impossible. Those who’re dealing with this skin disorder while suffering from hair loss shouldn’t lose hope.
It isn’t possible to cure the condition since the exact cause of it isn’t even known. However, its symptoms can be treated. So, in the period of remission, you can get hair transplant surgery successfully. However, you have to be careful in the recovery period.
Reviewed and Approved by Dr. Hassan Soueid.