Topical treatments for scalp psoriasis review

[Fred]

This review looked at treatments for scalp psoriasis.

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Abstract:
People with chronic plaque psoriasis often have lesions on the scalp that are difficult to treat. This is a summary of a Cochrane review on efficacy and safety of topical treatments for scalp psoriasis. For quality of evidence assessment, we used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group approach. Only randomised controlled trials (RCTs) were eligible for inclusion.

We searched the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, EMBASE and LILACS, ongoing trials, index of included studies and screened abstracts of six psoriasis-specific conferences up to August 2015.

We included 59 RCTs, with overall 11,561 participants. Most findings were limited to short-term treatments (< six months). According to the clinician and patients’ self-assessment a corticosteroid/vitamin D combination (e.g. betamethasone dipropionate plus calcipotriol) and corticosteroids of high and very high potency were better than vitamin D. The two-compound combination was superior to the corticosteroid alone, but the additional benefit was small. Reporting of quality of life data was insufficient. The two-compound combination and corticosteroids caused fewer withdrawals due to adverse events (AEs) than vitamin D. There was no difference between the two-compound combination and corticosteroid monotherapy concerning this outcome. Overall evidence was of moderate quality. Evaluation of other topical treatments was limited.

Given the comparable safety profile and only slim benefit of the two-compound combination over the corticosteroid alone, monotherapy with generic topical corticosteroids of high and very high potency may be fully acceptable for short-term therapy. More quality of life data and long-term assessments are needed.

This article is protected by copyright. All rights reserved.

Source: onlinelibrary.wiley.com

[mataribot]

This review looked at treatments for scalp psoriasis.

Quote:

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Abstract:
People with chronic plaque psoriasis often have lesions on the scalp that are difficult to treat. This is a summary of a Cochrane review on efficacy and safety of topical treatments for scalp psoriasis. For quality of evidence assessment, we used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group approach. Only randomised controlled trials (RCTs) were eligible for inclusion.

We searched the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, EMBASE and LILACS, ongoing trials, index of included studies and screened abstracts of six psoriasis-specific conferences up to August 2015.

We included 59 RCTs, with overall 11,561 participants. Most findings were limited to short-term treatments (< six months). According to the clinician and patients’ self-assessment a corticosteroid/vitamin D combination (e.g. betamethasone dipropionate plus calcipotriol) and corticosteroids of high and very high potency were better than vitamin D. The two-compound combination was superior to the corticosteroid alone, but the additional benefit was small. Reporting of quality of life data was insufficient. The two-compound combination and corticosteroids caused fewer withdrawals due to adverse events (AEs) than vitamin D. There was no difference between the two-compound combination and corticosteroid monotherapy concerning this outcome. Overall evidence was of moderate quality. Evaluation of other topical treatments was limited.

Given the comparable safety profile and only slim benefit of the two-compound combination over the corticosteroid alone, monotherapy with generic topical corticosteroids of high and very high potency may be fully acceptable for short-term therapy. More quality of life data and long-term assessments are needed.

This article is protected by copyright. All rights reserved.

Source: onlinelibrary.wiley.com

For me, nothing has beaten the combination of Derma-smoothe and coal tar shampoo. In all honesty, anyone with scalp psoriasis should be considered for systemic treatment because they run a high risk for PsA

[Bill]

I would second Matari on the use of tar based shampoo, but with the rest on the disease treated I cannot remember the last time I used any scalp treatment.

[JohnB]

I've never had it on my scalp, I think I have been very lucky. But of all the topical treatments I have road tested any coal tar based goo have been the most beneficial. However a lot of them have dissapeared from view here as either having been banned by our beloved beurocrats or ceased production through high costs and dwindling usage.

[Kat]

I haven't found the topical treatment for scalp from my dermatologist to work very well. I have noticed that after spending a lot of time outside this past week I've noticed a slight improvement.

I keep meaning to order some coal tar shampoo but haven't gotten around to trying it yet.