Best Treatments for Scalp Psoriasis
Psoriasis lesions on the scalp are common and present a challenge for effective treatment. A recent Cochrane review summarized the efficacy and safety of common topical treatments for scalp psoriasis. The review included 59 randomized control trials (RCTs) that had an overall total of 11,561 participants.
The review looked at evidence for four main outcomes: (1) reduction in clinician-assessed disease severity, measured by the number of patients achieving treatment response or clearance from scalp lesions; (2) improvement in quality of life; (3) how many participants withdrew due to adverse events; and (4) patients’ self-assessment of reduction in disease severity. The authors narrowed down the treatments to compare efficacy and safety of high or very high potency corticosteroids vs. vitamin D; or two-compound combination of a corticosteroid of high potency plus vitamin D vs. either the corticosteroid or vitamin D alone.
The review found that the overall quality of evidence for the major treatment comparisons was moderate. There was not enough evidence in the studies to draw conclusions about quality-of-life measures. For the treatments, corticosteroids of high and very high potency were superior to vitamin D on its own. While the two-compound combination of a corticosteroid and vitamin D was statistically more effective than corticosteroids as monotherapy, the authors note that additional benefit might not be clinically relevant. Both treatments were similarly safe and the two-compound combination was more effective than vitamin D alone.
Therefore, the authors conclude that a monotherapy with generic topical corticosteroids of high and very high potency may be fully acceptable for short-term therapy.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: May 8, 2017
Source: Wiley Online Library
Adapted from the original article.