Hello. Thanks for writing to us at healthcaremagic
Psoriasis is a chronic disease; it can recur after seemingly complete cure. Treatment of psoriasis is guided by the extent of involvement.
Limited disease is best managed with just topical applications (creams,
ointments, gels, lotions, shampoos); whereas extensive disease (involving >20% body surface area) is usually managed with systemic treatments in addition to topical applications.
Psoriasis is steroid responsive, as you have noticed in your case; the disease gets better with topical
steroids, however, it may recur; sometimes as soon as you stop steroids.
One has to be very careful in using steroids because though steroids are effective in psoriasis, one cannot use them forever because steroids can lead to side effects like skin atrophy if used over long term; moreover, steroids if stopped suddenly can lead to a rebound flare, which may be of increased intensity as compared to previous episodes.
Therefore while steroids are good for providing initial rapid improvement, they should be substituted with alternatives like Vitamin D analogues like
calcipotriol,
calcitriol once the initial rapid response is attained.
Vitamin D analogues are devoid of the side effects of steroids and can also be used safely over long term; moreover rebound flare is not an issue with vitamin D analogues.
Since you have limited disease (scalp involvement), therefore topical's would be adequate for you.
If I was the treating doctor I would have also added a coal tar+
salicylic acid based shampoo, to be used thrice weekly.
I would have asked you to use Vitamin D analogues for
scalp psoriasis rather than topical steroids. You may ask more about these from your treating
dermatologist.
Psoriasis, as I said before is a recurrent condition, therefore I would suggest that you follow up regularly with your treating dermatologist. Your dermatologist can modify your treatment depending on the response.
Regards