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When Psoriasis Affects Your Face

Here’s what you need to know about treatment and self-care if symptoms develop around your eyes, ears, or lips. By Julie Lynn MarksMedically Reviewed by Ross Radusky, MDReviewed: January 12, 2018Medically ReviewedPsoriasis on the face can be tricky to treat and may have a significant impact on a person’s everyday life.Fabrizio Misson/ShutterstockPsoriasis can cause thick, scaly plaques to develop on your skin. It commonly affects certain areas of the body, such as your knees, elbows, hands, feet, and scalp. Sometimes the disease can have a highly visible effect when it shows up on your face. “Skin diseases that are on the face, in my clinical experience, can really impact patients’ everyday life and how they feel about themselves,” says Ronda Farah, MD, a board-certified dermatologist and an assistant professor at the University of Minnesota Medical School in Minneapolis. The good news is there are effective treatments and ways to cope when psoriasis affects your face.

What Parts of the Face Does Psoriasis Affect

When psoriasis shows up on your face, it typically affects the following areas:Hairline A rash can develop on your upper forehead, around your hairline. This may be isolated or an extension of psoriasis on the scalp.In the ears If psoriasis scales build up in your ears, they can block your ear canal. Be sure to tell your doctor if this happens.Around your eyes Psoriasis scales can form on your eyelids and may cover your lashes. Areas around the eyebrows are also common sites for psoriasis on your face.Between the nose and upper lip This area is often sensitive. If scales form around your mouth, they may affect how you chew and swallow food. Rarely, psoriasis lesions can also surface inside your mouth, such as on the gums and tongue, or in the nose.

How Psoriasis on the Face Can Take a Psychological Toll

Having psoriasis in general is linked to emotional problems. “We do know that in patients with psoriasis, the prevalence of depression may be as high as 50 percent,” Dr. Farah says. But she suspects that depression may be even more common among people who develop psoriasis on their face. “It’s there for everyone to see, and this bothers some people more than others,” Farah says.

Treatment Options for Psoriasis on the Face

If you develop psoriasis on your face, you might want more aggressive treatment to manage your symptoms. “Tailoring the treatment options to a patient and their need is really important with psoriasis,” Farah says. “That’s really something we work with patients on. We’re always asking, ‘How much does this bother you?’” Typically, doctors will start with topical treatments. Facial skin is more sensitive, so long-term use of topical steroids may cause shininess, thinness, or enlarged capillaries. Your doctor will consider these factors and might alter your treatment schedule or prescribe a low-potency steroid cream. If topical therapies don’t offer results, your healthcare provider may recommend phototherapy or injectable, biologic medicines. According to the National Psoriasis Foundation (NPF), two Food and Drug Administration–approved drugs for treating eczema — Protopic (tacrolimus) and Elidel (pimecrolimus) — may work well for treating psoriasis on the face or other delicate areas.

Self-Care Tips for Managing Psoriasis on Your Face

Having psoriasis on your face can be difficult to manage. Here are six tips to consider.Try makeup. Sometimes, covering the areas with makeup can give you confidence. But be careful not to accentuate the rash. Also, don’t use any products that might irritate your skin.Avoid triggers. Try to identify what factors cause your flares, so you can avoid them. Keeping a journal of your symptoms can help you figure out what’s triggering your psoriasis.Lower stress. Stress is known to increase your risk for a psoriasis flare. Try to lower your stress levels with yoga, deep breathing, or meditation.Keep skin moisturized. Using moisturizers on a regular basis can help prevent dry skin and scaling on your face. Talk to your doctor about products that could help.Get support. A support group may help you cope emotionally with your psoriasis. The NPF offers an online support group on their website.Don’t pick. Just as with psoriasis on other parts of the body, manually removal of the scales can worsen them or cause new rashes to develop. NEWSLETTERS

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