Psoriasis around the eyes, ears, mouth and nose
Psoriasis around the eyes
When psoriasis affects the eyelids, lashes may become covered with scales, and the edges of the eyelids may be red and crusty. If inflamed for long periods, the rims of the lids may turn up or down. If the rim turns down, lashes can rub against the eyeball and cause irritation.
Treating eyelid inflammation may involve washing the edges of the eyelids and eyelashes with a solution of water and baby shampoo. Cotton tip applicators or washcloths are useful for carefully scrubbing the lids. An over-the-counter product, called Ocusoft, can help with removing scales on the lids and eye margins.
After removal of scales, moisturizers without corticosteroids may then be applied. In some cases, a special steroid medication made for use around the eyes may be used to treat scaling. Your doctor must carefully supervise the treatment because eyelid skin can be easily damaged. If topical steroids are overused in and around your eyes, glaucoma and/or cataracts may develop, which is the reason doctors suggest having your intraocular pressure checked regularly by an ophthalmologist (a doctor who specializes in treatment of eye diseases).
Protopic ointment or Elidel cream won't cause glaucoma and is effective on eyelids, but can sting the first few days of use. Using Protopic or Elidel for eyelid psoriasis may help you avoid the potential side effects of topical steroids.
Psoriasis of the eye is extremely rare. When it does occur, however, it can cause inflammation, dryness and discomfort, and may impair vision. Topical antibiotics may be used to treat infection.
Psoriasis in the ears
Psoriasis in the ears can cause scale buildup that blocks the ear canal. This buildup may lead to temporary hearing loss, and should be removed by a doctor. However, over-the-counter ear-cleaning kits that involve squirting small amounts of fluid into the ear and letting it drain may be used. Plain warm water, followed by a thin layer of mineral oil applied with a cotton swab, is also effective for some people.
Psoriasis generally occurs in the external ear canal, not inside the ear or behind the eardrum.
Prescription steroid solutions can be dripped into the ear canal or applied to the outside portion of the ear canal. Dovonex or Tazorac may cause irritation when used alone and may be best used in combination with a topical steroid. The eardrum is easily damaged. Care should be taken when inserting anything rigid into the ear. Also, impaction of scale already present from psoriasis can occur if medication prescribed for the skin on the ear is not appropriately applied inside the ear canal.
Psoriasis in and around the mouth and nose
For a very small number of people, psoriasis lesions appear on the gums, the tongue, inside the cheek, inside the nose or on the lips. The lesions are usually white or gray. Psoriasis in these areas can be relatively uncomfortable, and can cause difficulty in chewing and swallowing food.
For the most part, psoriasis treatments for the mouth and nose involve the use of topical steroids that have been designed to treat moist areas. Improving hygiene and rinsing frequently with a saline solution can help relieve oral discomfort. Low-potency steroids, such as hydrocortisone 1% ointment, may be useful in treating psoriasis on the lips. Protopic and Elidel may also be effective treatment options for psoriasis in and around the mouth.
Updated October 2005
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