Psoriasis on the Face
Facial psoriasis typically occurs on the eyebrows, the skin between the nose and upper lip, the upper forehead and the hairline.
Before treatment can begin, a biopsy is needed to confirm that it is psoriasis.
Psoriasis on and around the face should be treated carefully as the skin here is very sensitive. Possible treatment options include:
- Occasional use of mild topical steroids, also called corticosteroids.
- Dovonex, Tazorac and keratolytic products (scale removers).
- Ultraviolet light
- Protopic and Elidel are FDA-approved drugs for eczema that have found to work for some psoriasis patients.
You should only apply medication to the face carefully and sparingly, as the skin and eyes can irritate easily. Further, the prolonged use of steroids may cause facial skin to become thin, shiny and/or prone to enlarged capillaries. Be sure to talk to your doctor about all the risks associated with treatment before beginning.
Around the eyes
There is a possibility that psoriasis around the eyelids may cover lashes, causing eyelids to become red and rusty. 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.
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.
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 on the actual eyeball, while extremely rare, can cause inflammation, dryness, discomfort and may impair vision. Topical antibiotics may be used to treat infection.
In the ears
Psoriasis generally occurs in the external ear canal, not inside the ear or behind the eardrum. Scale buildup in the ear caused by psoriasis can block the ear canal, possibly leading to temporary hearing loss. Do not try to remove the scale yourself.
For treatment, prescription steroid solutions can be dripped into the ear canal or applied to the outside portion of the ear canal.
Around the mouth and nose
For a very small number of people, psoriasis lesions (usually white or gray) appear on the gums, the tongue, inside the cheek, inside the nose or on the lips. 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.
NPF webcast Hard to Treat: Scalp, face and ear psoriasis, presented by Jerry Bagel, M.D., M.S., will dive deep into how to identify, treat and thrive with psoriasis on the face.
Last updated by the National Psoriasis Foundation.