Psoriasis on the face can be confused for another skin condition. That's because psoriasis plaques on the face are often less clearly defined than elsewhere on the body. Here, your skin is also thinner and may be more sensitive to psoriasis treatment. It may also be more difficult to treat successfully. So treating psoriasis on your face may take some extra care and patience.
These are areas most often affected with facial psoriasis:
- Skin between the nose and upper lip
- Upper forehead
Regardless of where psoriasis appears on your face, you may be troubled by how visible it is. Take comfort in knowing there are many options for treating psoriasis on your face. Work closely with your doctor to find what works best for you.
Psoriasis Medications for Your Face
Doctors often use a tailored approach because people respond differently to psoriasis medications. These are topical therapies used for facial psoriasis:
- Low-potency corticosteroids, which are anti-inflammatory agents for delicate facial skin
- Synthetic vitamin D such as calcipotrene (Dovonex) ointment or cream, which slows production of skin cells; Calcitriol (Vectical) is a newer vitamin D topical drug approved for treatment of psoriasis that some studies suggest may be better on sensitive skin.
- Retinoids such as tazarotene gel (Tazorac), which help remove scales and may decrease inflammation
Vitamin D and retinoid creams and ointments can be irritating to the face. And long-term use of corticosteroids can cause skin to thin, become shiny, or develop enlarged capillaries. If your psoriasis medication causes too many side effects or is resistant to treatment, work with your doctor. Combination therapy may work better than any one treatment alone. For example, combining corticosteroids with other medications may help enhance effectiveness, as well as reduce side effects.
Tacrolimus (Protopic) and pimecrolimus (Elidel) are two topical drugs approved by the U.S. Food and Drug Administration (FDA) for eczema. This skin condition causes swollen, itchy, and irritated skin, but is not psoriasis. Some dermatologists recommend these drugs for treating psoriasis on the face. The FDA recommends short-term use because of concerns about cancer risks.
Another option is ultraviolet (UV) light (phototherapy), which blocks immune system cells in the skin and prompts production of vitamin D.
In addition to medication, ample use of moisturizers can make your skin feel better and keep scaling under control.
If these treatments don't help, ask your doctor whether systemic medications are right for your situation. There are many medications you take can orally or by injection or infusion to treat psoriasis, including methotrexate, cyclosporine, low-dose retinoids, and biologics such as Enbrel, Humira, Remicade, and Stelara. They work in different ways, but can be helpful for moderate to severe psoriasis.
How to Apply Psoriasis Medication on the Face
Here are a few basic tips for applying topical psoriasis medication on your face:
- Apply small amounts.
- Be careful when applying creams and ointments around eyes, which can become irritated.
- Follow treatment schedules closely to minimize side effects, especially with steroids.
- Check with your doctor about whether or not you can use make-up to conceal the psoriasis on your face. Some can interfere with how well your topical psoriasis treatment works.