Treating Psoriasis on Your Face

Psoriasis on the face is different than on other parts of the body. Your skin there is thinner and may be more sensitive to treatments. In this area, the condition usually affects your:

  • Eyebrows
  • Skin between your nose and upper lip
  • Upper forehead
  • Hairline

You have a lot of options for treating psoriasis in these areas. Work closely with your doctor to find what works best for you.

Psoriasis Medications for Your Face

There are a few main types of treatments specifically for facial psoriasis. The type you use depends on which part of the face is affected. Your doctor may prescribe just one or a mixture of them, including:

  • Low-potency corticosteroids, which are ointments, creams, lotions, or sprays that reduce redness and swelling. Doctors usually prescribe them for just a few weeks at a time. If you use them for longer, they can make your skin thin, shiny, bruise easily, or give it stretch marks and new blood vessels.
  • Synthetic vitamin D, such as calcipotriene (Dovonex, Sorilux) ointment or cream, slows the growth of skin cells. But it can also irritate your face. Calcitriol (Rocaltrol, Vectical) is a newer vitamin D drug for psoriasis that some studies suggest may be better for sensitive skin.
  • Retinoids, such as tazarotene gel (Tazorac), help remove scales and may ease inflammation. But skin irritation is a possible side effect.

Pimecrolimus (Elidel) and tacrolimus (Protopic) are two drugs the FDA has approved for eczema, a different skin condition. Some dermatologists recommend these drugs for psoriasis on the face. But talk to your doctor about whether you need these medicines. The FDA says people should use them only for a short time, since some studies have linked the drugs to cancer risks.

Crisaborole (Eucrisa) ointment is an other topical ointment recently approved by the FDA for eczema that can reduce inflammation. It can cause temporary burning or stinging upon application.

Psoriasis on Your Eyelids

If you have psoriasis on your eyelids:

  • Scales may cover the lashes.
  • The edges of the lids may get red and crusty.
  • The rims may turn up or down if they’re inflamed for a long time.

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To treat this area, your doctor may recommend:

  • Special corticosteroids to treat scaling. But don’t overuse them. If they get into your eyes, they can lead to glaucoma or cataracts.
  • The eczema drugs pimecrolimus (Elidel), tacrolimus (Protopic), or crisaborole (Eucrisa) ointment. They don't cause the side effects of steroids. They can sting the first few days you use them, though.

Be careful when you treat psoriasis around your eyes. The skin on eyelids is delicate and gets damaged easily. Tell your doctor about any problems you have.

Psoriasis in the eye is very rare. If you have it, your eyes can be painfully dry. You may need antibiotics to treat an eye infection if you get one.

Psoriasis in the Ears

In some cases, scales build up and can block your ear canal, causing hearing loss. Your doctor can remove the blockage to restore your hearing. Usually, psoriasis doesn’t affect the inner part of the ear.

Psoriasis medications can put your eardrum at risk, so be cautious when you apply any inside the ear. Your doctor may recommend:

  • A prescription corticosteroid you can drip in your ear or apply to the outside of your ear canal
  • Calcipotriene or tazarotene usually mixed with a corticosteroid cream or ointment

 

Psoriasis Around Your Mouth and Nose

It’s rare, but psoriasis can appear:

  • On the gums or tongue
  • Inside the cheek
  • Inside the nose
  • On your lips

Your doctor may recommend:

  • Steroid creams or ointments that are made for moist areas
  • Rinsing often with a saline solution to relieve pain
  • Low-potency corticosteroids like hydrocortisone 1% ointment
  • Pimecrolimus or tacrolimus

 

How to Apply Psoriasis Medication on Your Face

Here are a few basic tips:

  • Use small amounts.
  • Be careful when you apply creams and ointments around the eyes. Some treatments can irritate them.
  • Follow your doctor’s instructions for taking the medication so you can prevent side effects, especially with steroids.
  • Ask your doctor if you can use makeup to conceal the psoriasis on your face. Some products can prevent treatment from working.
  • If your medication doesn’t help or causes too many side effects, work with your doctor to figure out a treatment that will help.

 

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Other Options

Along with medications, there are other ways you can ease psoriasis symptoms. Use lotion, creams, or other moisturizers to make your skin feel better and keep scaling under control. Another option is treatment with ultraviolet (UV) light, called phototherapy, which slows skin cell growth.

If these treatments don't help, ask your doctor if you should take prescription pills or shots for your condition. These include apremilast (Otezla),  cyclosporine (Neoral), low-dose retinoids, methotrexate (Trexall), and biologics such as adalimumab (Humira), adalimumab-atto (Amjevita), a biosimilar to Humira, brodalumad (Sliq), etanercept (Enbrel), entanercept-szzs (Erlizi), infliximab (Remicade), secukinumab (Cosentyx), and ustekinumab (Stelara). Each works differently, but can be helpful for moderate to severe psoriasis.

 

 

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on April 20, 2017

Sources

SOURCES:

The Psoriasis Association: "Psoriasis in Sensitive Areas."

National Psoriasis Foundation: "Specific locations: Face."

Ortonne, J. Eur J Dermatol, 2010.

Yamamoto, T. European Journal of Dermatology.

FDA: "Elidel (pimecrolimus), Protopic (tacrolimus)."

FDA. “FDA approves Amjevita, a biosimilar to Humira.”

News release, FDA.

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