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:
- Skin between your nose and upper lip
- Upper forehead
You have a lot of options for treating psoriasis in these areas. Work closely with your doctor to find what works best for you.
They vary depending on what part of your face the psoriasis affects:
- Scales cover the lashes.
- The edges of your lids may get red and crusty.
- The rims may turn up or down if they’re inflamed for a long time.
- Dry, inflamed, irritated eyes
- Trouble seeing
- Scales build up and can block your ear canal, causing hearing loss.
- Usually, psoriasis doesn’t affect the inner ear.
You might have white and gray lesions:
- On your gums or tongue
- Inside the cheek
- Inside your nose
- On the lips
Psoriasis Causes and Risk Factors
Doctors aren’t sure what causes psoriasis, but they know that genes and your immune system play a major role. About 40% of people with psoriasis have a close family member with the disease. Many of the genes linked to psoriasis are those that help run your immune system. In addition to your genes, these things can make you more likely to get psoriasis:
- Vitamin D deficiency
Treatments for Face Psoriasis
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 treatments that go on your skin such as:
- Low-potency corticosteroids, which are ointments, creams, lotions, and 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, and 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 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 another topical medicine recently approved by the FDA for eczema that can reduce inflammation. It can cause temporary burning or stinging upon application.
- Coal tar. Derived from coal, this treatment comes in over-the-counter shampoos, creams, and oils. Prescription-strength products are also available.
- Lotion, creams, or other moisturizers. They can’t heal psoriasis, but they can make your skin feel better and ease itching, scaling, and dryness.
- Salicylic acid. Also available over-the-counter and by prescription in shampoos and scalp treatments, this remedy can help get rid of scales. Your doctor might pair it with steroids or coal tar.
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)
- Biologics such as:
- Adalimumab (Humira)
- Adalimumab-atto (Amjevita)
- Brodalumad (Sliq)
- Etanercept (Enbrel)
- Etanercept-szzs (Erelzi)
- Infliximab (Remicade)
- Risankizumab-rzaa (SKYRIZI)
- Secukinumab (Cosentyx)
- Ustekinumab (Stelara)
Each works differently, but they can be helpful for moderate to severe psoriasis.
Another option is treatment with ultraviolet (UV) light, called phototherapy, which slows skin cell growth. There are several types:
- Sunlight. You get ultraviolet rays from sunlight or artificial light.
- UVB phototherapy. You get UVB rays from an artificial source.
- Narrow band UVB phototherapy. This is a newer type of UVB treatment.
- Goeckerman therapy. This mixes UVB treatment with coal tar.
- Psoralen plus ultraviolet A (PUVA). Psoralen is a medication that makes your skin more sensitive to light. You take it before UVA therapy.
- Excimer laser. This is a controlled beam of UVB light that treats a small area.
Treatments for Specific Areas
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 crisaborole (Eucrisa) ointment, pimecrolimus (Elidel), or tacrolimus (Protopic). They don't cause the side effects of steroids. They can sting the first few days you use them.
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 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
Mouth and Nose
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.
Home Remedies for Facial Psoriasis
At-home self-care is about the basics -- trying not to scratch affected areas, avoiding the things that seem to trigger flare-ups, using cold compresses and moisturizer to soothe affected areas (see below), and keeping up with your treatment.
No supplements or herbal remedies have been proven to treat psoriasis on the face or any other part of the body.
Tips for Living With Facial Psoriasis
Don’t scratch your psoriasis. Be gentle with your skin. Use a cold compress on your psoriasis. To make a cold compress, dampen a cloth in cold water and squeeze out any extra water so it’s not dripping wet. You could also use an ice pack. But don’t put ice directly onto your skin. Moisturizing the area can also help. You may want to pick a fragrance-free moisturizer.
Wear sunscreen every day. You’d want to do this even if you didn’t have psoriasis to help prevent skin cancer and wrinkles. With facial psoriasis, it’s also important to avoid sunburns because they can make your psoriasis worse.
Check on makeup. If you want to hide your psoriasis, you can ask your doctor if you can use makeup to conceal. Don’t assume it’s OK to do, since some products can prevent treatment from working.
Practice stress management. Stress is a possible trigger for psoriasis. There are many healthy ways to handle stress, such as exercise, meditation, making time to relax, and spending time with people you like.
If you’re self-conscious about your facial psoriasis and it’s getting in the way of your life, consider talking to a licensed therapist. They can see if you have depression, and if you do, you can get it treated. Therapy can also help you start to build the confidence to move forward, without feeling like psoriasis is holding you back.