If you have psoriasis, a chronic skin condition caused by an overactive immune system, you may have patches of red, inflamed, or painful dead-skin buildup all over your body. Psoriasis also may show up in and around your eyes, which requires special attention.
About 1 in 10 people with psoriasis get eye-related problems.
Symptoms to Look For
Psoriasis most often shows up on your scalp, knees, elbows, chest, and belly. When it appears in or around your eyes, it looks a little different. Signs include:
- Red, swollen eyelids
- Crusted and flaky eyelids. This may cause the edges of your eyelids to curve up or down.
- Scales that cover your eyelashes
- An itchy or burning feeling in and/or around your eyes
Treatments
The skin around your eyes is sensitive and needs to be handled with more TLC than other parts of your body. Take care not to rub or scratch your eyes. That could worsen your symptoms or lead to infection.
Ways to manage psoriasis near your eyes include:
Warm compress. Put a warm, damp, clean washcloth over your closed eyes for at least a minute to help loosen flakes stuck on your eyelashes.
Eyelid wipes. Every day, soak a cotton swab in baby shampoo diluted in warm water, then use it to gently wipe the base of your eyelashes for about 15 seconds. This will remove scales and help keep the area clean to help avoid infection.
Artificial tears. These drops may help relieve some of the itching and burning in your eyes.
Topical medications. Your dermatologist or ophthalmologist can prescribe creams to treat psoriasis around your eyes. These include:
- Topical antibiotics. Put a small amount of ointment on the affected areas nightly, or as often as your doctor recommends.
- Tacrolimus (Protopic). This prescription ointment, known as a topical calcineurin inhibitor, is often used to treat another common skin disorder, eczema. But tacrolimus also may treat other skin irritations, like psoriasis. It’s safe to use around your eyes.
- Steroid creams. These prescription drugs usually aren’t recommended because using them for a long time may thin the skin around the eye and raise your chances for glaucoma or cataracts. But if you have a severe flare, your doctor may prescribe one for a short treatment of about 5 days.
- Non-steroid creams. Treatments such as roflumilast (Zoryve) and tapinarof (Vtama) may be prescribed by your doctor.
Biologics. These are drugs made with living cells. You can take them by mouth or as shots. Biologics help block specific immune cells or proteins that play a role in psoriasis. As they work to treat the disease, the symptoms around your eyes will likely improve over time as well.
Always use non-irritating cleansers or moisturizers around your eyes. Your dermatologist can offer some suggestions. Look for the word “hypoallergenic” on the label. You can also check out the National Psoriasis Foundation’s Seal of Recognition program for products that are safe for people with psoriasis.
Other Eye Complications
If you have psoriasis around your eyes, it’s a good idea to see an ophthalmologist regularly, along with your dermatologist. Among other things, these eye specialists can check for eye disorders that happen more often with psoriasis:
Uveitis, or swelling in the front, middle, or back of your eye.
Conjunctivitis. This is also called pinkeye. As many as two-thirds of people with psoriasis may get conjunctivitis, which is inflammation of the moist tissue covering the white of the eye.
Dry eye. It’s a common complaint, affecting almost 1 in 5 people with psoriasis.
Blepharitis, or redness or swelling of the eyelids.
Cataracts. Over 60% of people with psoriasis also have cataracts, or clouding of the lens of the eye. It’s not clear if this is due to treatments, such as steroids or light therapy, or if the psoriasis itself makes you more likely to have them.
