Psoriasis on the Face: Tips for Skincare, Treatment, and Prevention

What is Psoriasis?

Psoriasis is an autoimmune skin condition that causes itchy, flaky patches on the skin. These patches vary in color, depending on the skin tone. On lighter skin, they appear reddish-pink with silvery-white scales, while on deeper tones, they may appear purple-brown with grey scales.

The patches caused by psoriasis can be painful and itchy, which often leads to discomfort, especially while sleeping. Moreover, in severe cases, they may crack and bleed. Psoriasis is a chronic skin condition, meaning that it is long-lasting and may relapse from time to time.

Although there is no permanent cure for psoriasis, effective treatments and skincare can help manage symptoms, reduce flare-ups and alleviate pain.

What is Psoriasis on the Face?

Facial psoriasis causes the same thick, scaly patches (plaques) on the sensitive skin of your face. However, it’s not the same as psoriasis on other parts of the body because the skin on your face is much thinner and more easily irritated. Around 50% of people with psoriasis are likely to experience facial psoriasis.

Following are the areas generally affected by the condition:

• Eyebrows
• Hairline
• Eyelids
• Skin between your nose and upper lips
• Ears
• Upper forehead
• Mouth, gums, or tongue
• Inner cheeks
• Inner nose

How is Facial Psoriasis Different from Psoriasis on other Parts of the Body?

Unlike psoriasis on other areas of the body, facial psoriasis requires special care and attention for several reasons:

Thin and Sensitive Skin

Facial skin is much thinner and more likely to get irritated from harsh formulations and chemical treatments in contrast to skin on your body.

Visibility and Exposure

Psoriasis on the face is directly visible, often leading to a compromised self-image. As a result, people suffering from this condition feel extra conscious, which takes a huge toll on a person’s emotional well-being and confidence.

Treatment Considerations

Psoriasis on the body is usually treated with stronger biologics and corticosteroids, while facial psoriasis necessitates gentler approaches and carefully selected formulations.

What does Psoriasis on the Face Looks Like? (Symptoms)

The symptoms of facial psoriasis can vary from person to person. Nevertheless, some common signs can be:

• Painful, dry, and itchy plaques of skin around the eyebrows, hairline, and the skin between nose and upper lips
• Small bumps or spots
• Redness and discoloration of the skin
• Scaly, cracked skin that burns and bleeds
• Redness and sores on the gums, inner cheeks, tongue, or inside the nose
• Inflammation around the eyes
• General discomfort and itchiness

It should be noted that facial psoriasis typically begins at the hairline area, gradually spreading down toward the chin. The symptoms may resemble dandruff if the plaque extends from the upper forehead, with flakes shedding off.

You are likely to experience intense itchiness and irritation. However, scratching the affected skin can lead to open sores and infections. In fact, a burning sensation, swelling and pus are all signs of an infection.

What are the Types of Psoriasis that Affect the Face?

There are several types of psoriasis that cause symptoms that affect the skin on your face. Each of them has distinct characteristics:

• Plaque Psoriasis: It is the most common form psoriasis and appears on the skin as thick scaly patches.
• Guttate Psoriasis: Appears as small, round or tear shaped spots. These spots can be red, pink or purplish depending on the skin tone. This type of psoriasis is often triggered by a streptococcal infection.
• Pustular Psoriasis: A very rare type of psoriasis that causes small, pus-filled bumps on the face surrounded with redness and inflammation.
• Hairline Psoriasis: It is an extension of scalp psoriasis, spreading from the hairline to the forehead and around the ears.
• Sebo-Psoriasis: A cross between seborrheic dermatitis (dandruff) and scalp psoriasis. It causes flaking and redness similar to both conditions.
• True Facial Psoriasis: It refers to the psoriasis that primarily affects the face without being an extension of scalp psoriasis. It is characterized by symmetrical, sharply demarcated, red, scaly plaques appearing on any part of the face.

What Causes Psoriasis on the face?

Psoriasis is an immune-mediated disease, which means that your body’s immune system mistakenly overacts and starts attacking healthy skin cells. Furthermore, this attack causes inflammation and accelerates skin cell production, which leads to the symptoms of psoriasis.

Scientists aren’t fully sure what exactly activates the faulty immune cell activation, but they are certain it involves a combination of genetic and environmental factors.

What are the Risk Factors for Facial Psoriasis? (Triggers)

Like other forms of psoriasis, facial psoriasis is also influenced by a combination of immune, genetic and environmental factors.

Research suggests that the following factors can trigger or worsen psoriasis:

• 40% of people with psoriasis have a close family member with disease, so clearly family history is a huge risk factor
• Skin trauma or injury
• Infections, especially streptococcal and HIV
• Medications
• Excessive smoking
• Obesity
• Diabetes
• Stress
• Alcohol consumption
• Air pollution
• Vitamin D deficiency
• Extreme temperatures, and UV radiations

Best Treatments for Facial Psoriasis: (Effective Medical Treatments)

The most effective medical treatments for facial psoriasis are topical treatments, phototherapy and systemic medications. Depending on the type of psoriasis, a doctor may prescribe one or a combination of these treatments.

Topical Creams

Since the skin on the face is much thinner and more delicate than your body, your doctor may suggest a different gentler topical ointment such as:

• Low-potency corticosteroids (ointments, creams, and sprays) that help reduce redness and swelling
• Calcineurin inhibitors
• Topinrof (Vtama)
• Roflumilast (Zoryve)
• Calcipotriene cream
• Tazarotene (Tazorac)
• Salicylic acid
• And coal tar (not for pregnant or breastfeeding women)

Light Therapy

Next, we have Phototherapy, or light therapy, which uses ultraviolet (UV) light to slow down cell growth. There are several ways to do that:

• Sunlight (using natural sun rays)
• UVB phototherapy (UVB rays from artificial source)
• Narrowband UVB phototherapy (safer for children and pregnant women)
• And finally, Excimer laser therapy (targets smaller red patches with controlled beams)

Systemic Treatments

And finally, we have Systemic treatments that use biologics and immunosuppressants to slow down the immune system. They are effective for moderate to severe psoriasis but can compromise the immune system, making it harder for the body to fight infections.

• Methotrexate
• Cyclosporine
• Apremilast
• Acitretin (Synthetic Vitamin A)

Important Reminder: Always perform a patch test on your body before applying any topical cream directly to your face.

Home Remedies for Psoriasis

Taking care of facial psoriasis at home is all about taking basic preventive precautions. For example, avoiding scratching affected areas and making sure your skin is well hydrated. You can also try using ice packs or cold compresses to soothe out burning sensation.

Tips for Skincare and Prevention

You might not be able to prevent all cases of psoriasis on the face, there are some things you can do to improve the symptoms:

• Be gentle on your skin
• Use a mild cleanser or face wash
• Drink enough water and use a fragrance-free moisturizer
• Always apply sunscreen while outside
• Avoid going to polluted areas to manage environmental stressors
• Choose your makeup products wisely. Some ingredients in cosmetics can mess up with your treatment plans
• Try to stay calm and stress-free

Conclusion

In summary, although facial psoriasis can be a complex and challenging due to its visibility and impact on sensitive skin, effective treatments and consistent skincare can significantly help in controlling the symptoms.

Whether you go for topical treatments, phototherapy or home remedies, it’s important to approach your care with the guidance of a healthcare professional. With a little patience, acceptance and treatments, you can effectively manage facial psoriasis and maintain your skin’s health and appearance.