“Skin diseases that are on the face, in my clinical experience, can really impact patients’ everyday life and how they feel about themselves,” says Ronda Farah, MD, a dermatologist and an associate professor at the University of Minnesota Medical School in Minneapolis. According to the National Psoriasis Foundation, 50 percent of people with psoriasis will experience “facial involvement,” or psoriasis on the face, at some point. The good news is there are effective treatments for and ways to cope with facial psoriasis.
Where Does Facial Psoriasis Appear?
When psoriasis shows up on your face, it typically affects the following areas:
Hairline Scaly patches can develop on your upper forehead and around your hairline. This may be isolated or an extension of scalp psoriasis.Inside the ears If psoriasis scales build up in your ears, they can block your ear canal and affect your hearing. Be sure to tell your doctor if this happens.Around your eyes Psoriasis scales can form on the sensitive skin of your eyelids and may cover your lashes. Areas around the eyebrows are also common sites for facial psoriasis.Between the nose and upper lip This area is often sensitive. If scales form around your mouth, they may affect how you chew and swallow food. Rarely, psoriasis lesions can also surface inside your mouth, such as on the gums and tongue, or in the nose.
How Facial Psoriasis Can Take a Psychological Toll
Psoriasis in general can lead to emotional problems. “We do know that in patients with psoriasis, the prevalence of depression may be as high as 50 percent,” Dr. Farah says. But she suspects that depression may be even more common among people who develop psoriasis on their face. “It’s there for everyone to see, and this bothers some people more than others,” Farah says.
How to Treat Psoriasis on the Face
If you develop facial psoriasis, you may feel anxious to find effective treatments, so don’t hesitate to reach out to your healthcare provider. “Tailoring the treatment options to a patient and their need is really important with psoriasis,” Farah says. “That’s really something we work with patients on. We’re always asking, ‘How much does this bother you?’” Typically, doctors will start with topical treatments. Facial skin is more sensitive, so long-term use of steroid creams may cause skin thinning, shininess, or enlarged capillaries. Your doctor will consider these factors and might alter your treatment plan or prescribe a low-potency steroid cream. There are also now two nonsteroidal creams that have been approved to treat psoriasis: Zoryve (roflumilast) and Vtama (tapinarof). If topical medications don’t offer results, your healthcare provider may recommend phototherapy, or injectable or oral biologic medicines. According to the American Academy of Dermatology, two U.S. Food and Drug Administration–approved drugs for treating eczema — Protopic (tacrolimus) and Elidel (pimecrolimus) — may work well for treating psoriasis on the face or other delicate areas. They belong to a class of drugs known as topical calcineurin inhibitors, or TCIs. “The treatment options for psoriasis have rapidly expanded,” Farah says, for both children and adults. “For those who have not seen a dermatologist in the recent past, it’s a good idea to revisit seeing us.” She adds that psoriasis care has now expanded to teledermatology, making access potentially much easier. “As a physician, dermatologist, and mother, I know that skin disease can be devastating for some, and I want patients to know that we are there to support them every single step of the way.”
Self-Care Tips for Treating Psoriasis on Your Face
Facial psoriasis can be difficult to manage. Here are six tips to consider.
Try makeup. Sometimes, covering the areas with makeup can give you confidence. Be careful to avoid any products that might irritate your skin.Avoid triggers. Try to identify what factors cause your psoriasis flare-ups so you can avoid them. Keep a journal of your symptoms to figure out what’s triggering your psoriasis.Prioritize stress management. Stress is known to increase your risk of a psoriasis flare. Try to lower your stress levels with yoga, deep breathing, or meditation.Keep skin moisturized. Using moisturizers on a regular basis can help prevent dry skin and scaling on your face. Talk to your doctor about products that could help.Get support. A support group may help you cope emotionally with your psoriasis symptoms. The National Psoriasis Foundation offers an online support group on their website.Don’t pick. Just as with psoriasis on other parts of the body, manual removal of the scaly patches can worsen them or cause new skin plaques to develop.
