Psoriasis is a chronic (long-term) skin condition that causes discolored, itchy, and often painful plaques of dry skin on the body. The genes a person inherits and their immune system are the two key causes of psoriasis.
Psoriasis is an inflammatory condition, which means it results from the body’s immune system attacking your skin cells in addition to bacteria and other microbes.
According to the National Psoriasis Foundation, nearly half of all people with psoriasis experience plaques on the face.
Facial psoriasis plaques usually develop in the following areas:
- the eyebrows
- the forehead
- the hairline
- in and around the ears
While there is no cure for facial psoriasis, treatments are available to help manage the symptoms when they worsen.
Causes
There is no specific cause of facial psoriasis, and like psoriasis that occurs on the rest of the body, researchers note that genetics (or heredity) play a key role. For example, having a parent with psoriasis increases the chance of someone developing the condition.
Psoriasis plaques and sores form due to the immune system overreacting and causing your skin cells to overgrow rapidly. Plaques on the skin are the accumulation of these skin cells.
Sometimes environmental factors trigger symptoms to worsen. Triggers of these flare-ups are more likely to affect facial psoriasis, for example from:
- dry wind
- cold weather
- too much sun exposure
- the growth of microbes on the face, like the yeast Malassezia
Stress is a trigger for nearly 70% of people with psoriasis. Other possible triggers include:
- smoking
- infection
- a skin injury, like a cut
- certain medications, such as lithium
Understanding your triggers is helpful in learning how to manage symptoms of psoriasis.
Symptoms
Facial psoriasis can cause the skin to feel itchy, painful, or tight.
Plaques can look different on different skin colors. If you have light-colored skin, plaques can look silvery-white, while on skin of color they’re generally darker and more purple or brown. They can appear anywhere on the face, including the following areas:
Hairline
In some cases, facial psoriasis develops from scalp psoriasis. Plaques can extend downward from the scalp to the hairline. This can often look like dandruff but results from dead skin cells that break away from psoriasis plaques.
Plaque psoriasis of the hairline can migrate downward to your ears. If you develop psoriasis in your ears, there’s a risk that it can block the ear canal and cause difficulty hearing.
Eyes
When psoriasis forms around the eyes, it can be uncomfortable, as both blinking and your eyelashes can irritate the sore skin. Sometimes the eyelids may appear swollen. Men are more likely to experience psoriasis around the eyes.
Mouth
Although very rare, psoriasis can cause soreness on the lips, cheeks, gums, and tongue. This can be very uncomfortable and cause difficulty eating. It’s more common in people with severe types of psoriasis, like pustular psoriasis.
Treatments
A healthcare professional may recommend different approaches, depending on the severity of your condition. Psoriasis on the face needs careful treatment, as the skin is more sensitive there.
A doctor may recommend phototherapy. This uses ultraviolet (UV) light to slow the growth of skin cells. Phototherapy is usually prescription only, but sunlight may help slightly. It’s important to remember that some topical medications for psoriasis can increase your risk of sunburn.
Other types of treatment include:
Systemic medication
A dermatologist may prescribe medication if your symptoms of facial psoriasis are severe, and do not respond to other treatments. These are medications that work to treat the condition from the inside, often reducing inflammation and slowing skin cell turnover.
Systemic medications for treating psoriasis include:
| Name | Type | How it works |
| acitretin (Soriatane) | oral retinoid | Retinoids are a type of high-strength vitamin A. Because of this, you can only take this medication for limited periods at a time. |
| cyclosporine (Neoral) | oral immunosuppressant | Cyclosporine works to calm the immune system and reduce inflammation. This can reduce psoriasis symptoms. |
| adalimumab (Humira) | injectable biologic | Biologic medications reduce inflammation by affecting your body’s immune response. They are natural substances. |
At-home remedies
You may want to try some at-home remedies in addition to the medication a doctor recommends.
Some of these include:
- reducing stress
- avoiding your triggers
- avoiding scratching
- keeping your face moisturized
- applying a soothing 0.5% aloe vera serum to your face
Topical medications and facial creams
Because facial skin is more sensitive than the rest of your body, psoriasis on the face requires low strength or small quantities of topical medications to reduce symptoms.
Treatments include the following over-the-counter (OTC) and prescription options:
| Name | Type | What it does |
| salicylic acid (OTC) | facial serum | Helps to soften and lift plaques to reduce itchiness. It can increase your skin’s ability to hold moisture. |
| coal tar (OTC) | soap | According to a 2018 review, coal tar helps to slow the regrowth of skin cells, which can cause the formation of plaques. |
| vitamin D, Vectical (prescription) | topical cream | Decreases inflammation on the scalp and helps to reduce skin cell regrowth. |
| retinoids, Tazarotene (prescription) | topical cream | A high-strength type of vitamin A, retinoids reduce redness, swelling, and itchiness. It’s important to wear sunscreen every day on your face while using these products. |
| mild corticosteroids, hydrocortisone (OTC) | topical creams or ointments | People with facial psoriasis can apply this cream directly to the face to help relieve symptoms. But using steroids on facial skin can cause thinning, so only certain types are suitable for treating facial psoriasis. |
| calcineurin inhibitors, tacrolimus (prescription) | ointment | These substances stop an enzyme, calcineurin, from working. This reduces inflammation. These ointments are suitable for around the eye area. |
| aryl hydrocarbon receptor agonists, tapinarof (prescription) | topical ointment | These work by stopping inflammatory cells from being released by your immune system. They’re nonsteroidal, so avoid the negative side effects of corticosteroids on the face. |
| phosphodiesterase-4 (PDE4) inhibitors, roflumilast (prescription) | topical cream | These work by regulating the inflammation response in your body, which is beneficial in psoriasis. They’re also nonsteroidal. |
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