Psoriasis is a common chronic skin disease that speeds up the lifecycle of skin cells causing extra cells to build up on the skin. This buildup results in scaly patches that can be painful and itchy.
These patches — often red with silver scales — can come and go, flaring for weeks or months before cycling to a less prominent appearance.
Although psoriasis is more likely to affect your elbows, knees, lower back, and scalp, it can appear on your face. It’s rare for people to have psoriasis only on their face.
While the majority of people with facial psoriasis also have scalp psoriasis, some also have moderate to severe psoriasis on other parts of their body.
The three main subtypes of psoriasis that appear on the face are:
Hairline psoriasis is scalp psoriasis (plaque psoriasis) that has extended beyond the hairline onto the forehead and in and around the ears. Psoriasis scales in your ears can build up and block your ear canal.
Sebo-psoriasis is an overlap of seborrheic dermatitis and psoriasis. It’s often patchy at the hairline and can affect the eyebrows, eyelids, beard area, and the area where your nose meets your cheeks.
Even though sebo-psoriasis is commonly associated with diffuse scalp psoriasis, the patches are often thinner with a lighter color and smaller scales.
Facial psoriasis can affect any part of the face and is associated with psoriasis on other parts of your body including scalp, ears, elbows, knees, and body. It can be:
Just like psoriasis on other parts of your body, there’s no clear cause of facial psoriasis. Researchers have determined that heredity and the immune system both play a role.
Psoriasis and psoriasis flare-ups can be triggered by:
Because the skin on your face is very sensitive, facial psoriasis needs to be treated carefully. Your doctor might recommend:
- mild corticosteroids
- calcitriol (Rocaltrol, Vectical)
- calcipotriene (Dovonex, Sorilux)
- tazarotene (Tazorac)
- tacrolimus (Protopic)
- pimecrolimus (Elidel)
- crisaborole (Eucrisa)
Always avoid the eyes when applying any medication to the face. Special steroid medication is made to be used around the eyes, but too much can cause glaucoma and/or cataracts. Protopic ointment or Elidel cream won’t cause glaucoma but can sting the first few days of use.
Along with medication recommended by your doctor, you can take steps at home to help manage your psoriasis, including:
- Reduce stress. Consider meditation or yoga.
- Avoid triggers. Monitor your diet and activities to see if you can determine the factors that result in flare-ups.
- Don’t pick at your patches. Picking off scales typically results in making them worse, or initiating new rashes.
- Use moisturizer. Have your doctor recommend a moisturizer that can help reduce dry skin and scaling on your face.
- Get emotional support. Sometimes, having patches on your face can make you feel self-conscious and even depressed. Your doctor might have a recommendation for a support group or psychologist that can help.
Psoriasis on your face can be emotionally upsetting. See your doctor to determine the type of psoriasis that’s appearing on your face. They can recommend a treatment plan for your type of psoriasis. Treatment can include medical and home care.
Your doctor may also have suggestions for managing self-consciousness about your facial psoriasis patches. For example, they may recommend a support group or even types of makeup that will not interfere with your treatment.