Psoriasis is a common chronic skin disease that speeds up the life cycle of skin cells, which causes extra cells to build up on your 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 also appear on your face. It’s rare for people to have psoriasis only on their face, though.
While the majority of people with facial psoriasis also have scalp psoriasis, some have moderate to severe psoriasis on other parts of their body as well.
Because the skin on your face is very sensitive, facial psoriasis needs to be treated carefully.
Your doctor might recommend treatments including:
- mild corticosteroids
- calcitriol (Rocaltrol, Vectical)
- calcipotriene (Dovonex, Sorilux)
- tazarotene (Tazorac)
- tacrolimus (Protopic)
- pimecrolimus (Elidel)
- crisaborole (Eucrisa)
Always avoid your eyes when applying any medication to your face. Special steroid medication is made to be used around your eyes, but too much can cause glaucoma and cataracts.
Protopic ointment or Elidel cream won’t cause glaucoma but can sting the first few days of use.
If creams aren’t helpful, your dermatologist may prescribe oral medication. Another possibility is phototherapy, or light therapy, which uses ultraviolet light in a controlled setting.
Natural sunlight may sometimes help as well, but it’s not the same as prescription phototherapy. Keep in mind that your risk of sunburn may be higher when using some topical medicines.
The three main subtypes of psoriasis that appear on the face are the following:
Hairline psoriasis is scalp psoriasis (plaque psoriasis) that has extended beyond your hairline onto your forehead and in and around your 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 your hairline and can affect your 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 your face and is associated with psoriasis on other parts of your body including your:
It can be:
- plaque psoriasis
- guttate psoriasis
- erythrodermic psoriasis
There are several forms of facial psoriasis. They all involve skin that is:
Scratching can lead to broken skin and potentially infection.
Plaque psoriasis is the most common form, and it tends to appear as raised, scaly patches. Guttate psoriasis, on the other hand, comes with pink spots that are smaller and less thick.
Erythrodermic psoriasis is rare. It tends to come with a widespread red rash, as well as swings in body temperature and potentially increased vulnerability to infection.
Like with psoriasis on other parts of your body, there’s no clear cause of facial psoriasis. Researchers have determined that heredity and your immune system both play a role.
Psoriasis and psoriasis flare-ups can be triggered by:
- exposure to sun and sunburn
- yeast infection, such as Malassezia
- certain medications, including lithium, hydroxychloroquine, and prednisone
- cold, dry weather
- tobacco use
- heavy use of alcohol
While similarities exist between eczema and psoriasis, the causes differ, as can the treatments.
Psoriasis is a chronic condition that leads to an overproduction of skin cells, while eczema is an overreaction to an irritant, like certain clothes, soaps, or animals.
In both cases, the skin can be red, itchy, and uncomfortable — but scaling tends to be unique to psoriasis.
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.
Finding a skin care routine that helps with your facial psoriasis is key, although you may have to experiment a bit with different products to perfect it.
In addition to discussing prescription creams with your doctor, you may find it helps to use an over-the-counter emollient. These soothe the skin and can create a barrier of oil to protect your skin from drying out.
Humectants, like glycerin and aloe vera, can also help hydrate your skin.
You may also want to look for products with salicylic acid, which can help your skin shed psoriasis scales, or coal tar, which can reduce itching and inflammation.
Talk with 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, including medical and home care.
Because psoriasis on your face can be emotionally upsetting, your doctor may also have suggestions for managing self-consciousness about your facial psoriasis.
For example, they may recommend a support group or even types of makeup that won’t interfere with your treatment.