People living with psoriasis may choose to undergo cosmetic procedures such as Botox, permanent makeup, and tattoos. These procedures carry risks and may cause flare-ups.

People with psoriasis may choose to undergo a variety of cosmetic procedures.

Botox injections, microblading, and lip blushing are not necessarily discouraged for people with psoriasis, but these procedures do carry risks.

If you have psoriasis and plan to have cosmetic procedures, it’s helpful to learn about their potential risks, any special considerations, and how to speak with your provider about psoriasis.

In the prescribing information for Botox cosmetic injections, psoriasis is not listed as a condition that should prevent their use.

However, the prescribing information states that Botox injections should not be given in areas with pre-existing conditions. Botox injections should also not be given in any areas of existing inflammation.

A small amount of research suggests that for some people with psoriasis, Botox injections may actually provide a therapeutic benefit.

One small proof-of-concept study of eight people with psoriasis found that an injection with Botox resulted in significant improvement to psoriasis symptoms for all participants 4 weeks following treatment and with no notable side effects.

Skin affected by psoriasis has more nerve fibers and an elevated level of calcitonin gene-related peptide (CGRP), which plays a role in inflammation. Research suggests that Botox inhibits the release of CGRP, which may be useful as a supplemental therapy for people with psoriasis.

On the other hand, it has been reported that psoriasis has formed at the site of Botox injections. The prescribing information for Botox cosmetic injections notes that an eruption of psoriasis is a possible adverse reaction.

None of the medications that are known to interact with Botox cosmetic injections are specific to psoriasis.

However, if you choose to have Botox, be aware that some medications can interact with the injection. These include:

  • aminoglycosides, a broad-spectrum antibiotic
  • anticholinergic drugs
  • muscle relaxants

All medications, including over-the-counter products, have the potential for side effects and interactions. It’s a good idea to speak with a healthcare professional before trying a new treatment.

Half of the people living with psoriasis experience psoriasis on the face. Most commonly, this can occur on the skin in the area between the nose and the top lip, the eyebrows, the upper part of the forehead, and the hairline.

Facial treatments can sometimes be difficult for people living with psoriasis, as some products can irritate the skin.

People with psoriasis should avoid or limit the use of creams and lotions that contain:

  • dyes
  • fragrances
  • harmful chemicals
  • some essential oils

Even products that are marketed for sensitive skin may still be irritating for people with psoriasis. Any irritation to the skin can cause psoriasis to flare. When psoriasis develops at the sites of irritation, it’s known as the Koebner phenomenon. It’s a good idea to work with a dermatologist to discuss skin care products appropriate for your skin situation.

During a facial treatment, the aesthetician should approach the area with psoriasis very gently, as the skin in this area is very sensitive.

Both microblading and lip blushing are forms of permanent makeup. This is a form of tattoo in which a needle is used to insert colored ink into the skin to give the appearance of permanent eyebrows (for microblading) or lip color (for lip blushing).

Although tattooing is not strictly banned for those living with psoriasis, it comes with risks. Consider refraining from getting a tattoo when you’re receiving immunosuppressive treatments or when you’re in an active stage of psoriasis.

Risks of tattoo procedures include:

  • infections
  • serious illness like HIV or hepatitis
  • allergic reactions
  • scarring, redness, bumps, and an increased risk of sunburn
  • swelling or burning at the site of the tattoo during MRI scans
  • masking signs of skin cancers

Another known risk from tattooing procedures is the Koebner phenomenon. This occurs when new psoriasis plaques appear on skin that was previously unaffected. This affects roughly 25% of people with psoriasis who experience trauma to the skin.

Tattooing is considered trauma to the skin. The National Psoriasis Foundation notes that if you get a tattoo, there’s a significant risk that psoriasis may flare in the tattooed area. In addition, new psoriasis spots may appear at the site of a new tattoo.

Permanent makeup is a type of tattoo procedure that involves injecting ink into the skin to give the appearance of makeup, such as:

  • eyeliner
  • lipliner
  • filled-in eyebrows
  • other forms of makeup

Those with psoriasis should be aware that any permanent makeup procedure is a form of tattoo, and these procedures come with risks.

Permanent makeup uses colored ink injected into the skin to give the appearance of makeup. But no ink has been approved by the Food and Drug Administration (FDA) for injection into the skin.

Injecting ink into the skin can cause skin injury. This can then cause a flare. It’s also possible for psoriasis to develop in areas where the skin has been injected.

The American Academy of Dermatology recommends that any cosmetic procedure should be done by a physician like a board certified dermatologist.

Before undergoing any kind of cosmetic procedure, it’s important to ask questions. These may include:

  • What qualifications does this professional have?
  • How many of these procedures have they completed previously?
  • Is it possible to see before-and-after photos of previous patients?
  • What results should you expect?
  • What are the risks of the procedure?

If you choose to see a cosmetologist for a facial or other treatment, it’s a good idea to let them know about psoriasis and any active flares that may be present. Explaining that the skin can be very sensitive due to psoriasis may be helpful.

It may also be a good idea to ask what kind of products will be used, remembering that some ingredients may be irritating for the skin and could trigger a flare.

People living with psoriasis may choose to undergo a variety of cosmetic procedures. Psoriasis doesn’t strictly prevent people from having Botox injections for cosmetic purposes or from having permanent makeup like microblading or lip blushing.

Tattoo procedures of any kind carry risks and may cause a flare of psoriasis or the formation of new psoriasis.

Small studies suggest Botox may be helpful for some people with psoriasis, though it’s still recommended to avoid Botox injections in areas of active inflammation.