Psoriasis on the Face

Psoriasis on the face usually affects your eyebrows, upper forehead, hairline, and the skin between your nose and lips. Treating face psoriasis can be tricky because this skin is more sensitive than what covers your elbows or knees, for example.

It's estimated that up to half of people with psoriasis elsewhere on the body have it on their face as well. When the face is affected, the scalp typically is too. It's not common to have psoriasis on the face alone, however.

This article discusses what psoriasis on the face looks like and the different types that can affect facial skin. It also reviews what causes this chronic skin condition and how it can be treated.

What Does Psoriasis on the Face Look Like?

Psoriasis usually causes small, red bumps that grow into red or pink sores on the face. The sores are often covered in silvery-white plaques, which may flake off.

The appearance of facial psoriasis can differ a bit depending on the type you have.

True Facial Psoriasis

True facial psoriasis looks like classic psoriasis plaques on the face. The red, scaly plaques are usually symmetrical and also appear on other areas of the body.

The affected skin is often painful and itchy.

Hairline Psoriasis

It’s estimated that around half of people with psoriasis have scalp psoriasis, which can include the upper forehead.

Scalp and hairline psoriasis can be mild and look like fine dandruff flakes.

Some people get severe cases with thick plaques of skin covering the hairline and behind the ears.

Hairline plaques can also be greasy and yellow.

Sebo-Psoriasis

Sebo-psoriasis means you have both facial psoriasis and seborrheic dermatitis.

Sebo-psoriasis leads to thin, pink plaques that can be covered in greasy, yellow scales. They can appear on the hairline, eyelids, eyebrows, sides of the nose, and beard area. 

Other Symptoms Related to Facial Psoriasis

While the eyebrows, forehead, hairline, and the skin above the lip are the most common places affected by facial psoriasis, the condition can also affect other parts of the face.

When it does, it may also cause other symptoms specific to those locations.

Vision Issues

Psoriasis around the eyes is rare. It may cause dry, red patches of skin. You may have pain or impaired vision.

If you have psoriasis near your eyes, it’s important to work with your dermatologist to find a safe treatment that won’t affect your vision. 

Hearing Trouble

Facial psoriasis may also affect the inner and outer ears. Symptoms include redness, itching, and patches of scaly skin. The patches may show up on the skin behind the ears, around the ears, or inside the ear canal.

When scales build up inside the ear, it can lead to temporary hearing loss. Never try to push or remove the scales yourself. 

Mouth Pain and Bleeding

In rare cases, people with facial psoriasis have psoriasis symptoms in their mouths. You may notice redness, burning pain, and bleeding along the gums, tongue, or inner cheeks. The symptoms can make it hard to eat and drink.

Mouth psoriasis usually needs to be treated by both your dermatologist and your dentist.

What Causes Face Psoriasis?

Psoriasis is a chronic autoimmune condition that causes inflammation. In psoriasis, the skin cells grow too fast and pile up. The dead skin cells do not slough off like they’re supposed to, leading to silvery-white skin plaques.

It's not totally understood why some people get psoriasis. There is a genetic component and psoriasis tends to run in families. If someone in your family has it, you might be more likely to have it, too.

Face Psoriasis Triggers

Certain things can cause a psoriasis flare-up. For example, emotional stress, skin injury, infection, cold weather, and some prescription medications can trigger facial psoriasis.

Spending too much time in the sun and smoking can also worsen facial psoriasis symptoms.

How to Treat Psoriasis on the Face

There is no cure for psoriasis, but there are effective treatments. Since the skin on and around the face is sensitive, finding the best treatment for facial psoriasis can be challenging.

Your provider may suggest several therapies as part of your treatment plan including topical medications, oral prescriptions, phototherapy, and immune therapies.

Medications

There are several kinds of medications used to treat psoriasis. Your treatment will depend on the severity of your symptoms and which parts of your face are affected.

Your dermatologist may recommend the following medications to treat facial psoriasis:

• Topical treatments include medicated creams, ointments, and shampoos that treat psoriasis symptoms. First-line treatment often includes a steroid cream. Hairline psoriasis may need to be treated with a medicated shampoo.
• Phototherapy uses ultraviolet light (UV) treatments to help slow skin cell growth and reduce inflammation. This can improve facial psoriasis symptoms over time.
• Systemic medications are usually considered when you are having psoriasis symptoms all over your body. These medications can include methotrexate, cyclosporine, retinoids, and others.

How Can I Treat Facial Psoriasis at Home?

It’s not always possible to prevent psoriasis symptoms, but there are steps you can take to avoid triggers and take care of your skin.

Methods you can use to treat facial psoriasis at home include:

• Choosing skincare products carefully and avoiding any harsh ingredients. Check the labels to make sure the products do not contain irritating ingredients (e.g., they should say "hypoallergenic," "fragrance free," "for sensitive skin," "alcohol free," and/or "dye free").
• Using a gentle daily moisturizer, especially after washing your face.
• Not over-washing your face, even if it feels greasy.
• Learning your triggers for a psoriasis flare-up and working with your dermatologist to figure out how to avoid them. 
• Finding techniques for managing stress, such as mindfulness and physical activity. 
• Avoiding smoking and being around those who do.
• Wearing quality sunscreen any time you’re in the sun.

Summary

Facial psoriasis can affect different parts of your head, including your scalp and ears. It’s less common, but some people have psoriasis in their mouth or near their eyes. 

Facial psoriasis can be hard to treat because the skin of the face is very sensitive. Your dermatologist will help you figure out the best way to treat psoriasis on your face. You may need a combination of at-home, OTC, and prescription therapies to manage the condition.