How to Treat Psoriasis in or Around Your Nose

Psoriasis on the face is relatively common, occurring in approximately 50% of psoriasis cases. However, psoriasis that occurs solely on or inside the nose is rare. Psoriasis of the nose (and other areas of the face) can be hard to treat because of the sensitivity of the skin in these areas.

This article discusses psoriasis of the nose, including diagnosis and treatment.

Psoriasis in or Around Your Nose

When psoriatic lesions appear in the sensitive areas of the mouth and nose, they are typically gray or white. The lesions may also be found on the gums and tongue; inside the cheeks; inside the nose; or on the lips. 

Facial lesions more commonly appear on the sides of the nose and the area between the top lip and the nose. The skin is thinner and more sensitive in this area than it is in other parts of the body where psoriasis can occur, making these lesions particularly hard to treat.

Diagnosis

To make a diagnosis of psoriasis, a healthcare provider will do a physical examination and take a thorough medical history to help them rule out other possible causes of a person's skin symptoms.

A tissue sample (biopsy) is not usually needed to diagnose psoriasis, but when lesions are found in areas where it rarely occurs (such as inside the nose), a study of tissue (histopathology) may help differentiate psoriasis from other skin disorders.

Treatment

Medical Treatment

Treatment of psoriasis on the face can be complex and must be carefully considered because the skin is delicate.

Common psoriasis treatments and medications for lesions on the nose and face include:

• Topical (on the skin) low-strength steroids: These steroids are not as harsh on sensitive areas such as the folds of the side of the nose. Hydrocortisone 1% is an example of a low-strength topical steroid. Stronger steroid creams can cause thinning of the skin.
• Topical steroids combined with antifungal and antibacterial medications: This combination can be helpful when yeast or bacteria is present along with psoriasis. However, topical steroid creams can only be used for short-term treatment. Long-term use can lead to side effects (such as thinning of the skin). Close medical supervision is also important when steroids are used to treat facial psoriasis.
• Topical non-steroid treatment: The recently FDA-approved cream VTAMA (tapinarof) offers a new treatment option. Application is once-daily and there is a high chance of clearance in adults with localized plaque psoriasis.
• Oral (by mouth) medications: These can include tacrolimus (Protopic, Prograf) and pimecrolimus (Elidel), which help quiet the overactive immune system response that causes psoriasis symptoms. Oral medications are typically used for severe symptoms that do not respond to topical treatments.
• Ultraviolet light therapy: This is a common treatment for psoriasis in other areas of the body.
• Emollients, creams, and ointments: These products promote hydration and can ease skin symptoms.
• Topical vitamin D ointments and creams: These products may cause less irritation to sensitive facial skin. However, caution should be taken with some products that contain vitamin D.

Medications to Avoid for Psoriasis of the Nose

Some medications should not be used on the face to treat psoriasis on the nose or around the nose. These medications include:

• Vitamin A derivatives (retinoids), which can cause severe irritation
• Coal tar preparations

Home Treatment

Home remedies for psoriasis of the face may include over-the-counter (OTC) products (such as 1% hydrocortisone cream) or other OTC topical (on the skin) preparations. These products should be used only with the approval of the healthcare provider.

A strict daily skin care regimen is another home care treatment that is important for the long-term management of facial psoriasis. Only mild, natural skin care products—such as those that do not clog the pores (called noncomedogenic)—should be used by a person with psoriasis. 

Lifestyle

Lifestyle changes may also be recommended as part of the treatment of psoriasis. Several factors are linked with helping to prevent symptoms from getting worse or flaring up, including: 

• Quitting smoking
• Avoiding alcohol
• Avoiding certain environmental triggers (such as extremely cold, dry weather)
• Using humidifiers during winter in cold climates
• Avoiding extreme stress

When to See a Doctor

There are several circumstances when you should seek medical care for psoriasis, whether it's on your face, nose, or somewhere else on your body.

You should talk to your doctor if:

• Psoriasis has not yet been diagnosed but you have symptoms,
• Symptoms occur inside the nose (such as scabs).
• Symptoms cause pain or discomfort.
• The discomfort interferes with daily activities of living (such as bathing, dressing, or eating).
• Facial lesions are extending toward the eye area.
• Psychosocial symptoms (such as an aversion to participating in social activities) are experienced as a result of facial psoriasis symptoms (this may indicate a person needs a referral to a therapist or other mental health provider).

Frequently Asked Questions

How do you get rid of psoriasis on your nose?

Psoriasis is a chronic (long-term) skin condition. While it's rare for it to only involve the nose, it is possible. The condition usually involves ongoing periods of flare-ups and remissions. 

While there are treatments that can help alleviate symptoms and help avoid flare-ups, there is no cure for psoriasis.

What causes psoriasis on the face?

The exact cause of psoriasis is unknown, but genetics and environmental factors are thought to play a role in the development of the disorder. 

Psoriasis is thought to be an immune system disorder that causes skin cells to regenerate faster than normal. This rapid turnover rate of new skin cells causes the symptoms of plaque psoriasis (the most common form of psoriasis), which includes scales and red patches on the skin.

What does psoriasis on the face look like?

Psoriasis on the face involves thick, scaly patches of white or gray lesions. It may occur around or inside the nose, as well as in the space between the nose and the upper lip.

What type of treatment is used for psoriasis on the face?

It can be difficult to treat facial psoriasis because the skin is very sensitive. Low-concentration (such as 1%) hydrocortisone cream is often used for psoriasis on the face because it is less likely to cause side effects, such as thinning skin, than other products.

A Word From Verywell

Psoriasis on only the nose is uncommon, but it can happen. If your dermatologist diagnoses you with facial psoriasis that involves your nose, it can be hard to treat this delicate area of skin. You might need to try several treatments, such as topical medications and light therapy, until you find something that helps control your symptoms and prevent flare-ups.

You may experience feelings of embarrassment, anxiety, or even depression if your psoriasis is in a highly visible place, such as your face and nose. Getting involved with a psoriasis support group may help you cope with the emotional effects of the condition.