Psoriasis is a chronic inflammatory disease of the skin caused by excessive proliferation of skin cells. Consequently, the skin becomes thick, dry, with scaly patches and white-silver plaques on them. These symptoms often occur in a cycle of remission and flareups, which are triggered by external factors.
These scales typically occur on the hands, feet, neck, scalp, and rarely on the face. Facial psoriasis often develops from scalp psoriasis, with symptoms that could affect every part of the face. While psoriasis may produce similar symptoms in different parts of the body, its symptoms on the face are different than other parts of the body.
Symptoms of Facial Psoriasis
Symptoms of facial psoriasis you may experience depend on the part of your face it affects:
In psoriasis, you will notice the following symptoms in your eyelids:
- Rusty and red eyelids
- Swollen eyelids
- Scales over your lashes
- The rims of your eyelids may turn upward or downward as a result of the inflammation.
- Blurred vision
- Dry, irritated eyes
- White and gray lesions appear on your lips, inside your nose, inside your cheek, or on your gums and tongue.
- Pain when chewing or swallowing food.
- A build-up of scales in your ear canal
- Hearing loss.
What Causes Psoriasis?
Psoriasis is an autoimmune disorder in which the overactive immune T-cells stimulate the overproduction of skin cells. The body normally produces T-cells in response to bacteria and other infectious agents; however, in psoriasis – as with all autoimmune diseases – the body produces these cells when this trigger is absent. Consequently, these immune cells target healthy tissue – the skin, in the case of psoriasis – causing tissue dysfunction.
The attack on the skin by the immune cells leads to increase in the formation of skin cells, which accumulate on the surface of old skin. This forms red, raised, scaly patches on the skin, on which plaques build up.
To learn More Click Psoriasis Symptoms, Types and Treatment
About 40 percent of people with facial psoriasis have a family member with the disease. This suggests that there is a genetic predisposition to the disease. However, not everyone with a genetic predisposition to psoriasis develops it. The US. National Psoriasis Foundation estimates that only 2 to 3 percent of people with the gene for the disease develop it.
Other risk factors of facial psoriasis include:
- A history of skin infections
- Trauma to the skin such as from surgical incisions
In those who have facial psoriasis, the symptoms do not occur continuously; they occur in cycles of flareups with intervals of remissions. These flareups are typically triggered by certain environmental factors such as:
- Cold temperatures
- Excessive alcohol consumption
- Skin injuries, such as bite or sunburn
- Medications including lithium, antimalarial drugs, and beta-blockers.
- A coexisting immune disease such as HIV
- Infections including strep throat
You can clamp down on what factor triggers your facial symptoms by tracking what you are typically exposed to before a flareup. Identifying these triggers is a good way to reduce the frequency of flareups and lower your symptoms.
Facial Psoriasis Treatment
Facial psoriasis is often difficult to treat because the skin is thinner and more sensitive than most other areas. However, the treatment that is suitable for you depends on your skin type. Treatment options for facial psoriasis include:
Topical corticosteroids, such as hydrocortisone, help to lower the overactivity of the immune system. This helps to lower the severity and frequency of your symptoms. However, your doctor would only advise you to use topical steroids for a short time. This is to avoid or limit its potential adverse effects on your skin such as easy bruising, thinning, and friability of your skin.
Corticosteroids are suitable for scaling around the eyelids or in your ears. However, do not apply them to your eyes as they can lead to glaucoma and cataracts. You can also apply corticosteroids in your ear or outside your ear canal.
Topical corticosteroids are available over-the-counter as ointments, creams, sprays, and lotions and are to be used for only a few weeks.
If your symptoms do not respond to topical corticosteroid treatment or if you have moderate to severe symptoms, your doctor may recommend biologic medicines.
Biologics comprise medicines that work by blocking immune cells or proteins from triggering inflammation in normal tissues, thereby limiting the severity and progression of the disease. Your doctor may administer these medicines through injection or infusion.
Examples of biologics include Adalimumab, Infliximab, Secukinumab, Etanercept, and Brodalumad.
Tacrolimus (Protopic) and Pimecrolimus (Elidel)
These FDA-approved eczema medicines are also useful for treating facial psoriasis. While these medicines yield excellent results in treating facial psoriasis, they are only to be used for a short time. Furthermore, be careful to apply it sparingly and away from the eyes to prevent the severe stinging sensation they may cause.
These medicines are suitable for psoriasis affecting the eyelids, mouth, and nose. The good thing is they do not have the risk of glaucoma or cataract but may sting for a few days after you use them.
Your doctor may recommend salicylic acid together with steroids. It is available over-the-counter and is useful for removing the scales and relieving the inflammation.
These do not heal psoriasis but soothe the itching, dryness, and scaling on your face. Apply moisturizers on your face often to keep it from drying out and relieving these symptoms.
Antibiotics are useful when you have psoriasis affecting your eyes. Although this is very rare, when it occurs, it causes severe pain and dryness in your eyes. Topical antibiotics are essential in this situation to prevent or treat an eye infection.
Your doctor may recommend treatment with ultraviolet (UV) light if you have stubborn facial symptoms. This treatment uses UV light from an artificial source or from sunlight to limit the overproduction of skin cells and lower your symptoms.
Your doctor may pre-treat you with a medication called psoralen, which makes your skin more receptive to ultraviolet light. It is administered before treatment with UVA light.
Tips to Know Before Applying Psoriasis Medication on Your Face
Your face has very sensitive and delicate skin, and you must take certain precautions when applying psoriasis medications on it:
- Use small quantities of the medication
- Apply carefully around your eyes and eyelids, as the skin can get easily damaged and you may expose your eyes to serious complications.
- Use mild non-soap cleansers to clean the skin.
- Apply moisturizers regularly to keep your face from getting dry
- Follow your doctor’s recommendations with each medication
- Consult your doctor if you wish to use makeup or other facial cosmetics to conceal the psoriasis lesions on your face.
How to Prevent facial Psoriasis?
As with psoriasis affecting other parts of your body, facial psoriasis can also be prevented by taking certain steps. These include:
- Limit stress. You can do this by exercising or practicing mindfulness techniques such as yoga and meditation.
- Avoid excessive exposure to sunlight. You can do this by using sunscreen and wearing clothing, such as hats, that lowers your exposure to sunlight.
- Practice good hygiene: Psoriasis can be triggered by infections including ear infections and skin infections. Proper hand washing and wound care are ways you can prevent such infections.
Although facial psoriasis is rare, it may occur in people with scalp psoriasis. Because of how delicate facial skin is, the symptoms may be severe and discomforting. However, there are medicines you can apply on your face to limit the symptoms. Furthermore, the key things you should note if you have facial psoriasis is to keep your face moist and be careful when applying your medicines around your eyes and eyelids.