Psoriasis on the Face (Facial Psoriasis)

Facial Psoriasis Pictures

It can help to see photos of facial psoriasis to see what you may be dealing with. Browse these psoriasis pictures to see where the condition can appear and how it looks on different skin tones.

Facial Psoriasis Causes 

Doctors aren’t sure what causes psoriasis, but they know that genes and your immune system play a major role. Other factors also can increase your chances of having it.

About 40% of people with psoriasis have a close family member with the disease. Many of the genes linked to psoriasis are those that help run your immune system. In addition to your genes, these things can make you more likely to get psoriasis:

• Smoking
• Obesity
• Medications
• Infections
• Alcohol
• Vitamin D deficiency
• Stress

How common is facial psoriasis?

Most people who have psoriasis on the face have it on other parts of their body, too. More than 3% of people in the U.S. have a form of psoriasis. Of those, about half have facial psoriasis at least at one point in their lives.

Facial Psoriasis Diagnosis

You’ll need to see a dermatologist or your health care provider to get a diagnosis for psoriasis on the face. They’ll first examine the affected areas on your skin, then go over your symptoms with you. If there’s any doubt about the cause, your doctor might order tests, such as a skin biopsy.

Facial Psoriasis Treatment

There are a few main types of treatments specifically for facial psoriasis. The type you use depends on which part of the face is affected. Your doctor may prescribe just one or a mixture of them, including treatments that go on your skin.

Facial psoriasis cream

Because your facial skin is more delicate than skin on other parts of your body, your doctor might choose different topical treatments for psoriasis on the face.

They might include:

• Low-potency corticosteroids, which are ointments, creams, lotions, and sprays that reduce redness and swelling. Doctors usually prescribe them for just a few weeks at a time. If you use them for longer, they can make your skin thin, shiny, and bruise easily or give it stretch marks and new blood vessels.
• Synthetic vitamin D, such as calcipotriene (Dovonex, Sorilux) ointment, foam, or cream, slows the growth of skin cells. But it can also irritate your face. Calcitriol (Rocaltrol, Vectical) is a newer vitamin D drug for psoriasis that some studies suggest may be better for sensitive skin.
• Retinoids, such as tazarotene gel (Tazorac), help remove scales and may ease inflammation. But skin irritation is a side effect.
• Tapinarof (Vtama) is a type of nonsteroidal topical cream that you apply once a day on areas of your face affected by plaque psoriasis. It’s FDA-approved for adults, and you can use it in other sensitive areas like skin folds and genitals. One study found that 4 in 10 people saw their psoriasis symptoms completely go away at least once during the study.  Common side effects can include red bumps, pain or swelling in your nose or throat, burning, or peeling. 
• Roflumilast (Zoryve) is another type of once-daily nonsteroidal topical cream. One study found that it can clear your flare-up in about 6 weeks if you have mild psoriasis. Common side effects can include diarrhea, headache, insomnia, nausea, upper respiratory tract infection, and urinary tract infection. 
• Pimecrolimus (Elidel) and tacrolimus (Protopic) are two drugs the FDA has approved for eczema, a different skin condition. Some dermatologists recommend these drugs for psoriasis on the face. But talk to your doctor about whether you need these medicines. The FDA says people should use them only for a short time since some studies have linked the drugs to cancer risks.
• Crisaborole (Eucrisa) ointment is another topical medicine recently approved by the FDA for eczema that can reduce inflammation. It can cause temporary burning or stinging when you apply it.
• Coal tar. Derived from coal, this treatment comes in over-the-counter shampoos, creams, and oils. Prescription-strength products are also available.
• Lotion, creams, or other moisturizers. They can’t heal psoriasis, but they can make your skin feel better and ease itching, scaling, and dryness.
• Salicylic acid. Also available over the counter and by prescription in shampoos and scalp treatments, this remedy can help get rid of scales. Your doctor might pair it with steroids or coal tar.

Facial psoriasis medications

If these treatments don't help, ask your doctor if you should take prescription pills or shots for your condition. These include:

• Apremilast (Otezla)
• Cyclosporine (Neoral)
• Deucravacitinib (Sotyktu)
• Low-dose retinoids
• Methotrexate (Trexall)
• Biologics such as:
  • Adalimumab (Humira)
  • Adalimumab-atto (Amjevita)
  • Bimekizumab-bkzx (Bimzelx)
  • Brodalumad (Sliq)
  • Etanercept (Enbrel)
  • Etanercept-szzs (Erelzi)
  • Guselkumab (Tremfya)
  • Infliximab (Remicade)
  • Ixekizumab (Taltz)
  • Risankizumab-rzaa (Skyrizi)
  • Secukinumab (Cosentyx)
  • Tildrakizumab-asmn (Ilumya)
  • Ustekinumab (Stelara)

Each works differently, but they can be helpful for moderate to severe psoriasis.

Light treatment for facial psoriasis

Another option is treatment with ultraviolet (UV) light, called phototherapy, which slows skin cell growth. There are several types:

• Sunlight. You get ultraviolet rays from sunlight or artificial light.
• UVB phototherapy. You get UVB rays from an artificial source.
• Narrow band UVB phototherapy. This is a newer type of UVB treatment.
• Goeckerman therapy. This mixes UVB treatment with coal tar.
• Psoralen plus ultraviolet A (PUVA). Psoralen is a medication that makes your skin more sensitive to light. You take it before UVA therapy.
• Excimer laser. This is a controlled beam of UVB light that treats a small area.

Facial Psoriasis Treatments for Specific Areas

Eyelids

To treat this area, your doctor may recommend:

• Special corticosteroids to treat scaling. But don’t overuse them. If they get into your eyes, they can lead to glaucoma or cataracts.
• The eczema drugs crisaborole (Eucrisa) ointment, pimecrolimus (Elidel), or tacrolimus (Protopic). They don't cause the side effects of steroids. They can sting the first few days you use them.
• Your dermatologist may also suggest creams like roflumilast (Zoryve) and tapinarof (Vtama). They are also OK to apply to your face – eyelids, ears, mouth, and nose.

Be careful when you treat psoriasis around your eyes. The skin on eyelids is delicate and gets damaged easily. Tell your doctor about any problems you have.

Psoriasis in the eye is very rare. If you have it, your eyes can be painfully dry. You may need antibiotics to treat an eye infection.

Ears

Psoriasis medications can put your eardrum at risk, so be cautious when you apply any inside the ear. Your doctor may recommend:

• A prescription corticosteroid you can drip in your ear or apply to the outside of your ear canal
• Calcipotriene or tazarotene usually mixed with a corticosteroid cream, lotion, or ointment

Mouth and nose

Your doctor may recommend:

• Steroid creams or ointments that are made for moist areas
• Rinsing often with a saline solution to relieve pain
• Low-potency corticosteroids like hydrocortisone 1% ointment
• Pimecrolimus or tacrolimus

How to Put Facial Psoriasis Cream on Your Face

Here are a few basic tips:

• Use small amounts.
• Be careful when you apply creams and ointments around the eyes. Some treatments can irritate them.
• Follow your doctor’s instructions for taking the medication so you can prevent side effects, especially with steroids.
• Ask your doctor if you can use makeup to conceal the psoriasis on your face. Some products can prevent treatment from working.
• If your medication doesn’t help or causes too many side effects, work with your doctor to figure out a treatment that will help.

Home Remedies for Facial Psoriasis

At-home self-care is about the basics – trying not to scratch affected areas, avoiding the things that seem to trigger flare-ups, using cold compresses and moisturizer to soothe affected areas (see below), and keeping up with your treatment.

No supplements or herbal remedies have been proven to treat psoriasis on the face or any other part of the body.

Tips for Living With Facial Psoriasis

Don’t scratch your psoriasis. Be gentle with your skin. Use a cold compress on your psoriasis. To make a cold compress, dampen a cloth in cold water and squeeze out any extra water so it’s not dripping wet. You could also use an ice pack. But don’t put ice directly onto your skin. Moisturizing the area can also help. You may want to pick a fragrance-free moisturizing cream.

Wear sunscreen every day. You’d want to do this even if you didn’t have psoriasis to help prevent skin cancer and wrinkles. With facial psoriasis, it’s also important to avoid sunburns because they can make your psoriasis worse.

Takeaways

Facial psoriasis, or psoriasis of the face, is different from psoriasis on other parts of your body, largely because the skin of your face is more delicate. It’s common to have psoriasis in more than one place, though.

Facial psoriasis usually shows up on your eyebrows, on the skin between your nose and upper lip, your upper forehead, and your hairline. You can get in on your ears, eyelids, and other spots, too. There are treatments for facial psoriasis on all parts of your face.

Treatments usually include special creams as well as meds you take by mouth. Often, there’s a combination. Another approach is light therapy, which is safe for any type of skin. If you’re a person of color, there’s a chance certain UV (ultraviolet) light can cause darker spots to appear. Your doctor can recommend other treatments or help you protect your skin with sunscreen before having light therapy.

Self-care practices like avoiding stress, using sunscreen, not scratching your face, and seeing a licensed therapist if needed can help living with facial psoriasis easier.

Facial Psoriasis FAQs

Why am I getting psoriasis on my face?

Facial psoriasis often is caused by your body’s immune system overreacting to a perceived invader, such as bacteria. This can cause swelling and plaques or other lesions to appear. Other triggers include having an infection such as strep or your skin reacting to allergens.

What is the fastest way to treat psoriasis on the face?

Medicated treatments including topical – meaning you put it on your skin – or oral drugs your doctor prescribes will speed up treatment and healing.

What cream can I use for psoriasis on my face?

Your doctor will help choose the best treatment from among many creams, ointments, and lotions that can help psoriasis on the face.  They might include:

• Creams both with mild corticosteroids and without
• Synthetic vitamin D
• Retinoids
• Salicylic acid
• Coal tar
• Moisturizers

Is it eczema or psoriasis on my face?

Both psoriasis and eczema can seem rashy and itchy, but when you look closer, they’re different. Eczema can appear dry and scaly, while psoriasis on your face shows up as more well-defined scales and plaques. Your doctor will be able to spot or do tests to make sure of the diagnosis, too.