What Triggers Facial Psoriasis? Causes & Types

Symptoms of facial psoriasis include:

• Scaly plaques that are red or pink on lighter skin and brown or purple on darker skin
• Mild to intense itching
• Soreness
• Skin sensitivity or burning

Although symptoms are usually mild, facial psoriasis can be extensive and involve several areas such as the following:

• Facial skin
• Forehead
• Hairline
• Neck
• Ears

Facial psoriasis rarely occurs solely on the face. While the forehead is the most common area affected, it can also show up on the following:

• Upper lip
• Cheeks
• Ears
• Mouth
• Ears

• True facial psoriasis
  • Can appear anywhere on the face and are usually symmetrical
  • Plaques may be red, scaly, symmetrical, and sharply demarcated
• Sebopsoriasis
  • May appear as patchy, flaky areas near the hairline
  • Can show up on the brows, eyelids, facial hair, or T-zone
  • Plaques may be salmon pink and thin with bran-like scales
  • Usually associated with diffuse or patchy scalp psoriasis
• Hairline psoriasis
  • Typically scalp psoriasis that has extended to the face
  • Often impacts the forehead or the ears
  • May cause plugged ear canals in severe cases
  • Plaques may be thick, bright red, with variable white scales

Although there is no cure for facial psoriasis, symptoms can be controlled with medications. Since facial skin is thin and sensitive, this type of psoriasis can be more challenging to treat.

Consult with your dermatologist about treatment options that are right for you, which may include moisturizers, topical treatments, medications, and phototherapy.

1. General skin care

• Skin care products such as gentle non-soap cleansers and sunscreens may be recommended.
• Moisturizing lotions, creams, and ointments can help relieve itching, dryness, and discoloration.
• Products should be free of alcohol, artificial preservatives, colors, and fragrances to reduce irritation.

2. Topical steroids

• Dermatologists often recommend a low-potency topical corticosteroid, such as over-the-counter 1% hydrocortisone or prescription-strength 2.5% for moderate face psoriasis.
• Steroids help minimize swelling and redness by inhibiting inflammatory reactions in the body.
• Skin thinning and pigmentation changes are possible side effects.

3. Nonsteroidal topicals

• Topical calcineurin inhibitors may be used to reduce inflammation and can be administered for longer periods than steroids.
• Since these creams do not thin the skin, they are a good choice for areas where the skin is thinner.

4. Medications

• Drugs may be administered as pills or injections that enter the bloodstream and work to help clear the skin over the entire body, including the face.
• There are two main types of systemic treatments or medications:
  • Traditional systemics
    • Taken as a pill and helps control cell growth and shedding
    • May involve retinoids, immunosuppressive, and chemotherapy drugs
  • Biologics
    • Proteins that work against certain components of the immune system to help manage inflammation
    • Inhibit immune cells, such as T cells, or inflammatory mediators called cytokines
    • Cannot be administered orally because they would be broken down in the stomach and instead are administered via injections or infusions, allowing them to reach the bloodstream

5. Phototherapy

• Phototherapy is a psoriasis treatment that uses ultraviolet (UV) radiation to penetrate layers of skin, inhibiting the proliferation of skin cells.
• Phototherapy is usually done under the supervision of a dermatologist, who can keep track of the sessions and the quantity of UV light exposure.
• Types of phototherapy vary depending on the location and severity of the facial psoriasis.

6. Diet

• While there is no special diet for psoriasis, many doctors recommend eating fresh fruits, vegetables, lean meats, and unsaturated fats.
• Reducing sugar intake and increasing intake of vitamins, minerals, and antioxidants may help relieve symptoms in certain people.

7. Stress management

• Since stress is a trigger for facial psoriasis, managing or reducing stress can help prevent the condition from flaring up or worsening
• Experts from the National Psoriasis Foundation recommend the following stress management techniques:
  • Meditation and deep breathing
  • Exercise such as tai chi and yoga
  • Massage therapy

Facial psoriasis presents several psychological and emotional issues because it is difficult to conceal and can lead to low self-esteem. An appropriate combination of medication and support can help the affected person cope with the disease.