Facial psoriasis can be one of the more difficult types of psoriasis to manage, as it can affect a person's self-esteem and quality of life. However, there are ways to cope with this condition and improve facial psoriasis symptoms. This guide offers tips and resources to help those suffering from psoriasis on their face.

Tips for Treating Facial Psoriasis Symptoms

Your face has to be one of the most annoying places to get psoriasis. The dryness makes it difficult to use make-up, and it can be highly noticeable. 

Facial psoriasis symptoms include:

- Redness

- Irritation

- Dry/Scaly Patches

- Itching

Psoriasis patches are often around the hairline, ears, and eyebrows, but can appear anywhere on the face. Approximately 50% of psoriasis sufferers suffer from facial psoriasis. It is rare for someone to only have psoriasis on their face- the body and/or scalp are usually affected too. Eyebrows and the hairline tend to be the worst affected areas.

The types of psoriasis that can appear on the face include:

- Plaque Psoriasis- This is the most common type of psoriasis (80-90% of cases) which appears as dry, raised, and scaly patches. These lesions are known as plaques. They particularly affect the hairline. Often plaques can be itchy, sore, and red.

- Guttate Psoriasis- Guttate psoriasis is usually triggered by a throat infection. It produces smaller patches than plaque psoriasis (usually under 1cm) which tend to be pink and less raised. Guttate psoriasis usually either goes into remission over time or develops into plaque psoriasis.

- Erythrodermic Psoriasis- The rarest type of psoriasis. Erythrodermic produces a red rash that looks like a burn. It usually covers a large portion of the body, including your face. Other symptoms can include dehydration and a fever. If you suspect you have this type of psoriasis, you should contact your doctor right away, as there is an increased risk of infection.

There is no clear, established cause for facial psoriasis, but flare-ups are thought to be caused by:

- Family history- most cases are thought to be hereditary

- Stress

- Too much sun exposure and/or sunburn

- Extreme temperatures and dry air

- Certain medications

- An infection

- Too much alcohol

- Smoking

Facial psoriasis can sometimes be misdiagnosed as eczema. Many of the symptoms are the same (itching, redness, etc.), but the scaling tends to be unique to psoriasis. See a doctor to ensure you have an accurate diagnosis and the best possible treatment plan for you.

Facial psoriasis is more common in those with long-term, hereditary, and/or severe psoriasis. Facial psoriasis in itself is considered a severe form of psoriasis. The severity of psoriasis is judged by two factors- the amount of skin surface affected by psoriasis plaques, and the impact psoriasis has on a patient’s quality of life. Because facial psoriasis can have such a big emotional effect, it is considered a severe form.

The face on your skin is thinner and more sensitive, so it can be even more difficult to treat. 

Here are our top tips to handle facial psoriasis:

- Use steroid treatments sparingly- Steroid treatments thin the skin and therefore you should avoid using them on your face unless directed by a medical professional. If you must use steroids, go for a weaker one (such as Hydrocortisone). Speak to your doctor about any concerns, and follow their instructions exactly. These treatments should be a last resort as they come with a risk of side effects. This includes skin thinning, tearing, rashes, and easy bruising.

- If you have psoriasis around your hairline, read our post on Scalp Psoriasis. The majority of facial psoriasis sufferers also suffer from scalp psoriasis. Symptoms can include severe dandruff, plaques on the scalp, a burning sensation, and itching. There are shampoos, ointments, and scalp oils available for treatment.

- Look for topical treatments which contain zinc and/or Vitamin D. There are many studies that confirm zinc topical treatments are effective for treating psoriasis, and it is safe enough to use on your face. Topical Vitamin D treatments have also been found to be effective, particularly when combined with corticosteroids.

- Salicylic Acid- Salicylic is a common and effective treatment for skin conditions. In psoriasis, it can help lift and soften scales. There are several shampoos and treatments available in pharmacies that contain salicylic acid. We love CeraVe SA Smoothing Face and Body Cleanser with Salicylic Acid, which is designed for dry skin types. For shampoo, we recommend Healpsorin Therapeutic Psoriasis Shampoo. A formula made just for scalp psoriasis sufferers, this shampoo is designed to hydrate the scalp, whilst reducing itching and flaking. Speak to your pharmacist or doctor prior to use, as strong solutions can cause irritation.

- Smoking- We all know smoking is bad news for your health and skin. Smoking is also thought to increase the incidence and severity of facial psoriasis. We highly recommend you quit if possible. The smoke itself can also prove to be an irritant, so you should also avoid being around others while they are smoking.

- Coal Tar- Facial psoriasis often develops around the hairline and is linked to scalp psoriasis. Coal tar is derived from coal and is available in many pharmacies in the form of creams, oils, or shampoos. T-Gel offers a great range of shampoos. Your doctor can also prescribe higher-strength coal tar treatments.

- Remember your SPF lotion. The skin on your face gets the most sun, so an SPF is essential to avoid sunburn, which could lead to a flare-up. Keep in mind that some topical treatments can lead you to burn more easily. Go for an SPF of 50 for your face, even in winter months.

- Reduce or eliminate your alcohol intake- Alcohol dries the skin out, which makes it a trigger for facial psoriasis. It is often also full of sugar, which could also lead to a flare-up. Redness on the face is often a sign someone has been drinking heavily. The face is effected more severely than the rest of the body due to the skin being thinner.

- We have a whole post on Make-up for Skin Conditions. Make-up can be a huge confidence booster if you have psoriasis on your face. There are many options available for camouflage foundations and concealers, specifically designed to hide skin conditions and tattoos. Avoid make-up if you are having a flare-up though, as it may cause further irritation.

- Get outdoors. Not only is a walk outdoors good for exercise and well-being, but it may also help with facial psoriasis. Go out without make-up on if possible, and get some fresh air on your skin. Sunshine exposure in small doses has been known to help some patients. 

- Try The Elimination Diet- The elimination diet involves cutting out foods for a set period, which you deem to be potential skin condition triggers. They are then slowly re-introduced to see how they affect your skin. The elimination diet will help you to identify any dietary triggers so they can be avoided in the future and don’t result in a flare-up of facial psoriasis.

- Try not to scratch- The skin on our face is thinner and more sensitive than the body. Be careful not to scratch facial psoriasis as this can lead to broken skin and infection. In severe cases, this could lead to the Koebner phenomenon (psoriasis caused by injury).

Understand the Symptoms and Triggers of Facial Psoriasis.

The first step in managing facial psoriasis is to understand the symptoms and triggers of the condition. Symptoms can include red, scaly patches on the face, itching, and burning sensations. Triggers can vary from person to person, but common ones include stress, cold weather, some food groups, vices (smoking/alcohol), and certain medications. By identifying your symptoms and triggers, you can better manage your condition and prevent flare-ups of facial psoriasis.

Develop a Skincare Routine That Works for You

Developing a skincare routine that works for you is an important part of managing facial psoriasis. It’s vital to choose products that are gentle and non-irritating, as harsh products can make symptoms worse. Look for products that are fragrance-free and hypoallergenic.

Keep skin clean by using a mild cleanser designed for sensitive skin. Make sure it is fragrance and alcohol-free to avoid further irritation. Pat skin dry gently afterward with a soft, cotton towel. There are some products that contain salicylic acid, which may offer some relief for itching, scaling, and irritation.

Moisturising regularly can also help soothe dry, itchy skin. Go for a moisturiser containing urea. Urea is an agent which exfoliates without causing damage or drying out the skin. Eucerin Urea Repair Dry Skin Face Cream is an excellent choice. Moisturising at least once or twice a day is essential. It won’t cure your psoriasis, but it can help reduce dryness, itching, and scaling. Talk to your doctor or dermatologist about which products are best for your specific needs.

Seek Professional Treatment and Support

While there are many coping strategies that can help manage facial psoriasis, it’s important to seek professional treatment and support. Your doctor can provide a proper diagnosis and recommend treatment options, such as topical creams, light therapy, or oral medications. Use small amounts of any topical treatment you use on your face. Monitor any sudden changes in symptoms. The skin on the face tends to have a quicker reaction than the skin on our body. Make sure you avoid the eye area.

Additionally, joining a support group or seeking therapy can provide emotional support and help you connect with others who are going through similar experiences. Don’t hesitate to reach out for help – managing facial psoriasis is a journey, but you don’t have to go through it alone.

Connect with Others Who Have Facial Psoriasis

Living with facial psoriasis can be isolating, and is one of the most stressful and traumatic forms of psoriasis to deal with. Connecting with others who have the condition can provide a sense of community and support. Consider joining a support group, either in person or online, to connect with others who understand what you’re going through. The National Psoriasis Foundation offers a variety of resources, including online support groups and a community forum. Additionally, social media platforms like Instagram and Facebook can be a great way to connect with others and find inspiration for managing your condition. The Instagram psoriasis community is very supportive (you can view our page @droughtskin).

Practice Self-Care and Manage Stress

Living with facial psoriasis can be stressful and overwhelming, which can exacerbate symptoms. It’s important to prioritise self-care and stress management techniques to help manage your condition. Reducing stress is likely to improve psoriasis symptoms all over your body, including your face. Read our post- Managing Psoriasis + Eczema from Stress: Tips and Strategies. This can include activities like meditation, yoga, or deep breathing exercises. Additionally, make sure to get enough sleep, eat a healthy diet, and exercise regularly. Don’t be afraid to seek professional help if you’re struggling to manage your stress or mental health. A therapist or counselor can provide additional support and coping strategies.