Facial Psoriasis: what you need to know

What is Facial psoriasis?

Psoriasis is a chronic skin disorder, which means a skin condition that does not go away. People with psoriasis get thick pink or red patches of skin covered with a white or silvery thick scales called plaque.

Most people with psoriasis have plaque psoriasis.

Psoriasis tends to start in early adulthood, though it can begin later in life. People of any gender, age, or race can get it.

It can get better or worse throughout your life.

The national psoriasis foundation estimates that around 50% of people with psoriasis, experience it on their face. Facial psoriasis usually appears on the hairline, upper forehead, eyebrows, and the skin between the nose and upper lip.

What part of the body does it affect?

The rash can show up anywhere. In most people, it only covers a few patches of skin. In severe cases, the plaque can connect and cover a large area of the body.

Psoriasis can make you uncomfortable, itchy, and self-conscious.

Psoriasis tends to affect the:

• Elbows and knees
• Face, scalp, and inside the mouth
• Fingernails and toenails
• Genitals
• Lower back
• Palms and feet

What does it look like?

At first, you will see small red bumps. The bumps will grow, and scales form on top. The surface might shed easily, but the scales beneath them will stick together. If you scratch the rash, the scales may tear away from the skin, causing bleeding.

As the rash continues to grow, lesions (larger areas of damage) will form.

When to see a doctor

If you are uncertain if it is psoriasis or another condition that is causing symptoms go to the doctor.

A dermatologist, or skin specialist, will be the go to professionals to treat psoriasis. A primary care physician can refer a person to a dermatologist.

People should see a doctor when:

• Areas of the skin are painful
• The discomfort makes it hard to get through the day
• Lesions are extending towards the eye
• They have concerns about their skin's appearance
• They are experiencing joint pain as well as facial lesions

Generally, people should see a doctor when their psoriasis is causing them problems or when they wish to discuss treatment options.

Other types of psoriasis

Psoriasis will appear differently on your face depending on which type of psoriasis you have got and which part of the face it affects.

Plaque psoriasis is the most common psoriasis, about 80% to 90% of people with psoriasis have plaque psoriasis.

Hairline psoriasis

It is estimated that 45% to 56% of people with psoriasis experience scalp psoriasis. This can affect the upper forehead as well. Scalp psoriasis and hairline psoriasis can be mild, appearing as fine dandruff flakes, or they can have more severe psoriasis.

You may notice thick plaques of skin covering the hairline and behind the ears.

Hairline psoriasis can often be treated with over-the-counter products containing salicylic acid and tar. Scalp psoriasis may be associated with psoriatic arthritis, so speak to your doctor if you experience symptoms of this.

Sebo-psoriasis

Sebo-psoriasis is a condition that involves facial psoriasis and seborrheic dermatitis. It can appear on the hairline, eyelids, eyebrows, sides of the nose, and beard area. Sebo-psoriasis leads to thin, pink plaques that be covered in greasy, yellow scales.

True facial psoriasis

True facial psoriasis is the classic psoriasis plaques on the face. The red, scaly plaques are usually symmetrical and appear on other areas of the body as well. The skin is often painful and itchy in this condition.

Less common types are:

Inverse psoriasis

It appears in skin folds and it may look like thin pink plaques without scales.

Guttate psoriasis

May appear after a sore throat caused by a streptococcal infection. It looks small, red, drop-shaped scaly spots in children and young adults.

Pustular Facial psoriasis

Is small, pus-filled bumps on top of the red patches or plaques.

Is psoriasis the same as eczema?

Psoriasis and eczema are two different skin conditions.

They differ where the disease appears on the body, how much it itches and how it looks. Eczema tends to appear on most occasions behind the knees, and inside the elbows. Eczema also causes more intense itching than psoriasis. Many people, especially children, can get both psoriasis and eczema.

What causes psoriasis?

Psoriasis is an immune system problem. Your immune system response overreacts, causing inflammation, which leads to new skin cells growing too fast.

New skin cells on average grow every 28 to 30 days but in people with psoriasis, new cells grow and move to the skin surface every three to four days. The build-up of new cells replacing old cells creates the silvery scales of psoriasis.

Psoriasis runs in families. There may be a genetic component. Parents may pass it down to their children.

What causes the outbreaks of psoriasis?

Psoriasis outbreaks may differ from person to person. No one knows exactly why flare-ups are caused. Common psoriasis triggers are:

• Skin injury ( cuts, scrapes, or surgery)
• Emotional stress
• Streptococcal or other infections that affect the immune system
• Certain prescription medications
• Cold weather, when people have less exposure to the sunlight and humidity and more to hot, dry air

How common is it?

Facial Psoriasis affects millions of people globally, approximately 3% of the U.S. population has psoriasis.

Psoriasis symptoms

Facial Psoriasis symptoms will vary depending on which area of the face it affects. Psoriasis usually causes small, red bumps that grow into red or pink sores on the face. These sores will often be covered in silvery-white plaques, which might flake off.

Psoriasis symptoms may also be:

• Itchy skin
• Cracked, dry skin
• Scaly scalp
• Skin pain
• Nails that are pitted, cracked, or crumbly
• Joint pain

Is it contagious?

The rash is not contagious. You cannot get it from someone or pass it on to someone.

How do I know if I have it?

Do regular self-examinations of your skin and observe any changes in your skin. If you have a rash that will not go away, contact your health provider. They will look at the rash to find out if it is psoriasis or another condition. You may need to see a dermatologist, or a skin care specialist, for a diagnosis.

How is psoriasis diagnosed?

To diagnose facial psoriasis, a doctor or dermatologist will ask questions about your symptoms, such as whether you have itchy skin. They may also ask about your family history and whether any of your close relatives have had psoriasis.

In addition, the doctor or dermatologist may take a small sample, or biopsy, of your skin to study under a microscope and confirm your diagnosis. You may also be asked questions about the changes in your life, like whether you are under more stress or on new medications.

It is worth making sure you have the correct diagnosis, psoriasis can be mistaken for other conditions like:

• Seborrheic dermatitis
• Ringworm
• A reaction to medicine

What type of treatment will I have?

Several treatment options can relieve psoriasis. Creams or ointments may be enough to improve the rash in small areas of the skin. If the rash affects larger areas, or you have joint pain, you may need other treatments. Joint pain may mean you have arthritis.

Your Doctor will decide on a treatment plan based on:

• Severity
• Where the rash is on your body
• Your age
• Your overall health

What psoriasis treatment options are available?

Common psoriasis treatments include:

• Steroid creams
• Moisturizers for dry skin
• Anthralin, a medication to slow skin cell production
• Medicated lotions, a medicated shampoo, and bath solutions to improve scalp psoriasis, your provider may combine it with ultraviolet (UV) light therapy for severe cases
• Vitamin D3 ointment
• Vitamin A or retinoid creams
• CBD based balms and creams

Home remedies

Try not to stress

Consider meditation or yoga to help keep your stress levels as low as possible.

Avoid triggers when possible

Watch your diet carefully to see what causes flare ups.

Do not pick your plaques

Picking your scales off scales typically results in making them worse or creating a new rash.

Apply a moisturizer or CBD cream

Consider asking your doctor to recommend a moisturizer that can help reduce dry skin and scaling on your face. Or try our care and comfort moisturizer.

Consider emotional support

Sometimes, having plaque on your face may make you feel self-conscious or depressed. Your doctor can recommend supportive resources like scheduling an appointment with a psychologist or providing information about a support group.

Skincare to help with psoriasis on your face

Finding a skin care routine that helps with psoriasis on your face is very important, although you may need to experiment with a few different products before finding the right one for you.

In addition to discussing prescription creams with a doctor, you may find it helpful to use an CBD based products, or a emollient. Emollients smooth the skin and create a barrier of oil to help protect your skin from drying out.

Humectants, like glycerine and aloe vera, can also help to hydrate your face.

You may also want to look for products with salicylic acid, which can help your skin shed psoriasis scales, or coal tar, which can reduce itching and inflammation.

Alternative medications

Aloe extract cream

Taken from leaves of an aloe vera plant, aloe extract cream may reduce calling, itching, and inflammation. You might need to use the cream several times a day for a month or more before you see improvements.

Fish oil supplements

Oral fish therapy used in combination with UVB therapy might reduce the extent of the rash. Applying fish oil directly to the affected skin and covering it with a dressing for around six hours a day for four weeks may improve scaling.

Oregon grape

Oregon grape- also known as barberry- can be applied to the skin and may reduce the severity of psoriasis.

What if the treatments don't work?

If psoriasis treatments do not work, the doctor may recommend these to you:

Light therapy

UV light at specific wavelengths may decrease skin inflammation and help slow skin cell production.

PUVA

This treatment combines psoralen a medication with exposure to a special form of UV light.

Methotrexate

Doctors sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. However; You may need periodic liver biopsies to check your liver.

Retinoid’s

These vitamin A-related drugs cause side effects, including birth defects.

Cyclosporine

This medicine can help with severe psoriasis, but it may cause high blood pressure and kidney damage.

immune therapies

Newer immune therapy medications work by blocking the body's immune system so it can not jumpstart an autoimmune disease such as psoriasis.

Can I prevent psoriasis?

You cannot prevent psoriasis, but treatment can reduce symptoms even in people with severe psoriasis.

Will it ever go away? Is it curable?

Psoriasis has no cure. It may come and go throughout your life and there are treatments to help but you will have it for life.

Complications of psoriasis

In some people, psoriasis causes more itchiness and red skin. It can lead to swollen joints and arthritis. If you have psoriasis, you may be at higher risk of:

• Diabetes
• Obesity
• High cholesterol
• Strokes
• Heart attacks

If you have psoriasis, your doctor will do regular blood pressure checks. It is also important to quit smoking and maintain a healthy weight.

Lifestyle tips

Developing psoriasis on the face may have severe psychological effects on people, such as anxiety or depression.

People who have visible may find the condition particularly challenging. However, psoriasis is only a small part of a person and should not define them.

Some people with psoriasis find that sharing their feelings with their friends and family is helpful, as it can help their support network understand the challenges of living with psoriasis on the face.

If a person would rather talk to someone that is not family or friends, they could speak with a counsellor, their doctor, or a support group.

One online support group is called "Talk psoriasis forum" from the inspire community.

Although some people may be anxious or self-conscious about another individual seeing their skin close up, it is important that people understand psoriasis.

It is also vital to understand that psoriasis  is not contagious and anyone can develop it.

What is psoriatic arthritis?

In 1 in 3 people with psoriasis, the  inflammation can causes arthritis. Symptoms of psoriatic arthritis include joint stiffness, swelling, and pain. See your healthcare provider if you have any of these symptoms. Early treatment can reduce damage to your joints.

How can I take care of myself

To feel your best with psoriasis:

• Take medications as instructed
• Use moisturizer regularly, especially after bathing
• Avoid harsh soaps
• Use medicated shampoo for scales on your scalp

Other steps you can take to stay as healthy as possible:

• Talk to your healthcare provider about lowering your risk for related conditions, such as heart disease, depression, and diabetes
• Lower your stress with meditation

What should I ask my healthcare provider?

If you have psoriasis ask your doctor the following:

• How can I prevent outbreaks and control symptoms?
• What medications will work best for me?
• What else should I do to improve my symptoms?
• What are my options if the cream does not work?
• Will psoriasis ever go away?

A question that is frequently asked

Q: Can I get a suntan if I have psoriasis?

A: Sun exposure for People with psoriasis is complicated. If they get too much sun, it can trigger a flare-up of symptoms.

On the other hand, the sun can be an effective treatment for psoriasis. Ultraviolet B and ultraviolet are both present in sunlight, but UVB works best for psoriasis, and many people use it in phototherapy treatments.