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Psoriasis on Lips: Symptoms and Treatments

Posted on February 25, 2021
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Sarah Winfrey

At least 20 percent of people who have psoriasis have it somewhere on the face. However, psoriasis on the lips is extremely rare.

While it's rare to have psoriasis on the lips, it does occur. If you think that you or someone you love might be experiencing psoriasis on the lips, it’s important that you get the right diagnosis and work with your dermatologist to find the best treatment for your skin.

What Is It Like To Have Psoriasis on the Lips?

Some MyPsoriasisTeam members have shared that they’ve experienced psoriasis on their mouths. One member wrote that their psoriasis affects their “scalp, eyelids, ears, mouth, and body,” while another wrote, “the skin on my hands, face, and lips is lifting off.”

The symptoms of psoriasis on the lips are similar to symptoms of psoriasis elsewhere on the body. The symptoms can occur independently of, alongside, or prior to the appearance of psoriasis lesions on the rest of the body. People diagnosed with psoriasis on their lips can have cracked and scaly skin, as well as redness, silvery scales, burning, and peeling. These symptoms can develop on the lower portion of the face, including the mouth, or directly on the red part of the lips. Eating or moving the lips may also aggravate symptoms, leading to occasional bleeding, itching, and further discomfort.

Psoriasis on the lips can manifest differently than psoriasis does on other parts of the body, making it difficult sometimes to tell lip psoriasis apart from everyday lip chapping. Oral psoriasis plaques may look less like typical plaque psoriasis and more like cracked, dry lips.

If the inside of the mouth is also involved, people may experience a symptom called geographic tongue. With geographic tongue, the tongue develops flat, smooth lesions on its surface. These lesions can look like continents on a map, hence the name. The lesions may be painless in some people and hurt or burn in others.

What Causes Psoriasis on the Lips?

The causes of psoriasis on the lips are the same as those of psoriasis diagnosed elsewhere on the body.

Researchers are not exactly sure what causes psoriasis, but it is believed to result from a combination of environmental and genetic factors. Psoriasis is an autoimmune condition, meaning it occurs when the immune system is overactive and mistakenly attacks the body’s own healthy tissues. Psoriasis symptoms may be triggered by specific factors, such as an infection or dry weather. When a person with psoriasis experiences a trigger, their skin cells multiply faster than normal in certain areas (in this case, on the lips), causing the scales and itchy, red plaques characteristic of the disease. There are also several risk factors for psoriasis, including smoking, excessive stress, and having a family history of the condition.

Certain irritants, such as spicy foods, salty foods, or acidic foods, may make psoriasis on the lips worse and irritate open sores on the mouth.

Keep in mind that Trexall (methotrexate), a medication used to treat psoriasis, may also cause some people to develop mouth ulcers (sores). One MyPsoriasisTeam member experienced sores, asking others, “Does anyone else on methotrexate get a really sore mouth? I have constant ulcers in my mouth and on my tongue.” Another member shared, “I had a friend with awful sores in and around her mouth due to methotrexate. It has happened to me, too.” Although sores may resemble psoriasis plaques, they are not related to the autoimmune disease. Instead, they are a side effect of methotrexate that occurs in about one-third of people. If you or your loved one developed mouth sores after starting methotrexate, talk to your doctor or dermatologist. You may be able to ease your symptoms or try another medication.

Several other conditions, including eczema (atopic dermatitis) and contact dermatitis, could cause lip lesions that might look like psoriasis. If there is any doubt as to what is causing your symptoms, talk to your doctor. They are your best resource when it comes to diagnosing and treating your condition.

How To Treat Psoriasis on the Lips

Treatments for psoriasis on the lips overlap with treatments for psoriasis diagnosed elsewhere on the body. However, there are a few extra things to think about when choosing a treatment for lip psoriasis.

The skin on your face and lips is very thin and sensitive. It may respond differently to psoriasis treatments than other parts of your body will, or it may become irritated by topical treatments that you can tolerate elsewhere. You will also want to make sure that any treatment you put on your lips is safe to ingest.

Topical Treatments

Topical corticosteroid creams will likely be the first treatment that your dermatologist recommends for psoriasis on the lips. These are effective when treating oral psoriasis, and many are safe for use on the mouth.

Other topical options include retinoids and calcineurin inhibitors. While generally safe, these should be used under the direction of your doctor. Keep in mind that it may take several tries to find a topical treatment that works for you.

Phototherapy

Phototherapy, also known as light therapy, is a treatment used for psoriasis and other skin conditions that involves exposing the skin to certain types of light. Your dermatologist may recommend a broad spectrum of light or focus on one type, such as ultraviolet B (UVB) rays.

Lip Balms and Other Moisturizers

A variety of moisturizers and lip balms claim to work for psoriasis on the lips. However, the efficacy of these moisturizers has not always been thoroughly tested. Thick, petrolatum-based ointments will provide the best protection for dry, cracked lips. You should work with a dermatologist to find the right one for you.

Many of our members recommend using coconut oil to help with psoriasis. “I’ve been using the organic coconut oil with a tea tree oil mixture. It helps the itching and redness,” one member said. Food-grade coconut oil is safe for use on the lips.

Oral or Injected Medications

If your psoriasis is persistent or severe, your doctor may recommend systemic oral or injected medications, like biologics. These medications target the immune system, disrupting the disease cycle and helping bring about remission.

Get the Support You Need

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and those who care for them. Here, more than 88,000 members come together to ask and answer questions, offer support, and meet others who understand life with psoriasis.

Do you have psoriasis on your lips? How did your dermatologist recommend treating it? Start the conversation by leaving a comment below or by posting on MyPsoriasisTeam.

All updates must be accompanied by text or a picture.
Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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