Approximately 49 percent of people with psoriasis have it somewhere on the face — but symptoms very rarely appear on the lips. If you think that you or someone you love might be experiencing psoriasis on the lips, it’s important to get the right diagnosis and work with a dermatologist to find the best treatment.

Psoriasis is a common skin disorder that occurs when an immune reaction causes your body to mistakenly produce too many skin cells. Among its most prominent symptoms are areas of painful, itchy, discolored, dry, or scaly skin.

What Is It Like To Have Psoriasis on the Lips?

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

Psoriasis symptoms on the lips are similar to those elsewhere. They 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 discoloration (redness on lighter skin; purple on darker skin), silvery or gray scales, burning, and peeling. 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 your lips when they’re affected by psoriasis may make symptoms worse, leading to occasional bleeding, itching, and further discomfort.

However, psoriasis on the lips can manifest differently from psoriasis elsewhere, making it difficult to distinguish psoriasis from everyday lip chapping. Oral psoriasis plaques may look less like typical plaque psoriasis and more like cracked, dry lips.

Psoriasis can also affect the inside of your mouth. Some people experience a phenomenon called geographic tongue — flat, smooth lesions on the tongue’s surface. These lesions can look like continents on a map, hence the name. The lesions may be painless in some people but 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 aren’t exactly sure what causes psoriasis, but they believe the condition results from a combination of environmental and genetic factors. Psoriasis is an autoimmune condition, meaning it occurs when an overactive immune system mistakenly attacks healthy tissues.

Specific factors, such as an infection or dry weather, can trigger psoriasis symptoms. These triggers prompt skin cells to multiply faster than normal in certain areas (in this case, on the lips), leading to the scales and itchy, discolored plaques characteristic of the disease. Risk factors for psoriasis include smoking, being under excessive stress, and having a family history of the condition.

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

Keep in mind that medications for psoriasis containing methotrexate (Otrexup, Rasuvo, and Trexall) may also cause mouth ulcers. One MyPsoriasisTeam member experienced these sores, asking, “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 the sores may resemble psoriasis plaques, they aren’t related to the autoimmune disease. Instead, they’re a side effect that occurs in up to one-third of people who use methotrexate. If you or your loved one developed mouth sores after starting methotrexate, talk to your doctor or dermatologist. They may have suggestions for easing your symptoms or prescribe a different medication.

Several other conditions can cause lip lesions that might look like psoriasis, including atopic dermatitis (the most common subtype of eczema) and contact dermatitis (an allergic reaction or rash that occurs when your skin is exposed to certain substances). If there’s any doubt as to what’s behind your symptoms, talk to your doctor. They’re your best resource when it comes to diagnosing and treating your condition.

Four Ways To Treat Psoriasis on the Lips

Treatments for psoriasis on the lips overlap with those for psoriasis diagnosed elsewhere on the body. However, a few extra considerations apply 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 therapies than other parts of your body do, or it may become irritated by topical treatments that you can tolerate elsewhere. You’ll also want to make sure that anything you put on your lips is safe to ingest.

Consider these four potential treatments that may help you manage psoriasis on your lips.

1. Topical Treatments

Topical corticosteroids will likely be your dermatologist’s first recommendation for psoriasis on the lips. These creams are effective when treating oral psoriasis, and many are safe for use on the mouth.

Other topical options include retinoids — a synthetic form of vitamin A — vitamin D creams (like tacalcitol) and calcineurin inhibitors, which block the proteins that can lead to inflammation. While generally safe, these products 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.

2. 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 rays.

3. Lip Balms and Other Moisturizers

A variety of moisturizers and lip balms claim to work for psoriasis on the lips, but their efficacy hasn’t always been thoroughly tested. Thick ointments made with petrolatum (commonly known as petroleum jelly) tend to provide the best protection for dry, cracked lips. You should work with a dermatologist to find the right one for you.

Many MyPsoriaisTeam 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.

4. 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, when symptoms clear up.

Consult With Your Health Care Team

It’s important to talk to your doctor or dermatologist before trying any new treatment. Moreover, if you experience side effects from a new medication or treatment, contact your health care provider immediately. They’ll help you find the safest, most effective ways to manage psoriasis on the lips.

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 122,000 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 posting on your Activities page.