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Psoriasis on the Eyelid: Symptoms and Treatment

Posted on February 24, 2021
Medically reviewed by
Diane M. Horowitz, M.D.
Article written by
Joan Grossman

Psoriasis on the eyelid is a type of facial psoriasis that is usually caused by sebopsoriasis. Facial psoriasis is often associated with other types of psoriasis that also affect various areas of the body. These include:

  • Plaque psoriasis
  • Guttate psoriasis
  • Inverse psoriasis
  • Erythrodermic psoriasis

Psoriasis is an immune system disorder that causes inflammation of skin cells and can occur anywhere on the body. Approximately 10 percent of people with psoriasis have involvement with their eyes, including the eyelids. Psoriasis affecting the eyelids or eyes is considered rare. Other conditions associated with psoriasis can cause eyelid irritation and may resemble psoriasis.

MyPsoriasisTeam members frequently discuss their experiences with psoriasis on the eyelid, which can be distressing. “My facial psoriasis is playing up today. Itchy eyelids are no fun,” a member said. “I have developed a plaque on my eyelid!” one member wrote. “I had really hoped my face would not be affected.”

Symptoms of Psoriasis on the Eyelid

Different types of psoriasis can cause itchiness, pain, and inflammation on the eyelid. Any of these symptoms can cause a great deal of discomfort and should be discussed with your health care team.

One MyPsoriasisTeam member described her struggles with psoriasis on the eyelid. “My eyelid and under-eye area are affected particularly,” she said. “My eyelids are sore, and under my eye is very raw! This tends to happen with sudden change in temperature and lasts for around two months.”

Another member wrote, “I have it on my eyelid. It hurts like hell.”

Some of the specific symptoms associated with psoriasis on the eyelid may depend on the type of psoriasis.

Plaque Psoriasis

Some cases involving the eyelid are due to plaque psoriasis, the most common form of psoriasis. It causes thickened, red, purple, or dark brown skin with silvery scales. Plaque psoriasis can occur anywhere on the body, including the eyelid. Plaques on the eyelid can be itchy or painful and may have flaking scales.

Inverse Psoriasis

With inverse psoriasis, inflammation occurs in areas where skin touches skin, due to friction in skin folds. Inverse psoriasis is characterized by smooth, red or dark purple patches of inflamed skin and can occur on the upper eyelid.

Sebopsoriasis

Sebopsoriasis is linked to psoriasis and seborrheic dermatitis. It usually affects oily areas of the scalp, nose, eyebrows, and eyelids. Sebopsoriasis causes itchy, red, scaly, or crusty skin.

Blepharitis

Blepharitis is a type of eyelid inflammation that is associated with psoriasis. Symptoms include itching and burning on the eyelid. The skin on the eyelid can become red, irritated, and swollen, with flakes in eyelashes that may resemble psoriasis. Blepharitis usually occurs in both eyes and mostly affects the edges of the eyelids.

Treatment of Eyelid Psoriasis

Psoriasis on the eyelid is a delicate area to treat, and many members have questions about what to do regarding this particular skin condition. “I’m now getting lesions on my eyelids, right into the deep corners of both eyes, and also affecting the tear ducts,” a member said. “All of my usual creams and ointments are dangerous to use there, and moisturizers burn and inflame. Any ideas?”

Eyelids affected by psoriasis should be treated carefully to avoid irritating the eyes. Eyelid skin is also delicate and sensitive. Some treatments typically used for psoriasis may help reduce inflammation in the eyelid. These include over-the-counter (OTC) and prescription nonsteroidal and steroidal topical treatments. However, you may find that steroid creams cause irritation when used around the eyes. In that case, your doctor may prescribe calcineurin inhibitors, which gently reduce plaque buildup on thin skin like the eyelids. Before starting any treatment for the skin around the eyes, consult with your health care provider.

Systemic medications like methotrexate, biologics, and targeted synthetic disease-modifying agents are used to treat autoimmune diseases like psoriasis. They may also help reduce psoriasis on the eyelid. Phototherapy, also known as ultralight therapy, should be discussed with your doctors to be sure it can be used safely for the eyelid without protective goggles.

Take Caution

Some moisturizers, ointments, creams, and other topical treatments may not be appropriate for the eyelid, due to the risk of irritating the eyes. One MyPsoriasisTeam member described her frustration with topicals. “Worst spot ever: Eyelids!” she wrote. “Topicals near my eyes make them heavy and tired the next day.”

Sometimes, mild forms of corticosteroid topicals are prescribed for the eyelid. However, steroids may increase the risk for glaucoma and cataracts. Seek medical advice before using anything near your eyes.

Have Regular Eye Exams by an Ophthalmologist

Psoriasis around the eyes and on the eyelids should be checked by your dermatologist and ophthalmologist. Psoriasis on the eyelid can affect the eyes. This condition is known as ocular psoriasis, in which the cornea and conjunctiva are affected, as well as the eyelid. People with ocular psoriasis are also at risk for ocular surface disease, which includes conditions like conjunctivitis and corneal dryness. People with psoriasis should have yearly exams with an ophthalmologist to check for eye disorders associated with psoriasis.

Tips From MyPsoriasisTeam Members

MyPsoriasisTeam members often share their tips for managing psoriasis on the eyelid.

One member wrote, “I am applying Aquaphor in the morning and right before bed. When the itching gets intense, I use hydrocortisone 2.5 percent. I have to do it religiously to keep it at bay.”

Other members suggest coconut oil, cold-pressed castor oil, or A&D ointment for their eyelid psoriasis. Another member shared her tip: “Johnson’s Baby Shampoo. It's the only soap product I will use on my eyelids. It seems to help.”

Other members look beyond over-the-counter products for relief. “Try betamethasone cream 0.05 percent, available by prescription,” a member wrote. “I use it for sensitive areas, like around my eyes.”

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 88,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Are you living with psoriasis on the eyelid? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Diane M. Horowitz, M.D. is an internal medicine and rheumatology specialist. Review provided by VeriMed Healthcare Network. Learn more about her here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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