For many people, psoriasis that affects the nose, cheeks, forehead, or ears isn’t just uncomfortable — it can also feel isolating or emotionally distressing. About 50 percent of people with psoriasis develop symptoms on their faces.

The appearance of discolored, scaly patches on your most prominent body part can take a toll on self-esteem and quality of life. “Now that psoriasis has attacked my face, I (literally) can’t face going out,” said one member of MyPsoriasisTeam.

“People look at me like I have a disease,” shared another.

In this article, we’ll explore what causes psoriasis of the face, what it looks like, how it feels, and the treatment options available.

What Causes Facial Psoriasis?

Facial psoriasis, like psoriasis on other parts of the body, is caused by an overactive immune system that creates inflammation and the rapid buildup of skin cells.

Common triggers for psoriasis flare-ups include:

• Specific medications
• Infections
• Cold or dry weather
• Sun exposure
• Smoking
• Stress

In some cases, facial psoriasis may be a sign of more widespread or severe psoriasis overall.

What Does Facial Psoriasis Look Like?

Facial psoriasis appears on the forehead, cheeks, chin, eye area, and in or around the mouth and ears. Your skin may itch or hurt in areas where you have symptoms. The plaques can appear red or pink on lighter skin and brown or purple on darker skin.

“My forehead, scalp, ears, neck, and eyelids are covered, and I’m beyond miserable,” one MyPsoriasisTeam member said.

Psoriasis on the face is sometimes split into three categories: hairline or scalp psoriasis, sebopsoriasis, and true facial psoriasis.

Scalp Psoriasis

Scalp psoriasis affects between 45 percent and 56 percent of people living with psoriasis. It typically appears on the scalp, forehead, hairline, the skin around the ears, and the back of the neck.

Scalp psoriasis is sometimes mistaken for seborrheic dermatitis, a condition that includes dandruff as its milder form. Seborrheic dermatitis usually causes greasy, yellowish patches or flaky scalp, while scalp psoriasis tends to cause dry, white or silvery plaques. Psoriasis plaques are also usually more sharply defined than those caused by seborrheic dermatitis.

Sebopsoriasis

Sebopsoriasis is a cross between seborrheic dermatitis and psoriasis. Symptoms show up on the eyelids, eyebrows, upper lip, and behind the ears. If you have sebopsoriasis, you may have greasy, yellow scales like you’d see in seborrheic dermatitis. You might also have scales that are thicker and more red-toned than seborrheic dermatitis but less silvery than regular psoriasis.

Sebopsoriasis can also cover your eyelashes. “With every blink, I feel a rubbing, scratching, bleeding, raw feeling on my eyes,” shared one MyPsoriasisTeam member.

True Facial Psoriasis

People with true facial psoriasis, also called mixed facial psoriasis, will notice clearly defined scaly plaques. The symptoms may be symmetrical on each side of the face. Generally, people have symptoms on other parts of the body. Different types of psoriasis can show up on the face, including plaque psoriasis and guttate psoriasis.

Psoriasis and skin cancer symptoms can look very similar initially, appearing as crusty or scaly changes to the outer layers of skin most exposed to the sun. For that reason, it’s important to get an accurate diagnosis from a dermatologist (skin specialist). A biopsy — which entails removing a small sample of skin for analysis — may be necessary to determine if a scaly area is psoriasis or something else.

How Do You Calm a Psoriasis Flare-Up on Your Face?

Although there’s no cure for facial psoriasis, it can be controlled with prescription and over-the-counter (OTC) medications. Your dermatologist will consider factors like symptom severity and total body area affected when recommending treatment. Treatment options may include topical treatments, systemic treatments, phototherapy, and moisturizers.

• Topical steroids — Low-strength corticosteroids are used for facial psoriasis to reduce inflammation and discoloration.
• Nonsteroidal topicals — There are several types of nonsteroidal topicals that may be appropriate for your face. These may be more tolerable than topical steroids.
• Systemic treatments — Immune-suppressing medications are sometimes used to treat facial psoriasis.
• Biologics — Biologic drugs target a specific part of the immune system that causes inflammation. These drugs are injected or infused.
• Phototherapy — This treatment uses ultraviolet light to slow skin cell growth. Phototherapy is usually done under the supervision of a dermatologist, but at-home options are also available.
• Moisturizers — OTC moisturizers help keep your skin hydrated. You can look for products that have received the National Psoriasis Foundation’s Seal of Recognition.

Skin Care Tips for Facial Psoriasis

Caring for itchy, dry skin on your face can pose several challenges. Below are some tips to make it easier to care for your skin.

Apply Makeup Strategically

Some people with psoriasis turn to makeup to conceal symptoms that affect their self-esteem. However, it can be difficult to put makeup on psoriasis symptoms, especially when you’re active.

“During exercise class, I sweated off all the makeup covering my red, sore forehead!” a MyPsoriasisTeam member shared. “Mid-class, a woman shouted at me, ‘What’s wrong with your head?’ I went to the gym to de-stress and ended up crying alone in the toilet!”

Here are some tips for applying makeup:

• Use creams, not drying gels.
• Choose a liquid or cream foundation, not a dry powder.
• Apply foundation with a dabbing or stippling technique, using a clean fingertip or a sponge (not a brush that can irritate skin).
• Don’t apply makeup to open, raw psoriatic lesions.
• Consider a highly pigmented concealer to cover lesions.

Shave With Care

Removing beard stubble can aggravate facial patches and cause bleeding. The American Academy of Dermatology recommends these shaving tips:

• Shave your face in the direction of hair growth (not against the grain).
• Change your razor blade after every five to seven uses.
• Try shaving after a shower.
• Choose a shave cream or oil for sensitive skin.

Use the Right Kind of Sunscreen

Dermatologists recommend that people with psoriasis use mineral sunscreens containing zinc oxide or titanium dioxide. You should not apply sunscreen on open sores or inflamed skin. Wearing a hat and staying in shady areas are other ways to protect your skin.

Talk to Your Doctor About Your Specific Diagnosis

Each person’s psoriasis diagnosis is different, and what works for one person may not work for another. You should work with your dermatologist to determine the best treatment option for you. Be open regarding changes to your condition and whether new treatments are meeting your expectations. Be sure to report bothersome side effects.

Find Your Team

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

How does facial psoriasis affect your life? Has your doctor prescribed treatments to manage your symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.