How to Treat Psoriasis on Your Face

Psoriasis is a medical condition in which skin cells die and build up rapidly. Psoriasis creates blotchy, flaky patches on your skin that may itch or feel painful. It can occur anywhere on the body, including on the face. If you have psoriasis on your face, you will want to treat it carefully, as the skin on your face is very sensitive. Depending on how severe your psoriasis is, you may wish to use topical treatments, phototherapy (or light therapy), systemic medications, or a combination of several treatments. There is also some evidence that lifestyle changes can reduce psoriasis symptoms.

Method 1
Method 1 of 4:

Managing Psoriasis with Topical Treatments

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    Use emollients and moisturizers. An emollient is a rich moisturizing ointment that softens the skin. Emollients not only reduce the dry skin buildup associated with psoriasis, but they may also make your skin more receptive to other topical treatments.[1]
    • Ask your doctor to recommend an emollient that will work well with your skin type. You may be able to buy an effective emollient over the counter, or your doctor or dermatologist may prescribe one for you.
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    Ask your doctor about using corticosteroids. Your doctor may recommend using a steroid cream or ointment to reduce inflammation associated with psoriasis. Topical steroid treatments can also reduce itching and slow down the production of new skin cells.[2]
    • Don't use corticosteroids on your psoriasis without your doctor's recommendation.
    • Topical steroids can cause a variety of side effects, including irritation or rashes (contact dermatitis), thinning of the skin, acne breakouts, excessive hair growth, or changes in skin color.[3] If you experience any of these symptoms, stop using the steroids and talk to your doctor.
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    Use synthetic vitamin D. This vitamin slows the growth of skin cells and is usually applied in topical form. However, vitamin D analogues can irritate the skin, so they should be used sparingly and with caution.[4]
    • In many cases, vitamin D will be combined in a cream with corticosteroids.
    • If your skin is sensitive to vitamin D ointments, Calcitriol (Vectical) is a relatively gentle option. However, Calcitriol can be expensive.
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    Ask your doctor about using calcineurin inhibitors. Calcineurin inhibitors, like tacrolimus or pimecrolimus, work by inhibiting excessive immune system activity that can lead to inflammation and plaque buildup. They are especially good for treating sensitive areas, like the face and scalp.[5]
    • Calcineurin inhibitors should be used with caution, and only with your doctor's recommendation. Long-term use can increase your risk of skin cancer and lymphoma.[6]
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    Treat your psoriasis with coal tar. Coal tar is a very old remedy for psoriasis. It reduces inflammation and slows the buildup of plaque and dead skin cells. It is often used in combination with ultraviolet (UVB) therapy. However, coal tar smells unpleasant, can stain your clothes and bedding, and may cause irritation or an allergic reaction in some people.[7]
    • Coal tar can be applied before bed and left on overnight, or applied in the morning and washed off after 10-15 minutes. If you choose to leave coal tar on your skin overnight, let it dry for 10-15 minutes before getting into bed in order to minimize stains on your bedding.
    • Your doctor may recommend using coal tar in combination with topical steroid treatments.
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    Apply retinoid creams. Retinoids are derived from vitamin A and are used for a variety of skin conditions. They are applied directly to the skin in order to remove scales and ease inflammation. One common type of retinoid that is used for facial psoriasis is acitretin.[8]
    • This medication should not be taken if you are pregnant or breastfeeding.
    • Retinoids may increase your sensitivity to sunlight. Always use sunscreen before going outside while you are using retinoid creams.
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Method 2
Method 2 of 4:

Getting Phototherapy

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    Treat psoriasis with UVB therapy. Ultraviolet B (UVB) therapy slows skin cell production, and may reduce the scale and dead skin buildup that is often associated with psoriasis. This therapy involves exposing affected skin to ultraviolet light for a brief period of time. The frequency of these treatments may depend on the condition of your skin or the type of UVB treatment. UVB therapy can be used to treat psoriasis that resists other forms of treatment.[9]
    • Types of UVB therapy include broadband UVB therapy, narrow band UVB therapy, or limited daily exposure to natural sunlight (following your doctor's recommendations).
    • Any type of UVB therapy may result in skin irritation or burns. Your doctor may recommend moisturizer or other topical treatments to reduce the severity of these side effects.
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    Use psoralen plus ultraviolet A (PUVA) for severe psoriasis. For severe or hard-to-treat psoriasis, your doctor may recommend PUVA treatment, which combines a medication (psoralen) with exposure to UVA light. Psoralen helps UVA light penetrate deep into your skin in order to slow down the growth of new skin cells.[10]
    • Psoralen may be administered as an oral medication (in pill or tablet form) or as a topical treatment.
    • PUVA treatment may result in more severe side effects than UVB therapy, including nausea, headaches, and skin irritation. PUVA therapy may also increase your risk of developing skin cancer and cataracts.
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    Get combination light therapy. Sometimes phototherapy is combined with other forms of treatment. For example, your doctor may recommend combining UVB therapy with topical coal tar. The coal tar not only helps ease symptoms of psoriasis, but it can make your skin more receptive to UVB radiation.[11]
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Method 3
Method 3 of 4:

Using Systemic Medicines

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    Treat psoriasis with methotrexate. In addition to topical treatments, your doctor may prescribe an oral or injected medication, especially if your psoriasis is severe. One commonly prescribed medication for psoriasis is methotrexate. This is an anti-inflammatory medication that is taken either in pill form or as an injection. Most patients take it weekly in tablet form.[12]
    • Do not use methotrexate if you are pregnant or trying to conceive. Methotrexate can seriously harm a developing fetus, and can also damage sperm cells.
    • Long-term use of methotrexate can damage your liver. Do not use methotrexate if you have liver disease, and never use it in combination with alcohol.
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    Take cyclosporin. This is a drug that suppresses the immune system and reduces the inflammation associated with psoriasis. It is usually taken daily in pill form. Cyclosporine can cause kidney damage and may increase your risk of infectious diseases and cancer. It should only be taken under your doctor's close supervision, over a relatively short period of time.[13]
    • Your blood pressure and kidney function should be monitored while you are on this medication.
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    Use an oral retinoid medication for severe psoriasis. Oral retinoids, like acitretin, may be effective against severe psoriasis that does not respond to other types of treatment. However, retinoids can cause unpleasant side effects, such as cracked and inflamed lips, hair loss, or (in rare cases) liver damage. They are also extremely harmful to a developing fetus.[14]
    • If you are planning to become pregnant, you must wait at least three years after taking an oral retinoid before trying to conceive.
    • Oral retinoids have not been shown to cause mutations in sperm cells, so it is safe to try to father a child while taking retinoids.[15]
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    Take a biologic agent. These medications are made from natural materials, such as plants or microorganisms, and are sometimes known as biological response modifiers or targeted therapies. They interact with specific parts of the immune system, stopping it from attacking the skin and causing inflammation. While these medications can be effective against severe or stubborn psoriasis, they can also put you at serious risk for developing life-threatening infections. Some common biologic agents that are prescribed for facial psoriasis include:[16]
    • Infliximab (Remicade)
    • Etanercept (Enbrel)
    • Adalimumab (Humira)
    • Ustekinumab (Stelara)
    • Secukinumab (Cosentxy)
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Method 4
Method 4 of 4:

Making Lifestyle Changes

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    Wash your face every day. Regular washing can help calm your skin and relieve the itching, dryness, and inflammation associated with psoriasis. Wash your face with lukewarm water, and use a gentle cleanser formulated for dry or sensitive skin, like Cetaphil or Cerave. Make sure to moisturize with a rich, hydrating emollient or moisturizer when you are done.[17]
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    Avoid things that trigger psoriasis symptoms. Different things trigger psoriasis flare-ups in different people. Take care to avoid anything that might aggravate your psoriasis symptoms, if possible. Common triggers include:[18]
    • Stress
    • Smoking
    • Excessive sun exposure
    • Anything that might injure or irritate your skin
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    Cut back on alcohol. Alcohol consumption is dehydrating, and alcohol can reduce the effectiveness of many psoriasis treatments. Alcohol can also interact dangerously with some medications that are used to treat psoriasis. Try to keep your alcohol consumption to a minimum, or eliminate alcohol altogether if you are taking a medication like methotrexate.
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    Adopt a healthy diet. There is some evidence that psoriasis symptoms can be reduced through weight management and a healthy diet. It is possible that low calorie diets, or diets high in fruits, vegetables, and lean proteins, like the Mediterranean diet, can help minimize psoriasis symptoms.[19]
    • Psoriasis may also respond to some dietary supplements, like fish oil and vitamin D.
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    Stay active. Physical activity may also help reduce psoriasis symptoms, although it is unclear exactly why. Both exposure to sunlight and weight management can minimize the effects of psoriasis, so getting exercise outdoors may help reduce some of your symptoms.[20]
    • Ask your doctor if you have any questions about what kind of exercise or physical activity is appropriate for you.
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References

  1. ↑ http://www.nhs.uk/Conditions/Psoriasis/Pages/treatment.aspx
  2. ↑ http://www.nhs.uk/Conditions/Psoriasis/Pages/treatment.aspx
  3. ↑ http://www.nhs.uk/conditions/Corticosteroid-preparations-(topical)/Pages/Introduction.aspx
  4. ↑ https://dermnetnz.org/topics/psoriasis
  5. ↑ http://www.nhs.uk/Conditions/Psoriasis/Pages/treatment.aspx
  6. ↑ https://www.ncbi.nlm.nih.gov/books/NBK558995/
  7. ↑ http://www.aafp.org/afp/1999/0215/p957.html
  8. ↑ https://my.clevelandclinic.org/health/diseases/6866-psoriasis
  9. ↑ https://dermnetnz.org/topics/psoriasis
  1. ↑ https://www.aad.org/public/diseases/psoriasis/treatment/medications/phototherapy
  2. ↑ http://www.nhs.uk/Conditions/Psoriasis/Pages/treatment.aspx
  3. ↑ https://www.niams.nih.gov/health-topics/psoriasis/diagnosis-treatment-and-steps-to-take
  4. ↑ https://www.aad.org/public/diseases/psoriasis/treatment/medications/cyclosporine
  5. ↑ https://www.aad.org/public/diseases/psoriasis/treatment/medications/oral-retinoids
  6. ↑ http://www.nhs.uk/Conditions/Psoriasis/Pages/treatment.aspx
  7. ↑ https://dermnetnz.org/topics/psoriasis
  8. ↑ http://www.mayoclinic.org/diseases-conditions/psoriasis/manage/ptc-20317613
  9. ↑ https://www.aad.org/public/diseases/psoriasis/triggers/flares
  10. ↑ http://emedicine.medscape.com/article/1943419-treatment#d5
  11. ↑ http://emedicine.medscape.com/article/1943419-treatment#d6

About This Article

Daniel Wozniczka, MD, MPH
Medically reviewed by:
Daniel Wozniczka, MD, MPH
Internal Medicine Physician
This article was medically reviewed by Daniel Wozniczka, MD, MPH. Dr. Wozniczka is an Internal Medicine Physician, who is focused on the intersection of medicine, economics, and policy. He has global healthcare experience in Sub Saharan Africa, Eastern Europe, and Southeast Asia. He serves currently as a Lieutenant Commander in the U.S. Public Health Service and a Medical Officer for the Epidemic Intelligence Service in the CDC. He completed his MD at Jagiellonian University in 2014, and also holds an MBA and Masters in Public Health from the University of Illinois at Chicago. This article has been viewed 44,954 times.
30 votes - 79%
Co-authors: 13
Updated: August 5, 2022
Views: 44,954
Categories: Featured Articles | Psoriasis

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

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