Psoriasis is an immune-mediated disease in which skin cells multiply and move to the skin’s surface too quickly, building up and causing uncomfortable rashes and inflamed skin. This chronic condition can cause thick patches or plaques that appear scaly, dry, and inflamed and may affect several parts of the body. Most commonly affected are the face, scalp, elbows, and knees, but skin on any part of the body can be affected, and even fingernails and toenails may be involved. This article will concentrate on the sensitive matter of psoriasis on the face, as this condition can greatly affect your self-esteem and overall quality of life. Along with the types, causes, and holistic approaches to managing the impact of this condition’s inflammatory response, this piece will focus on 6 hallmark symptoms of psoriasis on the face. (Source)

What Is Psoriasis?

Psoriasis is an immune-mediated disease, meaning it is inflammatory and is associated with an abnormal immune response that has no clear cause. Although the most visible symptoms of psoriasis are irritation and plaques on the skin, elevated levels of cytokines, or pro-inflammatory signaling proteins, and other markers of inflammation are found throughout the body in people with the condition. Studies have found that moderate to severe psoriasis is often accompanied by inflammation of the liver, joints and tendons, and blood vessels that may be subclinical, or without noticeable symptoms. This means psoriasis is not just a skin condition, but a systemic disease. (Source, Source)

Nevertheless, it is psoriasis’ effect on the skin that is most obvious. Normally, it takes about a month for skin cells generated in the lower skin layers to migrate up to the surface, die, and be shed, but with psoriasis they rise to the surface within 3 or 4 days. Instead of shedding, or falling off, the cells pile up, forming thick, uncomfortable lesions called plaques. Diagnosing psoriasis may be difficult, as its symptoms often overlap with those of other skin disorders. Your health care provider may need to take a skin sample that can be examined under a microscope.

Because the chronic inflammation and immune dysfunction associated with psoriasis goes far beyond the skin, having the condition makes you more likely to develop other autoimmune or immune-mediated diseases. Psoriasis is associated with:

• systemic lupus erythematosus
• autoimmune thyroid disease
• celiac disease
• inflammatory bowel disease
• multiple sclerosis
• Sjögren's syndrome
• vitiligo
• alopecia areata

(Source, Source)

Affecting adults more often than children, psoriasis can actually occur at any age. Research has shown the average onset of psoriasis may occur between the ages of 15 and 20, and can peak between 55 and 60 years of age. Much like other immune-mediated diseases, psoriasis is characterized by periods of flares and remission that may vary with stress, traumatic events, and lifestyle factors such as smoking, heavy alcohol consumption, or excess weight. (Source)

Although there are many types of psoriasis, the most common type is plaque psoriasis that presents as white, silvery, scaly plaques found on the abdomen, arms, legs, and scalp. Psoriasis, which is not contagious and cannot be passed from person to person, affects people worldwide, with about 2%–3% of people affected in the United States. Though a cure for psoriasis is not available, there are many possible means of managing symptoms of this systemic disease to improve quality of life for people with psoriasis. (Source, Source)

Types of Facial Psoriasis

Psoriasis of the face is characterized by having one or more thick, red, and dry patches of skin on the face that do not go away. It may affect the scalp, forehead, hairline, eyes, eyelids, eyebrows, ears, the area between the nose and upper lip, and the inside and outside of the mouth. Facial psoriasis is usually quite mild and only occurs in about half of those with psoriatic disease. It’s uncommon to have psoriasis that affects only the face; most people with this rash on their face also have it somewhere else on their body. Because the skin on and around the face is so sensitive, it can be a difficult area to treat. 

There are 3 types of facial psoriasis, known as hairline psoriasis, sebopsoriasis, and true facial psoriasis. (Source, Source)

Hairline Psoriasis

Also known as peripherofacial psoriasis, this is psoriasis of the scalp that extends beyond the hairline onto the face. Red and thickened plaques may affect the skin on the forehead and around the ears. (Source)

Sebopsoriasis

Also known as centrofacial psoriasis, this type of psoriasis may also affect the hairline in addition to the eyelids, eyebrows, beard area, and the space between the nose and upper lip. The symptoms of sebopsoriasis are a combination of two overlapping conditions, psoriasis and seborrheic dermatitis. With time, it may become clear that symptoms are being caused by just one of these conditions. (Source, Source)

True Facial Psoriasis

Also known as mixed psoriasis, this type of psoriasis can affect any area of the face and is characterized by red and scaling plaques. True facial psoriasis presents as plaques that are symmetrical and distinguishable most of the time. (Source)

Causes of Facial Psoriasis

The exact cause of facial psoriasis isn’t yet known, but certain factors may influence disease symptoms. Research has found genetic predisposition and environmental factors may combine to trigger the immune system malfunction leading to psoriasis. Your risk of developing psoriasis could be heightened if you are genetically predisposed to the disorder, especially if you have family members that suffer from it. Lifestyle factors that may contribute to disease onset or make your psoriasis worse include:

• infections, especially streptococcus and HIV
• medicines, specifically those that manage heart disease, malaria, and mental health conditions
• smoking
• excess weight

• sun exposure
• skin bacteria, specifically the yeast Malassezia

(Source, Source)

6 Hallmark Symptoms of Facial Psoriasis

There are many different symptoms that may accompany psoriasis, and while some of them are unique to psoriasis alone, some mimic those of other skin conditions. Due to this challenge, psoriasis may be difficult to diagnose. The symptoms you experience will depend on what region of your face the psoriasis affects, but hallmark symptoms anyone may experience include:

1. patches of skin or plaques of thick skin with silvery-white scales
2. scaling that itches or burns
3. red and irritated skin
4. dry, cracked skin that may bleed when scratched
5. flaking
6. discoloration

(Source)

Areas Affected by Facial Psoriasis

Psoriasis of the face can involve the scalp, eyes, ears, and mouth. Symptoms of psoriasis in any particular facial region may include: 

• scaling that looks like dandruff 
• scaling that creates a thick skin plaque covering the affected area
• itchiness
• flaky patches
• redness
• discoloration
• dryness
• discomfort
• impaired vision

Scalp Psoriasis

Scalp psoriasis can be itchy and bothersome as the scalp, forehead, and hairline may all be affected. There are many topical treatments available over the counter, such as shampoos, topical therapy creams, and corticosteroids, that can help manage the itching and flakiness of scalp psoriasis.

Salicylic acid and tar made from coal or wood are two main ingredients to look for in scalp psoriasis products. Salicylic acid is useful to soften and remove plaques and scales, and tar is utilized to decrease inflammatory symptoms of itching and scaling as well as slow down new skin growth. Seeking out the care of a dermatologist or rheumatologist may help you get a proper diagnosis and begin effectively treating this chronic condition. (Source)

Psoriasis of the Eyes

If you are affected by psoriasis around your eyes, your symptoms may involve your eyelids and eyebrows as well. Fortunately, this form of psoriasis is rare. The skin is thin and sensitive around the eyes, and treatment of this delicate area may involve topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment. Both of these options have shown to be effective in treating this sensitive area, especially the eyelids. Find the proper provider, a dermatologist or ophthalmologist, to determine how to manage and treat your condition best. (Source, Source)

Psoriasis of the Ears

Psoriasis may affect skin around or behind the ear, or even in the ear canal, where scaling can build up and block your hearing. See an ear, nose, and throat specialist (ENT) for help with scaling in the ear canal, as trying to clear it yourself can make it worse. The ears are a sensitive area but ear psoriasis can be treated with creams or ointments, ultraviolet light therapy, oral medicine, or biological treatments. (Source, Source)

Psoriasis of the Mouth

It is possible but quite rare for psoriasis to affect the lips, gums, tongue, or the inside of the cheek. Psoriasis of the mouth does have symptoms similar to other facial psoriasis conditions but also may include ulcers, peeling gums, pustules, and irregular patches of red with white or yellow borders on the tongue. Mouth psoriasis may be treated with topical corticosteroids or antiseptic mouth rinses. Systemic medications to treat the condition include methotrexate, acitretin, and ciclosporin. If you struggle with symptoms of oral psoriasis, see a dentist or dermatologist for help. (Source, Source)

How To Manage Psoriasis Symptoms Naturally

While you may need to seek a medical treatment plan for your psoriatic disease from qualified health care providers, there may be options to help you manage this chronic condition naturally as well. To avoid unexpected side effects or possible interactions with your medical treatment, be sure to talk to your providers before making changes to your care plan. A natural approach to reducing common symptoms of psoriasis may include diet, soothing topical agents, herbal remedies, and other alternative topical therapy approaches. 

Diet

Though your diet may not cause psoriasis, adopting an anti-inflammatory eating style can reduce systemic inflammation that may be the culprit of worsening symptoms. Certain foods are inflammatory in nature, such as processed foods high in refined carbohydrates, sugar, fat, and calories, as well as sugary drinks, fried food, dairy, and gluten. Including fresh, whole, and lean foods may reduce overall inflammation and lessen your facial psoriasis symptoms. Try to consume nutrient-dense foods high in vitamins and minerals to increase the anti-inflammatory effects of a dietary approach. Include the following foods to support the healthy production of skin cells:

• turmeric
• fish and other lean protein sources
• colorful and diverse fruits and vegetables
• healthy fats including olive oil, ghee, and coconut oil

(Source)

Herbal Remedies

Herbal remedies applied to the skin may be useful in managing symptoms of psoriasis on the face, but keep in mind your face has thin and sensitive skin. To avoid reactions on large areas, try a small amount first to see how your skin reacts. Herbal remedies applied as topical medications in an ointment, solution, or cream include: 

• aloe vera gel or cream to reduce symptoms of redness and scaling
• oregon grape added to a cream to reduce overall mild to moderate psoriasis symptoms
• tea tree oil shampoos or sprays to help manage the appearance of psoriasis of the scalp
• capsaicin in a cream or ointment to reduce inflammation, redness, and scaling, and help block pain from psoriasis

(Source)

Soothing Topicals

In addition to herbal remedies applied to the skin, other soothing topicals include:

• apple cider vinegar diluted with water to help calm the itch associated with scalp psoriasis
• oat paste to reduce itching and redness
• Dead Sea salts to help remove scales and decrease itching 

(Source)

Other Alternative Therapies

In addition to the therapies listed above, other alternative methods of managing psoriasis symptoms may include:

• light therapy that exposes affected skin to sunlight or special UVA or UVB lights
• fish oil taken internally or applied topically 
• vitamin D through dietary intake or supplementation
• acupuncture

(Source, Source)

The Bottom Line

Psoriasis on the face can not only be uncomfortable, but can reduce your quality of life. Though psoriasis may be difficult to diagnose because it can look similar to other skin conditions, the 6 hallmark symptoms listed in this article may help you find answers you’ve been looking for to understand and manage your skin condition. If you struggle with psoriasis, dietary and lifestyle interventions may help manage your symptoms. Talking with one of our Nutritional Therapy Practitioners at WellTheory may help you identify and eliminate foods that trigger or worsen your psoriasis symptoms. Explore our high-touch care pathways to see how WellTheory can support you with a personalized dietary approach to reduce your burden of disease.