Psoriasis can start anywhere on the body. In rare cases, it can settle on the face. Dr Perrussel, dermatologist, venereologist and member of the National Union of Dermatologists, gives us his advice on how to best treat it.

Psoriasis affects the life of 2% of the French population . If this disease is absolutely not contagious, it is nonetheless very discriminating . This inflammatory pathology of the skin is characterized by the appearance of thick patches of skin which flake off.

Psoriasis: how to recognize it?

These plaques can appear in different places of the human body:

  • the hair ( scalp psoriasis),
  • the feet and hands ( palmoplantar psoriasis),
  • the genital area (genital psoriasis),
  • folds ( reverse psoriasis),
  • the nails,
  • elbows and knees,
  • the ears,
  • back and buttocks,
  • the face.

What is facial psoriasis?

The psoriasis face is expressed in different ways: the injuries take place on the forehead , the eyebrows , the sides of the nose , but the beard , the cheeks or eyelids . The patches are smaller than with classic psoriasis in different parts of the body, but they are still red and scaly , and rather poorly placed.

The psoriasis face is a rare location relative to the body.

Photo of psoriasis on the face: red patches on the nose, forehead and cheeks

Several forms of facial psoriasis

There are 3 types of facial psoriasis:

  • psoriasis of the edge of the hair: this form of psoriasis is often grouped with psoriasis of the scalp,
  • the psoriasis of the face itself: this psoriasis appears in the form of very limited red spots, with fine dry scales, or more oily
  • sebo-psoriasis: it is similar to another skin disease called seborrheic dermatitis

Psoriasis of the face: not to be confused with seborrheic dermatitis

Psoriasis of the face should not be confused with a chronic disease: dermatitis-seborrheic . When combined with psoriasis of the body, it is sometimes referred to as sebo-psoriasis .

Seborrheic dermatitis manifests itself as oily scales on the forehead , eyebrows and wings of the nose . In seborrheic dermatitis, the scales are thinner. Patients with sebo-psoriasis have patches around the scalp and in the middle area of ​​the body. “On the face, psoriasis can also develop in the wing of a butterfly, ” says Dr Marc Perrussel, dermatologist, venereologist and member of the National Union of Dermatologists.

What symptoms to recognize psoriasis of the face?

Psoriasis of the face is more common in children than in adults

According to the France Psoriasis Association , facial psoriasis is twice as common in children than in adults.

In children, the lesions are localized more:

  • on the eyelids,
  • around the mouth.

Symptoms of facial psoriasis in adults

In adults, involvement of the face is most often expressed by small fatty scales on:

  • the forehead,
  • the eyebrows,
  • the wings of the nose.

In 18% of cases , this form is also found in the external auditory canal . A rare location, but very troublesome for patients. They often suffer from severe skin irritation that should be relieved.

What parts of the face does psoriasis affect? The opinion of Dr Marc Perrussel, dermatologist

“Psoriasis can also develop on the face of patients. In this case, it mainly affects the forehead , nose and chin . When it is associated with psoriasis of the body, it is called sebo-psoriasis ”.

What are the complications of facial psoriasis?

People with psoriasis of the face usually suffer from:

  • of itchingof the skin or pruritus (irritating tingling sensation that makes you want to scratch)
  • nail psoriasismore often than others
  • more extensiveform of psoriasis , with higher severity scores.

Psoriasis of the face being difficult to live with, it also causes quite serious psychological complications. Some people can suffer from depression .

What treatments to treat psoriasis of the face?

There are several forms of treatment depending on the severity.

Local treatments for occasional mild forms of facial psoriasis: topical corticosteroids and vitamin D3 analogues

  • Topical corticosteroids: cortisone creams, ointments or lotions against itching

At the onset of psoriasis (or mild psoriasis) of the face , when the plaques are lighter and occur occasionally, they can be treated with a weak topical corticosteroid .

The corticosteroids are creams, ointments or cortisone lotions that are used for their anti-inflammatory to the skin. Topical corticosteroids are classified according to their potency into four classes (from the lightest to the most potent: I, II, III, IV).

With this local treatment at a skin doctor in south delhi, derived from cortisone, the improvement is rapid. Use should be limited to a short time. However, topical corticosteroids can also cause other skin concerns to appear: rosacea , rosacea , etc. This therapeutic class, aggressive for the skin , can alter the skin barrier.

  • Vitamin D3 analogues

The analogues of vitamin D3 are also applied locally on the lesions. According to France Psoriasis: “They act on the multiplication and maturation of keratinocytes . In common forms of plaque psoriasis , the local application to the lesions of an ointment based on analogues of vitamin D, is the treatment of first choice. Calcipotriol and calcitriol are applied twice daily and tacalcitol once daily. ”

Note: The combination of vitamin D3 analogues (calcipotriol) and topical corticosteroids: this is a very effective combination used in a daily application during the first month, then in the form of a maintenance treatment at a reasonable rate. of an application on weekends each week to avoid recurrence.

Immunosuppressants to treat more severe and recurring facial psoriasis

If moderate facial psoriasis is treated relatively well, it is more complicated for very recurrent or more severe forms . Indeed, this type of psoriasis can be treated with an anti-inflammatory , such as Protopic . An effective treatment prescribed by a dermatologist, but which, unlike topical corticosteroids, does not generate dependence.