Psoriasis: facial psoriasis

LAST UPDATED: Nov 18, 2021

Introduction

This chapter discusses the management of facial psoriasis and is set out as follows:

Clinical findings
Images
Management

Clinical findings

The face is a relatively uncommon site
Patients occasionally present with well-demarcated plaques. A more frequent finding is similar to that seen in seborrhoeic dermatitis, indeed the two can be very difficult to tell apart and as such this presentation is sometime referred to as sebo-psoriasis

Clinical Images

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Same patient as figure 3 - treated with…

Management

The face, along with the hands and genitalia represent important cosmetic areas and the presence of psoriasis at these sites produces disproportionate distress. Improving psoriasis at these sites is of great importance.

Emollients are required by all patients

Active treatments include:
- The most effective treatment is Tacrolimus 0.1% ointment OD-BD
- The vitamin D analogues - Curatoderm ® lotion / ointment and Silkis ® ointment
- Although weaker topical steroids such as 1% Hydrocortisone or Eumovate ® can be used, there is a risk of atrophy and so they should only be used on an intermittent basis. Eumovate ® can be safely used as an effective treatment for the hairline and ears

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Image Rights - The PCDS would like to thank Dermatoweb, DermQuest (Galderma), and others who have contributed images. All named individuals and organisations maintain copyright for the relevant images.