Psoriasis on the Face, Ears and Eyelids: Treatment and What to Avoid
Why facial psoriasis needs gentler treatment, and what helps on the hairline, eyebrows, ears and eyelids.
Part of our psoriasis guide.
Get urgent help first. Call 999 or go to A&E if your skin suddenly becomes red and inflamed over most of your body, or you have widespread pus-filled spots, especially with a fever, chills or feeling very unwell. These can be signs of erythrodermic or generalised pustular psoriasis, which are emergencies. See a GP soon if you have painful, swollen joints. Online treatment isn't suitable in these situations.
Key fact: psoriasis on the face is treated with a fragrance-free emollient and a mild or moderate steroid for no more than 2 weeks at a time. Potent steroids, Enstilar, Dovobet and coal tar aren't used on the face.
Adults only online, and not in pregnancy or breastfeeding. Access Doctor's online psoriasis service is for adults aged 18 and over, and can't supply treatment if you're pregnant or breastfeeding: your GP or midwife can help. Children with psoriasis should see their GP.
Why psoriasis on the face is different
The skin on the face, ears and eyelids is thin and absorbs medicines easily, so it's more prone to side effects such as thinning, redness and rosacea-like rashes. Psoriasis here also tends to be thinner and less scaly than on the body. That's why treatment is gentler and shorter.
Our online service doesn't supply psoriasis treatment for the face, genitals or skin folds. These areas need an in-person assessment and gentler treatment, so please see your GP or pharmacist. We can help with psoriasis on the body, arms and legs.
Where it appears on the face
- Hairline and forehead: often an extension of scalp psoriasis.
- Eyebrows and sides of the nose: can overlap with seborrhoeic dermatitis ("sebopsoriasis").
- Behind and in the ears: scaly, sometimes cracked or sore skin; the ear canal can become blocked with scale.
- Eyelids: red, dry, scaly lids; uncommon but uncomfortable.
- Lips and mouth: rare; usually needs a doctor to confirm the diagnosis.
On brown and black skin, facial patches may look darker or greyish rather than red. See psoriasis on black and brown skin.
How psoriasis on the face is treated
1
Emollient and gentle cleansing
Use a fragrance-free emollient as a moisturiser and soap substitute.
2
Mild or moderate steroid, up to 2 weeks
NICE recommends a mild or moderate steroid (such as hydrocortisone or clobetasone) once or twice a day for no more than 2 weeks, then a break. Steroids on the face should be used for only 1 to 2 weeks a month.
3
If it doesn't settle
A specialist, or a GP with experience, may prescribe a non-steroid cream or ointment (a calcineurin inhibitor such as tacrolimus), which is used off-label for facial psoriasis.
4
Treat the scalp too
If psoriasis spreads from the scalp to the hairline or ears, treating the scalp helps. See scalp psoriasis treatment.
Avoid on the face: potent and very potent steroids (Betnovate, Elocon, Dermovate), Enstilar and Dovobet, coal tar, dithranol and calcipotriol, which can irritate thin skin.
Psoriasis in and behind the ears
Psoriasis behind the ears often comes with scalp psoriasis. In the ear canal, scale can build up and block hearing or cause itching. Don't use cotton buds or put creams or drops in the ear canal yourself. A GP or practice nurse can check the ear and prescribe suitable drops or a mild steroid, or arrange removal of built-up scale.
Psoriasis on the eyelids
Eyelid skin is the thinnest on the body, and steroids near the eye can raise the risk of glaucoma and cataract with long use. Eyelid psoriasis should always be treated on a doctor's advice. Get help the same day if your eye is painful, red, sensitive to light or your vision changes.
Is it psoriasis, eczema or something else?
Several rashes look similar on the face: seborrhoeic dermatitis, eczema, rosacea and lupus. A GP can tell them apart. Our guide to psoriasis vs eczema explains the main differences.
UK safety and reporting side effects
Prescription psoriasis treatments are only supplied after a GPhC-registered pharmacist independent prescriber reviews your consultation, including where your psoriasis is, how much skin it covers and what you have used before. Always read the patient information leaflet. Since 2024, UK steroid packs show their strength on the front (mild, moderate, strong or very strong). The MHRA advises using topical steroids for the shortest time needed, and to tell a healthcare professional if your skin flares badly after you stop a steroid you have used for a long time, which can be a topical steroid withdrawal reaction.
If you think you've had a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme.
Getting help with psoriasis
For psoriasis on the face, ears or eyelids, please see your GP or pharmacist. If you also have psoriasis on your body, arms or legs, our pharmacist prescribers can assess that online: see our psoriasis treatment page and our psoriasis treatment options guide.
Frequently Asked Questions
How do you get rid of psoriasis on your face fast?
A mild or moderate steroid prescribed for up to 2 weeks often settles facial psoriasis quickly, alongside a fragrance-free emollient. Don't use strong body creams on your face, which can cause lasting damage.
What cream is best for psoriasis on the face?
A mild or moderate steroid such as hydrocortisone or clobetasone for short courses, and a fragrance-free emollient. If that doesn't work, a specialist may prescribe a non-steroid ointment such as tacrolimus.
Can I use Betnovate or Dermovate on my face?
No, not for psoriasis unless a dermatologist specifically advises it. They're potent and very potent steroids that can thin facial skin and cause rosacea-like rashes.
What triggers psoriasis on the face?
The same triggers as elsewhere: stress, infections, skin injury, cold weather and some medicines. Facial psoriasis often comes with scalp psoriasis, so treating the scalp can help.
How do I treat psoriasis in my ear canal?
See a GP or practice nurse rather than treating it yourself. They can check the ear, prescribe suitable drops or a mild steroid, and arrange removal of any built-up scale. Don't use cotton buds.
References
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
- NICE Clinical Knowledge Summaries. Psoriasis. cks.nice.org.uk
- Joint Formulary Committee. British National Formulary: topical corticosteroids. bnf.nice.org.uk
- British Association of Dermatologists. Psoriasis: an overview (patient information leaflet), August 2023. skinhealthinfo.org.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Prescription psoriasis treatments need a clinical consultation before they can be supplied. If your skin is red all over, you have widespread pus spots, a fever or you feel unwell, seek medical advice the same day. In a medical emergency, call 999.