Facial Psoriasis: Which Cream to Choose?

On the face, psoriasis plaques appear on the forehead, the eyebrows, the sides of the nose, the eyelids, near the ears , or even in the beard area for men. In children, the lesions are primarily concentrated around the mouth and on the eyelids.

Note : Psoriasis lesions on the face are often confused with seborrheic dermatitis due to similar manifestations.

Facial psoriasis manifests itself through the appearance of red patches covered with white scales. These can be accompanied by pruritus (an urge to scratch) of varying intensity.

Furthermore, since facial psoriasis is highly visible, individuals are more prone to stigmatization.

If you are suffering from psoriasis on the face, there are certain recommendations that you need to adopt:

• Consulting a dermatologist:

The first step is to consult a dermatologist. With their medical expertise, the dermatologist will provide an accurate diagnosis. If you are suffering from psoriasis, they will prescribe a medication treatment tailored to your case. There are local treatments available (dermocorticoids, dermocorticoids combined with a keratolytic agent, vitamin D analogues, etc.) as well as systemic treatments for more severe cases. These treatments are generally suspensive, with a risk of relapse upon their discontinuation.

Alongside treatments, adopting a suitable routine can improve the condition of the skin.

In the case of facial psoriasis, it is preferable to cleanse the face with water only in the evening. Indeed, repeated contact of water on the skin can be irritating due to the presence of limestone and chlorine.

To best respect your skin and restore your skin barrier, use a cleanser that is gentle, soap-free and with a neutral pH or close to the pH of the skin (which is 5.5).

Once your skin is cleansed, spray thermal water or floral water on your face to remove any remaining limestone residues.

Note : If you wish to refresh your face in the morning, opt for a hydrosol or thermal water.

• Gently drying your face:

Given that psoriasis lesions worsen with friction (a phenomenon known as the Koebner effect), facial drying should be as gentle as possible. Therefore, it should ideally be done with a cotton towel, by patting.

• Apply a suitable moisturizing cream:

The more a skin is hydrated and nourished, the more it will resist external aggressions and the less likely it will be to get irritated. Moreover, moisturizing creams help to reduce skin dryness and the formation of scales.

Note : The use of a moisturizing cream is especially important for individuals undergoing medicinal treatments such as oral retinoids or phototherapy, which are particularly drying for the skin.

As mentioned earlier, establishing a routine with suitable dermo-cosmetic products can improve the condition of the skin and reduce the frequency and severity of psoriasis flare-ups. But a question arises: how to choose a face cream in the case of facial psoriasis?

A cream suitable for skin prone to psoriasis should beas simple as possible. In other words, it should not contain allergenic components. Moreover, certain active ingredients are beneficial for improving the symptoms of psoriasis:

• The nourishing active ingredients:

Even though psoriasis does not necessarily equate to dry skin, nourishing active ingredients are beneficial against the scales that cover the lesions. These will help to reduce the dead skin resulting from the excessive proliferation of keratinocytes. Among these active ingredients, we can mention the ceramides, the vegetable oils or vegetable butters (flaxseed oil, calendula macerate, shea butter).

Note : there are also other active ingredients that reduce flaking. This is the case of allantoin for example.

• Keratolytic agents:

At the site of psoriasis lesions, numerous scales or immature dead cells are observed that cannot naturally be eliminated. These are particularly visible on the face and can be a source of poor self-esteem.

Keratolytic agents (glycolic acid, salicylic acid, lactic acid, urea...) therefore allow for the effective removal of these dead cells. For instance, salicylic acid is used in psoriasis to halt severe flaking and facilitate the removal of scales.

Note : Many creams combine moisturizing agents and keratolytic agents. This dual effect is very beneficial for skin prone to psoriasis.

• The soothing active ingredients.

Psoriasis often goes hand in hand with itching. These can be particularly bothersome in daily life. Moreover, scratching exacerbates psoriasis lesions ( 5 minutesof scratching accelerates skin renewal andis enoughto reactivate psoriasis for 2 weeks!). Soothing anti-itching agents such as the bisabolol or calendula can help calm and soothe itching sensations.

• GRIFFITHS C. E. M. & al. Psoriasis : epidemiology, clinical features, and quality of life. Annals of the Rheumatic Diseases (2005).

• FANG J. Y. & al. Apoptotic or antiproliferative activity of natural products against keratinocytes for the treatment of psoriasis. International Journal Of Molecular Sciences (2019).