Psoriasis on the face.

Psoriasis on the face is a chronic and often recurrent skin disease, classified as an autoimmune dermatosis. Its cause is the improper functioning of the immune system. In the course of the disease, T lymphocytes attack the skin's own cells, causing inflammation. As a result, skin cells multiply too quickly, with cytokines playing a key role in the whole process.

Genes play a major role in the development of psoriasis, making this disease often hereditary. However, various external factors can also influence its development:

• intense or chronic stress,
• infections,
• skin injuries,
• hormonal changes,
• unhealthy lifestyle habits, such as smoking or alcohol abuse.

Symptoms of psoriasis on the face result from an inflammatory condition that causes rapid skin cell proliferation. Characteristic red patches appear on the skin, which can take the form of bumps and then transform into plaques. Typically, they are covered with silvery, less commonly reddish, scales.

These eruptions often cause a range of unpleasant sensations:

• intense itching,
• burning,
• pain,
• skin dryness,
• irritation,
• burning sensation.

The eruptions usually occur on the forehead, cheeks, eyelids, and around the mouth. Although the most common form is plaque psoriasis, more severe variants of this disease can also appear on the face. Pustular psoriasis is characterized by pus-filled blisters, and erythrodermic psoriasis causes extensive redness of the skin.

A dermatologist diagnoses psoriasis on the face during a visit, carefully evaluating skin symptoms and their location. An important part of the diagnosis is also the family history. A crucial aspect is the differential diagnosis, which helps to rule out other conditions.

Psoriasis needs to be distinguished from seborrheic dermatitis (SD), characterized by greasy scales and excessive sebum secretion, often caused by the yeast Malassezia. It is also necessary to exclude atopic dermatitis (AD) - often associated with a damaged skin barrier and allergies. If the diagnosis is challenging, the doctor may order a skin biopsy (histopathological examination). Occasionally, vitamin D level tests are conducted as supportive analyses.

Treatment of facial psoriasis requires a comprehensive approach tailored to the severity of symptoms. It includes local and systemic therapies, often supported by complementary methods.

For local therapy, corticosteroid ointments are used. For delicate facial skin, calcineurin inhibitors such as tacrolimus or pimecrolimus are particularly recommended. Preparations containing vitamin D (e.g., calcipotriol) and retinoids are also effective.

In advanced cases, systemic therapy is necessary. This includes immunosuppressive drugs (e.g., methotrexate, cyclosporine) and oral retinoids (e.g., acitretin). High hopes are placed on modern biologic drugs that precisely target inflammatory processes, such as ustekinumab and adalimumab.

Complementary treatments include supportive therapies such as phototherapy (including LED light and photochemotherapy) and medical peels. Functional medicine and phenotypic therapies are also gaining importance, providing comprehensive support in combating the disease.

Daily facial care is crucial in alleviating symptoms of psoriasis. Choose hypoallergenic products for cleansing the skin. Then intensely moisturize the skin using emollients that will help rebuild its protective barrier. Look for cosmetics and dermocosmetics containing:

• hyaluronic acid,
• glycerin,
• urea,
• panthenol,
• allantoin,
• niacinamide.

Natural oils greatly support skin care:

• avocado oil,
• coconut oil,
• tea tree oil,
• hemp seed oil,
• sea buckthorn oil,
• evening primrose oil,
• sweet almond oil.

Also helpful can be: shea butter, aloe, pumpkin seed extract,

Remember also about sun protection and use cosmetics with UV filters. Always remove keratinized skin gently to avoid irritating the skin.

Diet plays an important role in treating psoriasis, helping to reduce overall inflammation in the body. A healthy anti-inflammatory diet is crucial, rich in omega-3 fatty acids (e.g., from fatty fish) and antioxidants (found in fresh fruits and vegetables).

It is also extremely important to address deficiencies in vitamins and minerals. These essential nutrients can be obtained through a well-balanced diet or, if necessary, through targeted supplementation:

• Vitamin A,
• Vitamin E,
• Vitamin D,
• Vitamin B,
• Zinc,
• Selenium.

It is worth considering various dietary patterns. The Mediterranean diet, gluten-free diet, ketogenic diet, or vegetarian diet may be helpful, but their effectiveness always requires individual evaluation and adaptation to the specific case.

Psoriasis on the face is not just a matter of aesthetics, but above all a serious health challenge. Damaged skin becomes particularly susceptible to bacterial infections. Disease-related changes on the eyelids are especially dangerous, as they can lead to serious eye problems such as conjunctivitis or eyelash loss. Similarly, eruptions around the ears can negatively affect hearing.

In addition to physical ailments, psoriasis significantly burdens mental health. Patients often experience strong stress, lose self-confidence, and are even more prone to depression or anxiety attacks. In difficult situations, the help of a psychologist and psychotherapy proves invaluable.

Effective treatment and proper skin care are the foundation that not only prevents serious complications but also minimizes the risk of disease relapse.