Psoriasis Around the Eyes: What to Do and How to Treat

About 10 percent of people who have psoriasis experience it on the eyelids or around the eyes.

The inflammatory skin condition, which produces thick, scaly patches of dryness, does not have a cure. People manage it with prescription medication, topical creams and ointments and a host of natural remedies.

Psoriasis around the eyes must be treated with extra care because of the potential for vision loss.

What Is Psoriasis?

Psoriasis is an inflammatory skin condition that causes overproduction of the body’s skin cells, leading to thick, scaly patches all over the body including around the eyes.

About 50 percent of people who have psoriasis experience it on the face, with 10 percent experiencing it around the eyes. When it shows up around the eyes, it can make them feel swollen or irritated, and it requires special attention because it can also affect your vision.

Tissues around your eyes are delicate and easily scarred. Treatments for psoriasis around the eyes need to be carefully monitored to avoid aggravating the skin and worsening the condition. 

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Symptoms of Psoriasis Around the Eyes

Symptoms of psoriasis around the eyes are like most of the symptoms of psoriasis around other parts of the body. However, psoriasis around the eyes might have a bigger impact on your daily life because of its location.

In some cases, the buildup of skin cells may lead to patches so large that you have trouble closing and opening your eyes. 

Other symptoms include:

• Red, scaly growths around the eyes 
• Dry, cracked skin that might bleed 
• Eyelid inflammation that may cause eyelashes to rub against the eye (trichiasis) 
• Pain when moving the eyelids
• Trouble opening and closing your eyelids
• Eye dryness because scales pull the eyelid outward  
• Scales that cover the eyelashes 
• An itchy or burning feeling around the eyes 

Causes of Psoriasis Around the Eyes

There is no definitive cause of psoriasis. However, a disorder of the immune system and genetics are contributing factors even if there may be no family history of the disease.

Certain triggers can cause symptoms to appear, flare-up, or even become more severe. Among the triggers are:  

• Stress
• Illness, specifically immune disorders such as HIV and throat infections such as strep throat 
• Skin injuries such as sunburns, bug bites, and some vaccinations 
• Weather such as less light and decreased humidity leading to dryer heated air indoors
• Medications such as beta-blockers used to control heart rate or high blood pressure and lithium used to treat bipolar disorder
• Allergies, excess alcohol intake, smoking, environmental factors, and certain foods
• Obesity

Treatment Options for Psoriasis Around the Eyes

Any malady that affects sensitive areas around the eyes should be managed carefully. Take care not to rub or scratch your eyes as this could worsen your symptoms or lead to infection.

Although it cannot be cured, psoriasis can be managed, including when it appears around your eyes. The aim is to ease any symptoms you have and help slow the growth of skin cells and reduce inflammation. Treatments are broken into medical treatments and home remedies

Home Remedies and Alternative Treatments for Psoriasis Around the Eyes

The two best treatments for eye-related psoriasis are to use warm compresses on your eyes and eyelid wipes.

• Warm compress. Put a warm clean damp washcloth over your eyes for a minute or so to help loosen the flakes stuck on your eyelashes. 
• Eyelid wipes. Soak a cotton swab in baby shampoo diluted in warm water every day and use it to gently wipe the base of your eyelashes for about 15 seconds. This will soothe the skin, remove the scales, and help keep the area clean and prevent infection.

Psoriasis is a multi-system condition and affects more than the area where symptoms appear. A person with psoriasis might benefit from treating the whole body. A review from 2018 concluded that the following alternative medications or complementary therapies may help people with psoriasis.

• Curcumin, present in turmeric 
• Indigo Naturalis
• Meditation
• Acupuncture
• Fish oil 

Medical Treatments for Psoriasis Around the Eyes

Topical treatments: Several types of ointments and creams can effectively treat mild cases of psoriasis. However, not all of them can be used on the delicate skin around the eyes. An overuse of topical treatment around the eyes can also increase your risk of cataracts and glaucoma. Your doctor should guide you on which topical treatment you can use safely. Some of the safe treatments that may be recommended include:

• Tacrolimus (Protopic)
• Pimecrolimus (Elidel)
• Some steroid ointments

Systemic medications: Your doctor may also prescribe injectable or oral medications if other treatments do not work for your psoriasis. Typically, these medications have side effects and should not be used on a long-term basis. most doctors only use them for initial treatment or for a recurring case of psoriasis. These medications include:

• Oral steroids
• Methotrexate
• Oral retinoids such as acitretin

Phototherapy (light therapy): Natural and artificial ultraviolet B light (UVB) can help ease the symptoms of psoriasis around the eyes. However, it is important to note that overexposure to UV or UVB light can worsen the symptoms of psoriasis. Overexposure can also increase your risk of skin damage and skin cancer. As such, make sure you consult with your doctor before beginning phototherapy.

Biologic therapy: This is a novel treatment approach that targets specific components of the immune system. This treatment appears to help reduce the number of flares and the severity of symptoms associated with psoriasis. When deciding whether to prescribe a biologic drug and which, your doctor will consider the type of Psoriasis you have and the severity of your symptoms. The current guidelines recommend that a biologic drug should be prescribed for moderate-to-severe symptoms of psoriasis.

Eye Complications Associated with Psoriasis

If you have psoriasis around the eyes, it is a good idea to see a dermatologist and an ophthalmologist regularly. Your eye specialist will check for complications that can happen more often with psoriasis including:

• Uveitis: Swelling in the front, middle, or back of the eye resulting in inflammation, dryness, and discomfort. 
• Dry eye: A common complaint affecting 1 in 5 people with psoriasis. 
• Conjunctivitis: Also called pink eye, this is an inflammation of the moist tissue covering the white of the eye. Up to two-thirds of people with psoriasis also have this condition. 
• Blepharitis: Swelling or redness of the eyelids.

Your doctor may prescribe topical creams, oral steroids or light therapy to help with psoriasis. However, these treatments can have adverse effects. 

A review from 2017 found that using steroids around the eyes can result in cataracts, glaucoma, and even vision loss. It is not clear if this is due to treatments or if psoriasis itself makes you more susceptible to these conditions. It is therefore important to follow your doctor’s instructions and recommendations when using these treatments.

Outlook for People with Psoriasis Around the Eyes

Although psoriasis can be a challenging condition to live with, especially if it affects the eyelids, there are treatments available that can ease your symptoms and treat the condition. Work with your doctor to find a treatment plan that eases your symptoms and be sure to follow your treatment plan closely.

Your doctor may need to adjust your treatments from time to time depending on your response. It is also important to note that, although makeup can reduce the appearance of scales and redness, be sure to choose makeup for sensitive skin.

Makeup might also interfere with the topical treatments you might be using and further irritate the eyelid.

Talk to your doctor or dermatologist about the best ways to use makeup. Lastly, make sure you practice exceptional hygiene. Although this will not prevent psoriasis, it will help avoid infections that are common while taking certain psoriasis medications.

FAQs

How do I get rid of psoriasis around my eyes? 

If you suspect that you have psoriasis around your eyes, talk to your eye doctor and dermatologist immediately. Although there are home remedies that you can use to ease symptoms, the skin around the eyes is very delicate and needs to be handled with care. Therefore, we recommend not starting any medication or treatment before you talk to your doctor. They will diagnose the condition and recommend appropriate treatments to follow.

What can I use for psoriasis on my eyelids? 

There are several treatment options for psoriasis on eyelids including; topical treatments, systemic medications, light therapy, home remedies, and biologic therapy. However, always talk to your doctor before you start any medication or treatment.

What causes psoriasis of the eyes? 

There is no definitive cause of psoriasis. However, a disorder of the immune system and genetics are contributing factors even if there may be no family history of the disease. Additionally, certain triggers can cause symptoms to appear, flare-up, or even become more severe including stress, lifestyle choices, illness and medications.

References

1. Psoriasis on the Face. (May 2008). National Psoriasis Foundation.

2. Madarosis: A marker of many Maladies. (August 2012). International Journal of Trichology.

3. Complementary and Alternative Medicine Therapies for Psoriasis. (November 2018). The Journal of the American Medical Association; Dermatology.

4. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. (February 2019). Journal of The American Academy of Dermatology.

5. Eye Inflammation and Psoriatic Arthritis. (April 2021). National Psoriasis Foundation.

6. Steroid-induced Glaucoma: An Avoidable Irreversible Blindness. (August 2017). Journal of Current Glaucoma Practice.

7. Diagnosis and management of psoriasis. (April 2017). The College of Family Physicians of Canada.

8. PSORIASIS: SIGNS AND SYMPTOMS. (March 2008). American Academy of Dermatology Association.

9. Psoriasis. (September 2020). The National Institute of Arthritis and Musculoskeletal and Skin Diseases.

10. Ocular psoriasis. (December 2011). Journal of The American Academy of Dermatology.