What's to know about psoriasis on the eyelids?
Psoriasis develops when an issue arises in the immune system. This results in an overgrowth of skin cells. The extra cells form plaques, or patches, on the body. It is possible for a person to experience these symptoms on their eyelids.
Several treatment options can help relieve the symptoms of psoriasis, but some are likely to be unsuitable for use on the eyelids.
Learn more about how psoriasis affects the eyelids, and what you can do to relieve it, here.
What is eyelid psoriasis?
Scaly patches of skin can appear on or around the eyelids.
Image credit: Dr Harout Tanielian, Science Photo Library
There are several types of psoriasis, and plaque psoriasis is the most common. It involves the development of patches, or plaques, of extra skin cells.
These can form thick, silvery scales, and they may be itchy and painful.
These plaques commonly affect the scalp, joints, hands, and feet, but they can appear almost anywhere on the body, including on the face and eyelids.
Eyelid psoriasis affects about 10% of all people who have psoriasis.
Psoriasis on or around the eyelids can be difficult to live with because the skin in this area is very sensitive.
Some of the symptoms of eyelid psoriasis include:
- redness, scaling, and crusting around the eyelids
- the rims of the eyes turning upward or downward
- irritation, including pain and itching
- eyelashes that rub on the eye
- scales that resemble dandruff flaking off and sticking to the eyelashes
- pain when moving the eye
Inflammation can lead to swelling, which may cause the eyelashes to rub against the eyeball.
If the inflammation continues for some time, the edges of the eyelids may turn upward or downward. If they become inverted, the lashes can rub against the eyeball. Irritation and other complications can develop as a result of this.
In rare cases, psoriasis can affect the eye, leading to inflammation, dryness, discomfort, and possibly vision loss.
Psoriasis results from a problem with the immune system. It develops when the body reacts incorrectly to its own skin cells and results in the rapid growth and turnover of skin cells.
Genetic factors play a role, and psoriasis can run in families. However, an environmental trigger is usually necessary for psoriasis to actually develop.
Such triggers include:
Learn more about how to avoid the triggers of psoriasis here.
A person should see a doctor if they notice:
- any new symptoms of psoriasis, especially on the eyelids
- worsening symptoms
- adverse effects of medication
Various treatments and home remedies can help relieve psoriasis, including that which affects the eyelids.
Treatment options include:
- topical medications
- oral medications
- systemic drugs
- biologic therapy
- home remedies
We discuss these in more detail below:
Some ointments can help manage eyelid psoriasis.
A doctor may prescribe an ointment containing corticosteroids or another ingredient.
Steroid ointment: In some cases, a special steroid medication for use around the eyes can treat scaling. A doctor must supervise the application of the ointment carefully, as the skin of the eyelids is very vulnerable to damage, and complications can arise with long-term use. A person may need regular appointments with an ophthalmologist to assess for glaucoma or cataracts.
Protopic ointment or Elidel cream: This is suitable for treating psoriasis around the eyes. These medications belong to the drug class of topical calcineurin inhibitors. They are not steroids, and they will not cause glaucoma. They work by acting on the immune system.
Protopic ointment can sting during the first few days of use. It is important not to get it in the eyes or the mouth.
Depending on how severely psoriasis affects the eyelids and how well the area reacts to other treatments, a doctor may prescribe a systemic oral or injectable medication.
- oral retinoids, such as acitretin
- oral steroids
These types of medication can have adverse effects. They are usually for short-term use in managing a flare, which is a period of time during which symptoms worsen.
This is an emerging form of treatment that targets specific components of the immune system. It appears to help reduce the number of flares and severity of symptoms.
A doctor will consider the type of psoriasis and severity of symptoms when deciding whether to prescribe a biologic drug and, if so, which.
Current guidelines recommend prescribing a biologic drug when symptoms are moderate to severe.
Psoriasis is a multisystem condition that can involve various parts of the body.
One complication of psoriasis is uveitis, which is inflammation within the eye. It is rare, but it can cause inflammation, dryness, and discomfort. Without treatment, it can have a drastic effect on eyesight.
A doctor may prescribe steroid cream to reduce inflammation, but this can have adverse effects.
In a review from 2017, researchers found that using steroids around the eyes can lead to glaucoma, cataracts, and possibly vision loss. Therefore, a doctor should monitor the use of these medications.
It is important to follow a doctor's recommendations and instructions when using topical or oral steroids.
In some cases, infections can develop. A doctor will prescribe antibiotics in these cases.
Rinsing the eyes with cool water can help relieve symptoms.
A person should follow their treatment plan for psoriasis, but they can also support this with some home remedies.
To treat eyelid psoriasis at home:
- Gently wash the eyelids with cool water and a sensitive skin or baby shampoo to relieve irritation.
- Use cool water to soothe the skin but avoid hot water, as it can dry the skin and worsen the symptoms.
Psoriasis is a multisystem condition. It does not only affect the area where symptoms appear. For this reason, a person with any type of psoriasis might benefit from treating the whole body.
In fact, one review from 2018 concluded that the following alternative or complementary therapies may help people with psoriasis:
A person should use any alternative therapy alongside their medical treatment plan, not as a replacement for it. They should also speak to their doctor before trying anything new or making any major changes.
Tips for living with eyelid psoriasis
Some daily habits and activities can worsen the symptoms of eyelid psoriasis. In the sections below, we discuss how to continue these activities while preventing the development of psoriasis symptoms on the eyelids.
Makeup can reduce the appearance of redness and scales, but people with psoriasis should choose makeup for sensitive skin.
Makeup can also interfere with the topical medications a person is using and further irritate the eyelid.
People with psoriasis should speak to a doctor or dermatologist about the best ways to use makeup to manage eyelid psoriasis.
For people with psoriasis, eyebrow piercings may increase the risk of experiencing a flare near the eye, as piercing, tattoos, and other types of skin trauma can trigger symptoms.
If psoriasis develops, eyebrow hair may fall out.
It is best to speak to a doctor before getting a piercing or a tattoo.
Psoriasis can be a challenging condition to live with, especially if it affects the eyelids. This is because the skin around this area is very sensitive.
Anyone who notices new symptoms or is concerned about existing symptoms should see a doctor, as many treatment options are available.
Can I wear contact lenses if I have eyelid psoriasis?
As long as a person applies their topical medication appropriately and does not get any in their eye, there should be no issues with wearing contact lenses.
A person may find that a particular brand of contact lens or solution causes additional irritation, but other than that, there should be no additional complications.Debra Sullivan, PhD, MSN, RN, CNE, COI Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.