There are several different types of psoriasis. The symptoms may be better at times and then worse during a flare.
There is no cure for psoriasis, but various treatments can help relieve symptoms. However, some treatments that are suitable for skin psoriasis may be unsuitable for the eyelids.
Find out more about how psoriasis affects the eyelids, and what you can do to relieve it.
What is psoriasis?
Plaque psoriasis leads to scaly, silvery patches of skin.
Psoriasis is a lifelong condition that leads to skin and other symptoms.
Figures published by the Centers for Disease Control and Prevention (CDC) in 2014 suggest that just over 3 percent of people in the United States have the condition.
Plaque psoriasis is the most common type. It involves unusual patches, or plaques. The plaques are extra skin cells. They create thick and silvery scales and red patches that are often itchy and can be painful.
The plaques usually occurs on the scalp, joints, hands, and feet, but they can appear almost anywhere on the body, including the face and eyelids.
Eyelid psoriasis affects about 10 percent of people with psoriasis.
Dry skin is more prone to psoriasis plaques. Trauma to the skin, such as a cut or scrape, makes that area more likely to get psoriasis as well.
Psoriasis symptoms vary, but the most common ones include:
- skin with red patches, covered with silvery, dandruff-like scales
- dry skin that may crack and bleed
- itchy skin
- nails that thicken or become pitted or ridged
- around 20 percent of people with psoriasis develop psoriatic arthritis and have stiff, achy, or swollen joints
Severity ranges from a handful of spots to patches on large areas of the skin. The condition tends to get better and worse at times. It can go into remission and disappear for some time.
Psoriasis is related to the immune system. It happens when the body reacts incorrectly to its skin cells. This immune reaction results in the rapid growth and turnover of skin cells.
Certain things can trigger the first signs of psoriasis or recurrences:
Doctors often prescribe topical and other treatments for psoriasis.
Psoriasis and the eyelids
In eyelid psoriasis, scaly patches of skin can appear on or around the eyelids.
Psoriasis on or around the eyelids is difficult to live with because the skin in this area is sensitive.
The swelling may cause the eyelashes to rub against the eyeball. The itchiness will also make psoriasis of the eyelid uncomfortable and painful at times.
In addition, since the eyeball is nearby, any topical medications, such as a steroid, can lead to more severe problems. People must take care when selecting and using any form of treatment.
In a review of studies published in 2017, researchers noted that using steroids around the eye can lead to glaucoma, cataracts, and possible loss of vision. A doctor should monitor the use of these medications.
As the scales of skin flake off the eyelids, they may stick to the eyelashes.
The rims of eyes may become red and crusty.
One complication of psoriasis is the risk of developing uveitis, an inflammation within the eye. It is rare, but it can cause inflammation, dryness, and discomfort. Without treatment, it can have a drastic effect on the eyesight.
Topical antibiotics can treat any infection. Doctors usually prescribe oral corticosteroids, such as prednisone, to reduce inflammation.
Using topical steroids on the eyelid can lead to serious side effects. The steroid can enter the eye and cause problems such as cataracts and glaucoma. It is important to follow a doctor's recommendation exactly, when using topical or oral steroids.
A common complication of psoriasis is a joint inflammation known as psoriatic arthritis. It causes symptoms of arthritis. It affects around 1 in 5 people with psoriasis.
Treatment and home remedies
Anyone with symptoms of psoriasis, especially on the eyelids, should see a doctor. A family doctor may refer the person to a skin specialist, or dermatologist.
People who have a diagnosis of psoriasis should see a doctor if their condition worsens, or if they have worrisome medication side effects.
There is no cure for psoriasis, but treatments and home care measures can offer some relief. Using cortisone creams with a doctor's supervision and exposing the skin to small amounts of natural sunlight can provide significant help.
In some cases, a special steroid medication for use around the eyes can treat scaling. A doctor must supervise the treatment carefully, because eyelid skin is easily damaged.
With steroid medications, there is a risk of glaucoma or cataracts developing. A doctor may suggest seeing an ophthalmologist to check the pressure within the eye regularly to reduce this risk.
Protopic ointment or Elidel cream is suitable for treating psoriasis around the eyes. These medications belong to the drug class of topical calcineurin inhibitors. They are not steroids. Instead, they affect the immune system.
Protopic ointment or Elidel cream will not cause glaucoma, and it is effective on the eyelids. However, it can sting the first few days of use. It is also important not to get it in the eyes or mouth.
Using these medications for eyelid psoriasis can help prevent the potential side effects of topical steroids.
Phototherapy (light therapy)
A doctor may recommend using natural and artificial ultraviolet (UV) light, as this can help ease the symptoms of psoriasis around the eyes.
However, a health professional must monitor the use of light therapy. People should only use phototherapy after discussing it with a doctor.
Depending on how severe the psoriasis is overall, and especially on the eyelids, a doctor may prescribe a systemic oral or injectable medication, if other treatments do not work.
A doctor must monitor the use of these types of medications, as they often have side effects. This type of treatment is not usually for long-term use.
Home remedies and self-care
Rinsing the eyes with cool water can help relieve symptoms.
Here are some ways of treating 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 symptoms.
Turmeric in the form of a spice or a supplement may help, according to the National Psoriasis Foundation, but people should speak to a doctor before using any supplements. The FDA consider 1.5 to 3 grams of turmeric a day to be safe.
Treatments to avoid
When people apply topical steroids to the eyelid, there is a risk of getting them in the eye. This can cause serious side effects.
Using topical steroids can increase the risk of glaucoma and cataracts. A person with psoriasis of the eyelid should consult with their doctor about treatment options.
Living with psoriasis of the eyelid
Some activities can worsen the symptoms of eyelid psoriasis.
Makeup can reduce the appearance of redness and scales, but people should choose makeup for sensitive skin.
Makeup can also interfere with topical medications and further irritate the eyelid.
People with psoriasis should speak to a doctor about the best ways to use makeup and manage eyelid psoriasis.
For people with psoriasis, eyebrow piercing increases the risk of getting psoriasis in the eyebrow.
Psoriasis can result from trauma to the skin, such as a cut, bruise, and piercings or tattoos.
A person with psoriasis may want to speak to a doctor about getting a piercing or tattoo.
People with eyebrow piercings and psoriasis may get psoriasis in that area, and eyebrow hair may fall out. They should consult with a doctor about prevention and treatment options.
Psoriasis is difficult to treat, but doctors and scientists hope that, as new drugs undergo testing and receive approval, more effective treatments will appear, including drugs that affect how auto-immune reactions work.
Anyone who is interested in joining a clinical trial for psoriasis medication can see what is available here.
People talk about using alternative herbs and lotions, including capsaicin, for psoriasis. This sounds painful and dangerous for the eyes and other senstive areas. What do you think?
Using topical treatments with alternative herbs and lotions for psoriasis can be beneficial for plaque psoriasis in general. However, for psoriasis of the eyelid this is not true.
Topical treatments used around the eye could cause delicate skin and eye irritation and pain as well as affect your vision.
Always check with your doctor before using any type of treatment around your eyes, your vision is too valuable to take any chances.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.