What to Know About Psoriasis Around the Eyes

Psoriasis is a chronic skin disease in which cells build up quickly, resulting in patches on the skin surface that may be red or discolored, scaly, and itchy. It can be mild to severe, and is the result of immune system dysfunction.

Here’s what you should know about psoriasis in this particularly challenging location.

• Redness or discoloration
• Dry, scaly, or flaky skin
• Itching and discomfort
• Swollen skin
• Eyelashes growing inward toward the eye (trichiasis)

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• Eye irritation
• Vision impairment (including blurred vision due to swelling)

Aside from skin involvement around the eyes, the systemic inflammation that causes psoriasis can lead to eye health issues such as dry eye disease, blepharitis (inflammation of the eyelid), conjunctivitis (pink eye), and uveitis (inflammation of the central layer of the eye known as the uvea).

“Sometimes in this area the patches may be less thick and less scaly, which can make the diagnosis of eyelid psoriasis harder to make,” says Faranak Kamangar, MD, a dermatologist at Palo Alto Foundation Medical Group in Palo Alto, California.

Diagnosing psoriasis in the eye area can be challenging, especially if someone doesn’t already have an established psoriasis diagnosis based on symptoms in other areas of the body.

“When we think of rashes on the eyelids, allergic contact dermatitis is more common, so it certainly could be misdiagnosed,” says Jordan Praytor, an instructor in the department of dermatology at Oregon Health & Science University in Portland.

When someone shows symptoms of what may be psoriasis around the eyes, it’s important to do a thorough skin exam of other areas of the body, says Praytor. Often, she says, doing so will reveal signs of psoriasis in more typical areas — such as around the ears, on the scalp, or within skin folds — that patients were not aware of, or did not find bothersome enough to call attention to. This “gives the provider additional clues that can help differentiate psoriasis from other diagnoses,” she says, such as eczema around the eyes.

Psoriasis around the eyes may not be treated the same as when the disease affects other areas of the body, since skin around the eyes tends to be thinner and more delicate.

“Using steroids around the eyes long-term can cause thinning of the skin, glaucoma or cataracts,” says Praytor. For this reason, she says, nonsteroid topical treatments for psoriasis are often preferred for the eye area. Topical treatments may include:

• Calcipotriene
• Tacrolimus
• Pimecrolimus
• Lower-potency corticosteroids
• Zoryve
• Vtama

Dr. Kamangar says that while topical steroids are a mainstay of treatment in the eye area, they need to be “limited in amount and length of application” based on your doctor’s instructions.

• Oral therapies
• Biologic therapies (injected)
• Phototherapy (light therapy)

Recommended over-the-counter products may contain the following potentially beneficial ingredients:

• Coal tar (reduces itching and skin flaking)
• Hydrocortisone (reduces swelling and itching)
• Oil-based moisturizing ingredients (petroleum or plant-based oils)

For itching, on the other hand, Kamangar says that applying a cold compress on the eye area can be beneficial.

When it comes to oil-based moisturizers, Praytor says that calendula oil may be particularly helpful because of its soothing effects. Another option that may be effective is petroleum jelly (Vaseline).

• Psoriasis can cause redness or discoloration, itching, dryness, and skin flaking around your eyes.
• It may not be clear whether psoriasis or another condition, like eczema, is causing symptoms in the eye area, making it important to look for signs of psoriasis in other areas.
• Nonsteroid topical treatments are often the first choice for treating psoriasis around the eyes.
• Self-care measures, like using a gentle cleanser and moisturizer and applying a warm compress, can ease symptoms.