Psoriasis On The Eyelids

  • Zaynab Karim BS Biochemistry, Queen Mary University of London, UK

Get health & wellness advice into your inbox

Your privacy is important to us. Any information you provide to us via this website may be placed by us on servers. If you do not agree to these placements, please do not provide the information.

Best Milk Alternative

Introduction

Psoriasis is a skin condition characterised by the presence of flaky and scaly patches of skin.  Although these appear primarily on the elbows, scalp, knees, and lower back, in general, they can appear anywhere. The severity of this chronic disease can vary between individuals, some experience minor itch, while others have their whole lives affected. Psoriasis on the eyelids causes these patches around the eye and also causes the skin to swell. Although rare, it does affect over 3% of the US population. If this is not understood or managed it can lead to further complications such as uveitis (inflammation of the eye, causing redness and cloudy vision), leading to dryness and discomfort which can result in compromised eyesight.  This article will explore psoriasis on the eyelids in-depth and provide solutions to this chronic disease. 

Understanding psoriasis

There is no overall clear cause for this condition, but genetics and the immune system are driving factors.  Some symptoms can include: 

  • Scaly, red patches
  • Dry, cracked skin (that can bleed)
  • Inflammation
  • Dandruff that sticks to eyelashes
  • Eye dryness
  • Pain when moving the eyelids
  • Vision impairment

These can affect the skin around the eye, eyelid, eyelashes, and the eyebrow. This can also result in the eyelid to curve.

During a psoriasis outbreak, the immune system targets healthy skin cells and increases the rate of cell division and growth. This, therefore, causes an excess of dead skin cells to build up on the skin causing the symptoms mentioned above.2 Fortunately, this is not contagious and cannot be passed on. 

Psoriasis can vary in severity depending on certain factors and even family history. Although, the exact cause of the disease cannot be confirmed some trigger points include:3

  • Stress
  • Illness, infections, and immunity disorders
  • Skin injuries such as sunburns, bites, and other trauma
  • Weather (less sunlight and low humidity lead to dry, hot air)
  • Allergies
  • Smoking
  • Excess alcohol consumption
  • Environmental factors
  • Medications, such as beta-blockers(for high blood pressure) or lithium (for bipolar disorder)[5]

Unique features of eyelid psoriasis

Some may question what the difference is between psoriasis and eczema, as these are both skin conditions with similar symptoms. Psoriasis is a result of dead skin cells on the skin, while eczema occurs after irritation or allergic reactions.2 As well as this, psoriasis can start from the age of 15, whereas eczema begins from childhood and carries through to adulthood.5

Some complications can include lesions (damage) of the eyelids, conjunctiva (the membrane at the front of the eye), and other areas,  the main reason for this is inflammation. Additionally, psoriasis can also be linked with other conditions that arise beyond the skin such as: 

  • Cardiovascular- the heart and surrounding blood vessels
  • Metabolic- the processing in a living organism
  • Cerebrovascular- the brain and surrounding blood vessels
  • Articular- the joints
  • Hepatic- the liver
  • Autoimmune- the immune system

This can reduce an individual’s quality of life, as they might find it difficult to carry out daily tasks, due to ocular (eye) damage. This is a physical impact of eyelid psoriasis, but this can also lead to a psychological impact as individuals might feel uncomfortable in their skin.  This leads to patients experiencing loss of self-esteem, problems with body image, and feelings of embarrassment. 

Diagnosis and treatment

A diagnosis can be made by either a dermatologist or an ophthalmologist, who will be able to do a physical exam, reviewing your symptoms, and put you through tests. This can include a skin biopsy, where they will remove a small sample of skin tissue and analyse it under a microscope. 

An individual should seek medical help if:

  • There are any new symptoms
  • Worsening symptoms
  • Adverse effects when medication is given3

Some treatment options can include: 

  1. Topical therapy:
    • Corticosteroids- this can treat mild to moderate psoriasis. This is recommended for sensitive areas such as the face and can be applied daily when it flares up and every other day continuing from this. The long-term use of this causes the skin to thin and may also stop working after some time
    • Vitamin D analogues- similar forms of vitamin D can slow down skin cell growth and can be used with or independently with corticosteroids
    • Retinoids- this is applied daily but can cause skin irritation or sensitivity to light. An example of this is Tazarotene, but this is not suitable for pregnant or breastfeeding woman
    • Calcineurin inhibitors- this reduces the rash and dead skin build-up. This is good for areas of thin skin like around the eyes. This solution, however, is not a long-term treatment as it can increase the risk of skin cancer and lymphoma (cancer of the lymph nodes)
    • Salicylic acid- this can be used with other treatments or independently as it allows the scalp to absorb the medicine easily
    • Coal tar- this reduces itching, inflammation, and scaling, but it is able to irritate the skin
    • Anthralin- this slows down skin cell growth and results in removing scales. This specifically is not used on the face as it can irritate the skin
  2. Light therapy:
    • Sunlight- short periods of sunlight can improve psoriasis
    • Goeckerman therapy- this is a combination of coal tar and light therapy
    • UVB broadband- this is controlled artificial light exposure, which can improve psoriasis that has not been treated by topical treatments
    • Psoralen plus ultraviolet- this uses UVA light which goes deeper into the skin than UVB, and is used for severe psoriasis 
    • Excimer laser- this uses a stronger UVB ray that targets affected skin
  3. Oral or injected:
    • Steroids- this can be the injection of triamcinolone
    • Retinoids- this reduces the production of skin cells
    • Biologics- this is injected and can alter the immune system by improving the symptoms of this disease, but it can increase the risk of infections
    • Methotrexate- this reduces skin cell production and inflammation
    • Cyclosporine- this suppresses the immune system but increases the risk of infection

Speak with your doctor to choose the best option for you and to treat your psoriasis based on its severity. Discussing and following a tailored treatment plan is important, as the condition varies between each patient.

Home care and lifestyle management

On the other hand, home remedies can be used to treat psoriasis and various remedies can help this condition. These can include:3,5

  1. Aloe extract cream- reducing itching, inflammation, and scales
  2. Fish oil-  reduces rash when combined with UVB
  3. Oregon grape- applying this on the skin also reduces the rash patches
  4. Using a cold compress on the skin
  5. Using sensitive cleaning products
  6. Avoiding hot water
  7. Turmeric- consumption and application - Meditation
  8. Indigo naturalis- this is a herb which can be used to reduce psoriasis 

Some individuals who struggle with body image due to eyelid psoriasis may want physical solutions to prevent the development of this condition. This includes:

  1. Makeup- if you struggle with self-esteem this can decrease the visible redness and scales, but this can disrupt the usage of topical treatments as a combination of the two can lead to increased irritation
  2. Eyebrow piercings/ tattoos- this increases the likelihood of swelling around the eye as this is a type of skin trauma
  3. Contact lenses- there are no issues with this solution, but this can be problematic if topical treatments get into the eye while wearing contact lenses as it can cause irritation

Prevention strategies

This can be prevented by avoiding the triggers mentioned above and maintaining a healthy diet that contains anti-inflammatory foods,  such as: 

  • Tomatoes
  • Olive oil
  • Green leafy vegetables
  • Nuts
  • Fatty fish
  • Fruits

Regular check-ups are advisable to detect early eyelid psoriasis. But it is also important as in rare cases a condition called erythrodermic and generalised pustular psoriasis can emerge, which can be life-threatening.  

Summary

In conclusion, eyelid psoriasis does not have a clear origin but is consistently linked to immune deficiencies and family history. Flare-ups can be a result of a range of triggers, which are mainly seen to be environmental factors. The condition can be characterised mainly by the presence of scaly, red patches and can lead to both physical, it can damage eyesight and leave uncomfortable patches, and emotional damage, as it can hinder a patient’s self-worth and perception. There are a variety of topical, light, and oral treatments that can aid this, but it is recommended to talk to your doctor first before pursuing any of these treatments as each case is different for each individual. This can be paired with home remedies to excel the treatment process. Overall, the only way to prevent this is to maintain a balanced diet and consult with a doctor to detect early signs of eyelid psoriasis. 

References

  1. nhs.uk [Internet]. 2017 [cited 2023 Nov 15]. Psoriasis. Available from: https://www.nhs.uk/conditions/psoriasis/
  2. Cleveland Clinic [Internet]. [cited 2023 Nov 15]. Psoriasis on the eyelids: vs. Eczema, causes & treatment. Available from: https://my.clevelandclinic.org/health/diseases/25025-psoriasis-on-the-eyelids
  3. Psoriasis on the eyelids: Symptoms, causes, and treatment [Internet]. 2019 [cited 2023 Nov 15]. Available from: https://www.medicalnewstoday.com/articles/314408 
  4. Raharja A, Mahil SK, Barker JN. Psoriasis: a brief overview. Clin Med (Lond) [Internet]. 2021 May [cited 2023 Nov 16];21(3):170–3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140694/ 
  5. All About Vision [Internet]. [cited 2023 Nov 16]. Eyelid psoriasis. Available from: https://www.allaboutvision.com/conditions/eyelid-psoriasis/ 
  6. Constantin MM, Ciurduc MD, Bucur S, Olteanu R, Ionescu RA, Constantin T, et al. Psoriasis beyond the skin: Ophthalmological changes (Review). Exp Ther Med [Internet]. 2021 Sep [cited 2023 Nov 16];22(3):981. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311223/ 
  7. Bhosle MJ, Kulkarni A, Feldman SR, Balkrishnan R. Quality of life in patients with psoriasis. Health and Quality of Life Outcomes [Internet]. 2006 [cited 2023 Nov 16];4:35. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1501000/ 
  8. Cleveland Clinic [Internet]. [cited 2023 Nov 16]. Skin biopsy: skin cancer test, punch biopsy, shave biopsy. Available from: https://my.clevelandclinic.org/health/diagnostics/21857-skin-biopsy
  9. Psoriasis [Internet]. Available from: https://www.mayoclinic.org/diseases-conditions/psoriasis/diagnosis-treatment/drc-20355845#:~:text=Your%20health%20care%20provider%20will,and%20rule%20out%20other%20disorders
  10. Verywell Health [Internet]. [cited 2023 Nov 17]. What happens when you have psoriasis on your eyelids? Available from: https://www.verywellhealth.com/eyelid-psoriasis-7100806 
  11. Harvard Health [Internet]. 2014 [cited 2023 Nov 17]. Foods that fight inflammation. Available from: https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation
  12. NICE [Internet]. [cited 2023 Nov 17]. CKS is only available in the UK. Available from: https://www.nice.org.uk/cks-uk-only

Get health & wellness advice into your inbox

Your privacy is important to us. Any information you provide to us via this website may be placed by us on servers. If you do not agree to these placements, please do not provide the information.

Best Milk Alternative
[optin-monster-inline slug="yw0fgpzdy6fjeb0bbekx"]
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

Get our health newsletter

Get daily health and wellness advice from our medical team.
Your privacy is important to us. Any information you provide to this website may be placed by us on our servers. If you do not agree do not provide the information.

Zaynab Karim

BS Biochemistry, Queen Mary University of London, UK

Zaynab, a biochemistry graduate, possesses a robust background in writing and presenting information for the lay audience. With previous experience in crafting articles, she enthusiastically explores the captivating realm of medical writing.

my.klarity.health presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles. 
Email:
Klarity / Managed Self Ltd
Alum House
5 Alum Chine Road
Westbourne Bournemouth BH4 8DT
VAT Number: 362 5758 74
Company Number: 10696687

Phone Number:

 +44 20 3239 9818