Psoriasis on the face

Psoriasis can affect any part of the body. Especially often the disease is found on the elbows, under the knees, in the groin and underarms, on the head. Psoriasis on the face is relatively rare, but it gives the patient a lot of discomfort - first of all, psychological. Rashes on the face can not hide: they are visible to all. And very few people know that the disease is not contagious and is not transmitted to others.

What you need to know about psoriasis that affects the face? How can you deal with pathology?

[1], [2], [3]

Epidemiology

Psoriasis on the face can reveal itself at any age, but most often it is diagnosed before the age of 30. In women, pathology is often detected at the age of 15 to 55 years, and in men - from 28 to 55 years.

In 70% of cases, this disease is present in other family members (relatives).

In our country, the incidence of psoriasis is less than 1%. The disease is more common in northern countries.

Psoriasis on the face is equally likely to occur in female and male patients.

[4], [5], [6]

Causes of the psoriasis on the face

There is no generally accepted explanation of the development of psoriasis on the face. The main cause of pathology is considered to be the disorder of metabolic processes. However, experts still do not have a single opinion about the origin of the disease. Only theories that are considered as assumptions are proposed:

• causes can be autoimmune disorders - including those of genetic origin, transmitted through a recessive or autosomal dominant trait;
• for other reasons, there may be metabolic and autoimmune disorders, triggered by nervous overexertion, eating disorders, infectious diseases, climate characteristics, alcohol consumption.

All scientific researchers and physicians are unanimous in the opinion: psoriasis on the face is a polyethological pathology, in which there can not exist any one cause. Often the disease is preceded by a whole combination of various factors.

[7]

Risk factors

• Chronic inflammation, infectious diseases.
• Disorders of the exchange function.
• Failure of the endocrine system.
• Immunity disorders.
• Hormonal disorders (puberty, childbearing, menopause, long-term use of contraceptives).
• Injuries and damage to the skin of the face.
• Digestive disorders.
• Regular and prolonged stress.
• Influence of cold, frostbite of the face.
• Chronic poisoning.
• Taking medication (ACE inhibitors, beta-blockers, NSAIDs, antiviral drugs).
• Alcoholism, excessive use of alcoholic beverages.

[8], [9]

Pathogenesis

According to the theory of autoimmune origin of the disease, psoriasis on the face is the result of a specific reaction of the body to certain stimuli, which leads to excessive development and growth of cells on the surface of the skin.

Standard average duration of the cell division cycle is about 25 days. With psoriasis on the face, division is faster, and the period is shortened by 20 days. As a result, the previous cellular structures do not have time to peel off, coarsening and layering of cells (proliferation) is observed, which leads to the onset of an inflammatory reaction. Inflammatory areas have the appearance of light pink hillocks, on top of which there are characteristic whitish crusts of dead surface tissue.

With the increase in symptoms, the tubercles unite among themselves, and become significant in size with pinkish spots of various shapes.

[10], [11], [12], [13]

Symptoms of the psoriasis on the face

The first signs reveal themselves as small inflamed spots on the skin of the face, which over time grow and merge, turning into small compacted nodules of a reddish-pinkish color. These nodules are nothing more than psoriatic papules, which are considered the main manifestation of psoriasis.

Nodules are covered in a very short time with scaly crusts of silver hue. They can easily be scraped off the surface of the stain.

In medicine, it is customary to pay attention to the three main and characteristic signs of psoriasis on the face:

• a symptom of the stearin stain is the appearance on the surface of nodules of supple light-silvery scales that gently separate when scraping;
• a symptom of film formation is the exposure of the glossy-red surface when trying to scrape off the scales;
• a symptom of a spot hemorrhage ("bloody dew") is the result of the above mentioned signs, when after the removal of a scaly and the appearance of a psoriatic film, a dotted discharge of blood appears.

Nodules have the property of rapidly growing and connecting to other papules, forming plaques - spots that protrude on the surface of the skin.

The main localization of the rashes - the wings of the nose and nasolabial triangle, eyebrows and superciliary sites, eyelids, lip rim, frontal zone.

Stages

Stages of development of psoriasis on the face:

• The initial stage - appear rashes on the face, which gradually increase and have the appearance of plaques of rounded shape, a pinkish hue, covered with light scales.
• The stationary stage (1-4 weeks from the onset of the disease) - plaques become light, papules - rounded, scales - silver.
• The stage of attenuation - plaques become less noticeable and almost merge with the skin, the itching subsides, a dense cornified fringe forms around the papule. This stage can last on average 2-6 months.

[14], [15], [16]

Forms

Forms of psoriatic eruptions on the face:

• pustular (ring or generalized);
• non-pustular (classical, or erythroderma).

Types of psoriasis on the face:

• normal (it is - vulgar) - accompanied by the appearance of pink papules, a sensation of itching and burning;
• with exudation - manifested papules, covered with yellow crusts, when removing which emits a yellowish liquid;
• follicular - characterized by the formation of miliary papules with a funnel-shaped depression in the center;
• atypical - accompanied by the appearance of papules in atypical for psoriasis sites;
• plaque-like - is characterized by the appearance of papules in the form of reddish plaques covered with light scales;
• drop-like - accompanied by the appearance of pustules drop-like form, which through time unite with each other;
• spotted - characterized by the presence of erythema, in some cases - with poorly expressed infiltration.

Degrees of psoriasis on the face:

• light degree;
• severe degree.

Varieties of psoriasis relative to seasonality:

• year-round;
• year-old;
• winter;
• demi-season.

[17], [18], [19]

Complications and consequences

Unfortunately, it is almost impossible to completely cure psoriasis on the face - this disease is considered chronic, which occurs with periodic outbreaks of activity. Often, patients experience significant psychological discomfort: trying to cure the disease, fall into depressive states, fixate on the problem and avoid social contacts. But the problem does not solve it - if you do not conduct medical measures, you can have much more serious consequences - the generalization of the psoriatic process:

• inflammatory reaction in the joints - arthritis;
• inflammatory reaction in the kidney - glomerulonephritis;
• inflammatory changes in the liver - psoriatic hepatitis;
• disturbance of metabolic processes.

In addition, in some patients, psoriasis on the face proceeds in the form of erythroderma, with spread to the hair follicles.

[20], [21], [22], [23], [24]

Diagnostics of the psoriasis on the face

At the initial stage, the doctor conducts extensive diagnosis in order to make sure of the diagnosis of psoriasis on the face and evaluate the extent of its spread.

Standard diagnostic procedures include examination and questioning of the patient:

• listening to complaints;
• examination of psoriatic rashes;
• verification of data on other background diseases.

The main symptoms that the dermatologist will pay special attention to:

• a symptom stearinovogo spots - the appearance on the nodules easily removed light-silvery crusts, which are scraped off without problems;
• a symptom of psoriasis is the appearance of a glossy, hyperemic surface when trying to scrape a crust;
• a symptom of a spot hemorrhage ("bloody dew") is a consequence of the above signs, if after scraping the scales and the appearance of the psoriasis film, a dotted drop of blood is detected.

The fading stage of the disease is determined by the presence of Voronov's symptom - the formation along the edge of the spot and healthy skin of the light border.

Analyzes are prescribed in order to clarify the diagnosis:

• micro-examination of scales scraped from pathological tubercles;
• cutaneous biopsy followed by a histology.

Instrumental diagnostics may be necessary only if adverse effects occur.

[25], [26]

Differential diagnosis

Differential diagnosis is assigned:

• with suspected dermatitis;
• to eliminate rosacea;
• to exclude red flat lichen;
• with suspicion of dermatomyositis, etc.

In most cases, psoriasis on the face is distinguished from dermatitis, as well as from such a rare enough disease, asbestos-like lichen. This type of lichen refers to one of the varieties of streptoderma. The disease is accompanied by the appearance of large scaly elements, in appearance resembling asbestos.

[27], [28], [29], [30]

Treatment of the psoriasis on the face

At the first suspicion of psoriasis, you should immediately visit a dermatologist. Earlier, the beginning of treatment will help to "curb" the disease more quickly and to transfer it into a stable stage of attenuation of the process.

Medications for oral administration are usually prescribed for long-standing psoriasis, in advanced and complex cases of the disease. The following groups usually become the drugs of choice:

• cytostatic agents - slow down the multiplication of epithelial cells (methotrexate);
• immunosuppressants - weaken autoimmune processes (cyclosporin A);
• aromatic retinoids - inhibit proliferative processes in epithelial cells (analogues of vitamin A);
• glucocorticosteroid hormones - suppress the development of the inflammatory process (prednisolone, dexamethasone);
• biologically active agents - block the growth and development of cells (alefacept, avastin).

Drugs of systemic use are prescribed by a doctor and only in extreme cases, when the external effect on psoriatic rashes does not bring the expected effect, and the disease continues to spread. Self-administration of these drugs is strictly contraindicated.

Methotrexate
Dosage of the drug	Take 5 to 25 mg of the drug inside, 1 time per week.
Side effects	Inhibition of bone marrow function, erosion and ulcers, pain in the head, alopecia.
Special instructions	Methotrexate is prescribed only for severe psoriasis.

Cyclosporin A
Dosage of the drug	Take inwards from 3.5 to 6 mg / kg of body weight per day.
Side effects	Heaviness in the stomach, hypertension, violation of the menstrual cycle in women.
Special instructions	It is important not to allow excessive inhibition of immunity.

Retinol
Dosage of the drug	Assign adults of 50 thousand to 100 thousand IU per day.
Side effects	Drowsiness, apathy, redness of the face, indigestion.
Special instructions	Assign with caution to patients with impaired renal function.

Dexamethasone
Dosage of the drug	In the acute period, the administration of 4-10 mg of the drug per day, divided by 3-4 times.
Side effects	Violation of the menstrual cycle in women, pancreatitis, heart rhythm disturbances, edema, allergies.
Special instructions	To reduce the severity of adverse symptoms, you can take potassium preparations.

Alephacept
Dosage of the drug	Dosage is strictly individual.
Side effects	Shortness of breath, swelling on the face, itching, hypotension.
Special instructions	Individual reactions may occur: if the temperature rises sharply, consult a doctor immediately.

Ointments and creams from psoriasis on the face are appointed in the first place, and only with their ineffectiveness the doctor passes to the appointment of the above systemic drugs.

In psoriasis, the following external agents may be used on the face:

• External glucocorticoid ointments - stop inflammation at any stage of the process (Lorinden A, prednisolone ointment).
• External agents with vitamin D - normalize metabolic processes in damaged epidermal cells (diveones, davobet).
• Keratolytic and keratoplastic remedies - soften the stratified skin layering (salicylic ointment, salicylic-zinc ointment).

As an additional treatment appoint:

• antihistamines, which help to remove itching and unpleasant sensations (fenkarol, erius, etc.);
• sedatives, which improve the psycho-emotional background (valerian drops, motherwort);
• vitamins, improving the properties of the skin and creating additional protection from damage to cellular structures (vitamins A and E, a successful combination of which is presented in the preparation of Aevit);
• antibiotics, preventing the development of secondary infection in the foci of psoriasis (drugs macrolide group).

Physiotherapeutic treatment

Against the background of medical treatment of psoriasis on the face, physiotherapy is actively used. Depending on the indications, it is possible to assign various useful procedures:

• Electrosleep is a procedure with sedative effect, normalizing the psyche of a patient whose illness is caused by stresses and periods of intense anxiety. The session lasts 20-60 minutes, every day, or once every two days. The minimum number of sessions is 8 pcs.
• UFO-therapy is a procedure for narrow-band medium-wave irradiation.
• Phototherapy is one of the varieties of UFD, which is prescribed in the stage of attenuation of the process to prolong the period of remission.
• Puva-therapy - ultraviolet irradiation with oral administration of photosensitizing agents (for example, psoralen). Usually, two courses of procedures are performed: cleansing and anti-relapse treatment.
• X-ray therapy - irradiation of the affected skin with X-rays. The session is repeated 1 time in 5-6 days.
• Laser therapy is a safe procedure, with laser exposure to zones with psoriatic eruptions.

As an additional treatment, spa treatment, balneotherapy, peloidotherapy are welcomed.

Alternative treatment

How to alleviate the symptoms of psoriasis with alternative recipes? Indeed, by alternative methods, it is sometimes possible to achieve a persistent remission of the painful process. For example, you can try to help the patient with psoriasis on the face, using the following methods:

• two or three times a week to apply lotions on the face area with such a composition: sea salt and warm water, in a ratio of 1: 3;
• apply to the affected areas for 5-6 minutes cotton balls, moistened with coconut oil, juniper oil, jojoba oil, or lavender oil;
• lubricate the affected areas with 5% sea-buckthorn oil, and also take it inside - 2 ml every morning.

In addition, it is recommended to consume more plant foods, especially fruits and vegetables of orange and red color. Preference should be given to carrots and pumpkin, as they contain a large amount of vitamin A.

[31], [32], [33]

Herbal Treatment

On the basis of medicinal herbs, you can prepare external ointments, for daily application to the affected areas of psoriasis.

1. Prepare a mixture of 50 g of oak ash, 50 g of ash from hips, 20 g of dry ground herb celandine, raw egg white, 200 g of solidol. The mass is well mixed and kept at normal temperature for 2 weeks. The resulting ointment is best kept in the refrigerator.
2. Prepare a mixture of 10 ml of colanhoic juice, 30 ml of eucalyptus oil and 10 ml of natural honey. Endure three nights in a dark cool place.
3. Prepare a mixture of 100 grams of birch tar, 40 grams of ashes from hips, 40 g of castor oil and 20 g of natural honey. Soak 3 days in the fridge and use.

If you prepare such ointments and use them every day, a positive result will appear one month after the application is started.

Homeopathy

Homeopathy with psoriasis on the face is prescribed concomitantly with conservative medication.

Such homeopathic remedies can be recommended:

• Arsenicum Yodatum breeding 3, 6, 12 and 30;
• Cardum Marianus - breeding 3, 6;
• Helidonyum - breeding 3, 6;
• Sulfur - breeding 3, 6, 12, 30.

Good medications are Psorinocheel and Psoriaten, which can be purchased from pharmacies without a prescription. Such drugs have a minimal set of side effects (very rarely - allergies), and can be prescribed with almost no restrictions.

• Psorinhehel - drink 10 drops. 3 times a day, before meals.
• Psoriaten - apply to affected areas 3 times a day.

Operative treatment

Surgical treatment of psoriatic rashes on the face - plastic surgery - does not guarantee that the disease will not manifest itself again, since the pathology is considered chronic, with autoimmune etiology. For this reason, the use of surgery for psoriasis on the face is considered unpopular and inexpedient.

Prevention

To prevent the development of psoriasis on the face, as well as reduce the frequency and severity of relapses, you can, following such simple advice.

1. Regularly moisturize and clean the skin on the face and body.
2. Avoid overdrying and weathering the skin, protect your face from cold.
3. Protect skin from mechanical damage, do not use aggressive face scrubs. In question is the use of a razor.
4. Avoid stress, conflict and nervous breakdown.
5. Strengthen immunity in order to withstand infectious diseases in a timely manner.
6. Abandon the use of alcohol and from smoking.
7. Do not take any medications without prescribing a doctor (the doctor should be advised that the patient is suffering from psoriasis).
8. Do not use unfamiliar and unproven means for the face, since they can cause allergies and worsen the skin condition.

[34], [35], [36]

Forecast

Psoriasis on the face is recognized as an incurable pathology, with a chronic course, with periods of remission and worsening of the condition. The prognosis, by the way, often depends on how often recurrences of the disease occur.

It is generally believed that the most favorable is the ordinary, classical form of psoriasis, which is not complicated by infections and only occasionally exacerbated at certain times of the year.

A lot of discomfort is created by the unaesthetic appearance of the face, which is often perceived by other people with caution. Unfortunately, many do not know that psoriasis on the face and other parts of the body is not a contagious disease and can not spread and be transmitted to other people. As a result of mental stress and constant experiences, psoriasis patients everywhere have depressive conditions, neuroses and nervous breakdowns.