What are the causes of eyelid psoriasis?

Eyelid psoriasis, also known as facial psoriasis, occurs twice as frequently in children as it does in adults. This skin condition can be challenging to manage on a daily basis, both physically and in terms of psychological and emotional wellbeing.

Several factors have been suggested in scientific literature to promote the onset of psoriasis on the eyelids. Among them, we find:

• Blepharitis: a common inflammation of the eyelids, was the most frequent ocular finding in patients suffering from psoriasis.

• Affliction of the eyelids has been observed with pustular psoriasis, characterised by the presence of pustules.

Other factors are suggested, such as a dysfunctional immune system. This leads to the skin cells renewing themselves rapidly. Normally, these cells renew after a few weeks, but in patients with psoriasis, the process is accelerated to between four to six days. This acceleration results in a surplus of skin because the epidermis can no longer shed dead skin. As a result, the skin thickens and begins to have an inflammatory reaction and itching. Environmental factors or the use of certain medications are also factors that could potentially promote the onset of psoriasis.

The symptoms accompanying psoriasis are characterised by the emergence of patches and redness, flaking and itching. The eyelids become red and swollen. They can also become crusty and scaly, and scales may cover the eyelashes.

The management of eye psoriasis may include medical treatments combined with a change in daily habits. These are administered based on the severity of the disease manifestation.

• Treatments

To treat eyelid psoriasis, the careful use of dermocorticoid-based medications may be prescribed by a doctor. Dermocorticoids, derivatives of cortisone, should be used over a specified period and not over a long duration. Topically applied, dermocorticoids help to soothe the skin by combating inflammation. They inhibit the NF-kB transcription factor by activating the transcription of the IkB gene, thus conferring anti-inflammatory effects. These medications require a medical prescription. If they do not work, it is recommended to contact a dermatologist to seek other solutions.

• Daily habits to adopt

Patients suffering from eyelid psoriasis are also advised to cleanse with a "soap-free" gel or even products with a neutral pH as they do not exacerbate skin dryness and thus respect the hydrolipidic film. It is recommended to wash the face with hands and avoid washcloths that could further irritate the skin. As for daily hydration, patients can use a fragrance-free cream several times a day as needed.

Protecting the skin of the face against climatic aggressions is essential as psoriasis causes fragility and sensitivity of the skin to external aggressions. Thus, the application of a protective cream for the face helps to strengthen its protection against environmental factors.

REHAL B. & al. Ocular psoriasis. American Academy of Dermatology (2010).

Psoriasis du visage. Association France Psoriasis (2022).