From the Guidelines
For facial psoriasis, I strongly recommend using a combination of calcipotriene and hydrocortisone, as this treatment has been shown to be efficacious and well-tolerated, with a significant improvement in symptoms compared to monotherapy 1. The use of calcipotriene or tacalcitol ointment combined with hydrocortisone is a recommended treatment option for facial psoriasis, as it has been demonstrated to be effective in reducing inflammation and normalizing skin cell turnover 1. Some key points to consider when using this treatment include:
- The combination of calcipotriene and hydrocortisone has been shown to be more effective on the face than on the body, with an odds ratio of 2.01 and a 95% confidence interval of 1.33-3.05 (P = .001) 1.
- The treatment should be used for a duration of 8 weeks, as the efficacy of vitamin D analogues has been noted at 8 weeks but not at 4 weeks 1.
- It is essential to apply the treatment only to the affected areas, avoiding the eyes and using a thin layer to minimize the risk of side effects.
- Regular moisturizing with fragrance-free products like CeraVe, Cetaphil, or Vanicream can help maintain the skin barrier and reduce the risk of irritation.
- If symptoms do not improve within 2-3 weeks or worsen, it is crucial to consult a dermatologist for further evaluation and potential prescription of stronger treatment options. The evidence from the study 1 supports the use of combination treatments with vitamin D analogues and potent topical corticosteroids for the treatment of psoriasis, including facial psoriasis. Additionally, the study 1 provides recommendations for the use of vitamin D analogues, including calcipotriene, for the treatment of mild to moderate psoriasis, and supports the use of combination products with calcipotriene and corticosteroids for the treatment of psoriasis.
From the FDA Drug Label
Calcipotriene ointment, 0.005%, is indicated for the treatment of plaque psoriasis in adults. Apply triamcinolone acetonide cream USP, 0. 1% as appropriate, to the affected area two to three times daily.
The recommended topical treatments for facial psoriasis are not explicitly stated in the provided drug labels. However, based on the available information:
- Calcipotriene ointment, 0.005%, is indicated for the treatment of plaque psoriasis in adults 2.
- Triamcinolone acetonide cream USP, 0.1%, can be applied to the affected area two to three times daily 3. It is essential to note that the safety and effectiveness of these treatments for facial psoriasis specifically have not been established in the provided drug labels.
From the Research
Topical Treatments for Facial Psoriasis
The following topical treatments are recommended for facial psoriasis:
- Topical corticosteroids and vitamin D analogs are the drugs of choice during the induction phase 4
- Vitamin D analogs continue to be drugs of choice for maintenance therapy 4
- Tazarotene and dithranol are suitable options in patients with certain, specific characteristics 4
- The calcineurin inhibitors can be considered to be second-line treatment for psoriasis of the face and flexures 4
- The combination of topical corticosteroids and vitamin D analogues has proven to be the therapy of choice in the initial phase 5
- Fixed combination therapy is recommended once or twice a week in maintenance therapy 5
Special Considerations
When choosing a topical treatment for facial psoriasis, the following factors should be considered:
- The choice of the right formulation plays an important role 5
- Personal preferences and experiences of the patient should be taken into account to increase adherence 5
- Individual approach is absolutely necessary in each patient with psoriasis 6
Additional Options
Other topical treatments that may be effective for facial psoriasis include: