Do you have scaly patches on your eyelids? (Psoriasis) Let's talk about this!

Are your eyelids red, itchy, and painful? Maybe you see little flakes coming off? These may not just be allergies. This could also be a condition called psoriasis, which affects the eyelids. Don't worry, let's talk about this in detail.

What is Psoriasis of the eyelids?

Simply put, psoriasis is a chronic skin disease in which our skin cells grow faster than normal, and dead cells build up on top of each other, forming a thick, scaly layer on the skin. The main cause of this is an overactivity of our immune system . It is actually rare for this to occur on the eyelids, but it is not impossible. When it does, it causes red, swollen, itchy, and sometimes discolored, scaly plaques to form on the eyelid or on the skin around the eye. This is a bit uncomfortable, but nothing to worry about.

Who is most affected by this situation?

Psoriasis on the eyelids is usually seen in people who already have psoriasis elsewhere on their body. Often, it is not just around the eyes, but symptoms can also be seen on the scalp, elbows, and knees at the same time. So if you have psoriasis anywhere on your body, it is a good idea to take a little care of your eyelids as well.

How common are eyelid crusts?

In fact, it is very rare for psoriasis to appear on the eyelids and the skin around the eyes. However, some people with psoriasis can develop the condition on other parts of the face, such as the forehead and cheeks. Overall, psoriasis is a disease that affects millions of people around the world. For example, it is said that more than 3% of the population in the United States suffers from this disease.

What is the difference between psoriasis and eczema on the eyelids?

Both of these can occur on the eyelids, and sometimes they look the same, but are actually two different skin diseases.

• Psoriasis, as we discussed earlier, is a condition where dead skin cells build up rapidly, become thick, crusty, and scaly. The skin may become red and raised with a clear border.
• Eczema , especially when it affects the eyelids, is called eyelid dermatitis . This occurs when an allergen or irritant comes into contact with the eyelids, causing the skin to become red, itchy, and possibly painful, blistering, or inflamed.

Although both are itchy, eczema is usually said to be a little more itchy . Also, the scaly appearance of the skin lesions is more noticeable. However, it is best to see a doctor to make a proper diagnosis.

What are the symptoms of eyelid psoriasis?

These symptoms can be very mild for some people, and more severe for others. See if you have any of these:

• Skin discoloration: The affected area may turn pinkish-red. Sometimes it may also turn brown.
• Scaling or peeling: You may see silvery white scales, like the scales of a sparrow, peeling off.
• Dry skin: The skin may feel dry, tight, and cracked.
• Itchy skin: This is the main and most annoying symptom for many people. Sometimes the itching can be unbearable.
• Pain or discomfort: Sometimes it can hurt or feel like burning.
• Vision impairment: If the eyelid becomes severely swollen, it can be difficult to open the eye properly, obstructing vision. The sclera can also stick to the eyelids, making them heavy.
• Skin swelling: The eyelid appears puffy and thickened.

These symptoms can affect the skin around the eyes, the upper eyelid, the lower eyelid, and the eyebrows. Sometimes, the eyelids can also become crusted and when they come off, the eyelids can fall off. This can also cause the edge of the eyelid to turn up or down (ectropion or entropion) . Think of it as an eyelid that just rolls inward and irritates the eye.

What causes psoriasis on the eyelids?

Simply put, the main reason for this is that dead skin cells accumulate at an abnormally fast rate. Our body's immune system is like an army that protects our country. Its job is to keep us healthy by fighting germs and bacteria that come from outside. However, in a person with psoriasis, some of the cells in this immune system (especially the T cells) mistakenly start attacking their own healthy skin cells. As a result, the process of producing skin cells becomes extremely fast. Normally, it takes about 28-30 days for a new skin cell to grow, mature, come to the surface of the skin, die and be shed. But in a place with psoriasis, this process happens very quickly, in 3-4 days. So, these rapidly growing cells pile up on top of each other before they are shed. That layer of dead cells is what we see as scales and scales. Other symptoms, such as swelling, redness, and itching, are caused by the overactivity of these cells and the associated inflammation.

Is eyelid psoriasis contagious?

No, not at all! This is a common misconception. Psoriasis is not contagious. It is not spread from person to person, by close contact, or by sharing a used towel. So if you have this condition, there is no reason to stay away from others, or for others to stay away from you.

How to diagnose eyelid psoriasis?

Your doctor can examine you and ask about your symptoms to determine if you have this condition. In most cases, it is possible to assume that it is psoriasis based on the appearance of your skin. However, sometimes a few tests may be done to confirm the diagnosis.

One special test is a skin biopsy. This involves taking a very small piece of the affected skin (after numbing it with medicine) and looking at it under a microscope. This can help to make sure it's not a similar condition like eczema.

Who diagnoses this disease?

Typically, to diagnose and treat a condition like this, you will need to go to:

• To a dermatologist . He is a person who specializes in skin diseases.
• Or to an ophthalmologist . Because this is an eye problem, it is important to treat it to prevent damage to the eye. Sometimes, both of these can be treated together.

What are the treatments for eyelid psoriasis?

Okay, now let's see what treatments are available for this. The skin around the eyes is very delicate, so you need to be very careful when treating it. Don't just go and do whatever you feel like without medical advice.

• Warm compress: You can apply a clean cloth soaked in warm (but not too hot, lukewarm) water to the affected eyelid for a few minutes at a time. This will help soften the sty and help it fall off, reducing discomfort.
• Use a mild soap or cleanser: When washing your eyelashes, use a gentle cleanser, such as baby shampoo, that is free of harsh chemicals and fragrances, and gently wash them. Do not rub vigorously.
• Topical medications: These are the main treatment. The doctor will prescribe:
• Mild corticosteroid creams . These reduce inflammation and itching. However, they are not recommended for long-term use around the eyes, as they can thin the skin.
• Tacrolimus ointments or Pimecrolimus creams . These are non-steroidal ointments that are somewhat safer for long-term use.

When using these medications , you should use them exactly as your doctor tells you, in the amount and for the duration of time prescribed. Be careful not to let them get into your eyes.

• Antibiotics: Sometimes, if your skin is injured and a bacterial infection develops, your doctor may prescribe antibiotics, either as a pill or as a topical cream.
• Artificial tears / hydrating eye drops to prevent dry eyes: If your eyes feel dry, you can use these types of eye drops to moisturize your eyes.

Can psoriasis be treated at home?

Yes, in some mild cases, along with medical advice, there are things you can do at home to manage your symptoms.

First of all, keep your skin clean with a soap or cleanser that is suitable for sensitive skin. This can reduce the risk of infection if the skin is damaged by scratching due to itching.

Next, apply a moisturizer to the skin around the affected eyelid. This will help reduce dryness and control itching. There are gentle creams available at the pharmacy that are specifically designed for scabies and are suitable for use around the eyes. However, if the symptoms are severe, a doctor should prescribe medication.

When choosing a cream to use at home, choose products that contain the following ingredients and are suitable for the eye area:

• Products containing coal tar (but only on medical advice around the eyes, as some people may be allergic to it). This reduces skin peeling, itching, and swelling.
• Low-strength hydrocortisone cream (e.g. 1%). This can also be used for a short period of time under medical advice to reduce swelling and itching.
• Unscented, hypoallergenic products: Fragrances can sometimes irritate the skin and cause allergies.
• Oil-based moisturizers: These help prevent skin from drying out. For example, if your doctor approves of something like petroleum jelly, you can apply a thin layer.

If your eyelid is sore or swollen, as mentioned earlier, make a compress with lukewarm water (not too hot). Close your eye and gently rub it. Do not press too hard.

Most importantly: If your symptoms do not improve within a few days with these home remedies, or if they seem to get worse, be sure to see a doctor.

Are there any side effects of the treatment?

Yes, you need to be very careful when using topical medications, especially steroids, especially those that are applied to the eyelids. Follow your doctor's instructions exactly as they say, including how often to apply them, how much to apply, how long to apply them, and where to apply them. Because if you use too much of these medications or if they get into your eyes the wrong way, they can be dangerous to your vision.

• Thinning of the skin
• Dry eye
• Cataracts
• Conditions such as glaucoma ( increased eye pressure) may occur. That is why it is important to undergo this treatment under the supervision of a doctor.

How soon will I feel better after starting treatment?

Itching and discomfort may subside as soon as treatment begins. However, some symptoms, especially skin thickening and scaling, may persist for several weeks, even with medication. Skin discoloration (redness or discoloration) may take several months to return to normal.

Most importantly, if these symptoms are affecting your mental health (such as feeling sad, anxious, or ashamed), or are interfering with your daily activities, see a doctor. Professional treatment can help speed up your recovery and boost your self-confidence.

What to expect if you have psoriasis on your eyelids?

Psoriasis is a chronic condition. This means that symptoms can flare-ups and go away (remission) throughout life. Symptoms may appear more frequently on other parts of the body than the eyelids. There may also be periods of complete remission, lasting months or even years.

Since eyelid crusts can interfere with clear vision, it's best to seek treatment as soon as symptoms begin. Early detection and proper management can prevent major problems from developing.

Can eyelid psoriasis be completely cured?

Unfortunately, there is currently no cure for psoriasis. Available treatments can only control symptoms, reduce the frequency of flare-ups, and maintain a good quality of life. Even if the disease appears once and is treated, it can still flare up in the future. Therefore, it is important to learn to live with it.

How to prevent eyelid psoriasis?

Although it is difficult to completely prevent flare-ups for someone who already has hives, you can do the following to reduce the risk:

• Keep your facial skin clean, especially around your eyes, by using a mild soap or cleanser daily.
• Apply a gentle, fragrance-free moisturizer around your eyes daily, or whenever your skin feels dry. This will strengthen the skin barrier.
• When going out in the sun, be sure to wear sunglasses with UV protection and use a sunscreen that is suitable for your face (but be careful not to get it around your eyes).
• Try to reduce stress. Things like yoga, meditation, and exercise can help, as stress can increase acne breakouts.
• Eat a balanced diet, drink plenty of water, and get enough sleep. These things are important for overall health, as well as skin health.

When should I see a doctor?

• If you have the previously described symptoms on your eyelids, be sure to see a doctor first to make sure it's a stye or something else.
• If your symptoms do not improve after several weeks of treatment, or even get worse.
• If your vision is affected (can't see clearly, eyes hurt).
• Sometimes, if the itching causes the skin to become irritated and pus-like discharge comes out of the wound, and there is swelling and inflammation, it could be an infection. If this happens, see a doctor immediately.
• If you feel like the medication you are taking is causing side effects.

What questions should I ask my doctor?

When you go to see the doctor, it's a good idea to be prepared to ask questions like these:

• Can I wear contact lenses if I have psoriasis on my eyelids? Or should I stop wearing them for a while?
• Are there any side effects to these medications? What are they?
• How often and how exactly should you apply eyelash cream?
• What should you do if this medicated cream accidentally gets into your eyes?
• Could this condition affect my vision in the long term?
• What else should I do at home to control this?

The most important things for you to remember (Take-Home Message)

Okay, so here are some of the most important things you need to remember from what we've talked about:

• Psoriasis is not a contagious disease, so don't be afraid or embarrassed.
• This is a chronic condition caused by changes in the functioning of the immune system. Although there is no complete cure, it can be well controlled.
• There are effective treatments to control the symptoms. So don't panic and follow your doctor's advice.
• When using topical medications around the eyelids , use them very carefully, as directed by your doctor. If they accidentally get into your eyes, they can damage your vision.
• If you have symptoms, especially if your vision is impaired, see a dermatologist or ophthalmologist immediately.
• It's normal to feel uncomfortable when you face a situation like this. If necessary, seek mental health counseling. It will give you strength.
• Keeping the skin clean, moisturized, and protected from the sun will help control this condition.

I hope this information is helpful to you. Remember, you are not alone. Many people live with these kinds of problems. If you have any questions, don't be afraid to ask a doctor!

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