Treatment of Psoriasis Involving the Face or Inverse (Intertriginous) Areas

Psoriasis affecting the face or skin-fold (intertriginous) areas requires a tailored approach. These sites are particularly susceptible to local adverse effects from certain topical agents, making careful treatment selection important.

Clinical Scenario

This protocol covers facial psoriasis and inverse (intertriginous) psoriasis — anatomic locations where the skin is thinner or occluded. Lower potency corticosteroids are recommended for the face, intertriginous areas, and other sites susceptible to steroid atrophy and related adverse effects.

Treatment Approach Partial preview

The protocol centres on steroid-sparing topical therapy, with specific agents selected according to whether the involvement is facial, inverse, or both. The complete regimen — including which agents apply to each location, sequencing, and course length — is available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jaad.2020.07.087

Lower potency corticosteroids should be used on the face, intertriginous areas, and areas that are susceptible to steroid atrophy (eg, forearms) and other adverse effects.

The off-label use of 0.1% tacrolimus for psoriasis involving the face as well as inverse psoriasis for up to 8 weeks can be considered.

The off-label use of pimecrolimus for inverse psoriasis for 4–8 weeks is recommended.

Topical tacalcitol ointment or calcipotriene combined with hydrocortisone for 8 weeks can be used for the treatment of facial psoriasis.

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