For a study, researchers sought to find a link between facial involvement and clinical aspects like psoriasis severity in children and adolescents. Patients diagnosed with psoriasis under 20 were retrospectively examined and classified depending on the presence or absence of face involvement at presentation. Between groups, demographic and clinical data were compared. At the presentation time, 110 of the 175 patients (62.9%) had psoriasis on the face. Face involvement was associated with a lower body mass index (BMI) (P=.043) and a higher psoriasis area and severity index (PASI) score (P<.001). The severity of pruritus in the facial group was substantially higher than in the non-facial group (P=.020). The nose was related to the most severe disease severity as measured by the PASI score and the most afflicted body surface area. The face group used a considerably larger number of treatment modalities than the non-facial group (P=.013). The BMI (odds ratio (OR), 1.39; 95% CI, 1.07–1.80) and PASI score (OR, 1.45; 95% CI, 1.03–2.03) were both found to be independent predictors in psoriasis face involvement. Facial involvement was linked to higher disease severity and more therapy options in children and adolescents with psoriasis.