What Types of Medicines Are Used to Treat Psoriasis?

Psoriasis is a common skin condition. People with psoriasis develop areas of raised, reddened skin (plaques) due to inflammation. These patches are often covered with a layer of silvery scales.¹

There is no cure for psoriasis. But treatments can help control symptoms. Psoriasis can take a toll on your overall quality of life, and medicine can help you manage the condition. Drug treatment options include:²

• Over-the-counter (OTC) treatments
• Prescription topical treatments
• Systemic drugs
• Biologic drugs
• Biosimilars

The right treatment depends on your symptom severity, personal preferences, and other factors. Many psoriasis treatments can be combined. Talk to your doctor about what options are right for you.^1-3

Over-the-counter medicines

Most people with psoriasis have mild symptoms. This means that symptoms affect less than 3 percent of their body. People with mild psoriasis may be able to control their symptoms with only OTC treatments. These are available without a prescription.

Common OTC treatments for psoriasis include:^1,2,4,5

• Moisturizers and emollients
• Salicylic acid products
• Coal tar products
• Itch-relief products

You may use these products as add-on therapies with prescription medicines. They help keep skin soft and moist. They also reduce the production of new skin cells, which helps lessen itching, irritation, and cracking.^1,2,5

Prescription topical treatments

OTC drugs may not control symptoms for people with more severe psoriasis. For these people, stronger topical treatments are available by prescription. The most common of these are topical corticosteroids. They reduce inflammation to relieve swelling, redness, and itching. Examples of topical corticosteroids include:^1,2,4

• Bryhali^® lotion (halobetasol propionate)
• Trianex^® (triamcinolone)
• Cormax (clobetasol)

Vitamin D analogs are also common prescription topical treatments. They slow skin cell growth to reduce plaques. They are often combined with corticosteroids in a single treatment. Examples include:^1,2,4

• Dovonex^® (calcipotriene)
• Vectical (calcitriol)
• Taclonex^®, Enstilar^® (calcipotriene and betamethasone dipropionate)
• Wynzora^® cream (calcipotriene and betamethasone dipropionate)

Retinoids are medicines that look similar to vitamin A. They also slow skin growth and are often combined with corticosteroids. Examples of retinoids include:^1,2,4

• Tazorac^® (tazarotene)
• Duobrii^® (halobetasol propionate and tazarotene)

Calcineurin inhibitors help treat psoriasis in sensitive areas such as the face and groin. They slow the growth of certain immune cells involved in psoriasis. Examples include:^1,2,4

• Protopic^® (tacrolimus)
• Elidel^® (pimecrolimus)

Other topical treatments work in different ways to reduce inflammation and skin growth. These include:^1,2

• Zithranol (anthralin)
• Vtama^® cream (tapinarof)
• Zoryve^® cream (roflumilast)

Systemic medicines

People with more severe psoriasis may need systemic medicines. These are stronger drugs taken by mouth or injection. Systemic drugs work in different ways to suppress the immune system and reduce inflammation throughout the body. Inflammation is a main cause of psoriasis symptoms.^2,6

Examples of systemic medicines include:^1,2,6

• Jylamvo^® and others (methotrexate)
• Sandimmune^® (cyclosporine)
• Otezla^® (apremilast)
• Sotyktu™ (deucravacitinb)

Systemic medicines can have serious side effects and warnings from the US Food and Drug Administration (FDA). Be sure to discuss this with your doctor.

Biologic medicines

Biologics are a type of systemic medication made from parts of living cells. Biologics target specific agents in the immune system to reduce inflammation. These drugs are some of the most effective treatments for severe psoriasis.^2,7,8

Some biologics block a protein called tumor necrosis factor-alpha (TNF-alpha). These are given by injections or intravenously (IV). They include:^2,9

• Enbrel^® (etanercept)
• Remicade^® (infliximab) and unbranded infliximab
• Humira^® (adalimumab)
• Cimzia^® (certolizumab pegol)
• Simponi^® (golimumab)

Other biologics block the activity of a protein called interleukin (IL)-17. These include:^2,9

• Cosentyx^® (secukinumab)
• Taltz^® (ixekizumab)
• Siliq^® (brodalumab)
• Bimzelx^® (bimekizumab)

Different biologics block the activity of other proteins called IL-12 and IL-23. These include:^2,9

• Ilumya^® (tildrakizumab-asmn)
• Skyrizi^® (risankizumab-rzaa)
• Stelara^® (ustekinumab)
• Tremfya^® (guselkumab)

What are biosimilars?

Biosimilars are biologic drugs that are very similar to biologics that have been approved by the FDA. They may cost less than the original biologic drug. They have the same active ingredients, benefits, and side effects. In certain states, a pharmacist can substitute an “interchangeable” biosimilar for the original drug without a doctor’s approval.^10-12

Biosimilars approved to treat psoriasis include:^10-12

• Humira biosimilars – Amjevita^®, Cyltezo^®, Hyrimoz^®, and others
• Remicade biosimilars – Inflectra^®, Renflexis™, Avsola^®, and Ixifi™
• Enbrel biosimilars – Erelzi™ and Eticovo™
• Stelara biosimilar – Wezlana™

Biosimilars have the same boxed warnings as their reference drugs. Not all of these biosimilars may be available yet.¹⁰

Emerging treatments

Many medicines are under investigation for psoriasis treatment. For example, Omvoh® (mirikizumab) is a biologic approved to treat ulcerative colitis. Clinical trials have shown it also may be useful in treating psoriasis. Other new systemic and topical treatments are also emerging.^2,13

Other things to know

All drugs can cause side effects, and side effects can vary depending on the drug you are taking. Talk to your doctor about the risks and benefits before starting any new medicine for psoriasis.

Before beginning treatment for psoriasis, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.