People with psoriasis, a chronic autoimmune condition, have a specific set of symptoms of the skin called plaques that develop due to inflammation in the body. This process of inflammation causes an excessive number of new skin cells to be produced, which push older skin cells to the surface layer of the skin before they are ready to be shed. Plaques are areas of raised, reddened skin that are often covered with a layer of slivery scales.
Although psoriasis cannot be cured, there are many different medications that people can use to help control symptoms and manage the condition. These include:
- Over-the-counter (OTC) treatments
- Prescription topical treatments
- Systemic medications
- Biologic targeted medications
Topical treatments are applied directly to skin affected by psoriasis symptoms. They are available in a wide range of forms, including creams, gels, foams, solutions, and shampoos. Systemic medications, including biologic targeted therapies, are more powerful medications that reduce symptoms by affecting the way the immune system functions. They are usually taken by mouth, an injection, or infusion. Many psoriasis medications can be used in combination with each other, and your healthcare provider will let you know which are safe to combine.
What over-the-counter treatments?
Most people with psoriasis have a mild form of the disease, with symptoms affecting less than 3% of the body. Many people with mild psoriasis have symptom relief from over-the-counter treatments, which are available without a prescription in a drugstore or supermarket. Common over-the-counter treatments include3:
- Moisturizers and emollients
- Salicylic acid products
- Coal tar products
- Itch relief products
Non-medicated topical moisturizers are frequently used as an adjunct therapy and may be used to help soften areas of plaque to help reduce pain, cracking and bleeding symptoms. Salicylic acid products work by helping to soften and lift the scales on psoriasis plaques, as well as reducing itch. They are also known as scale lifters or peeling agents. Coal tar products help to reduce the amount of new skin cells produced and also relieve itching, inflammation, and scaliness. Itch relief products contain substances that reduce itching, one of the most common symptoms of psoriasis.
Read more about over-the-counter treatments for psoriasis.
What are prescription topical treatments?
Stronger topical treatments are available by prescription for people whose symptoms are not controlled well enough with over-the-counter topical treatments. These include:
- Topical corticosteroids
- Dovonex (calcipotriene)
- Taclonex, Enstilar (calcipotriene and betamethasone dipropionate)
- Vectical (calcitriol)
- Tazorac (tazarotene)
- Zithromax-RR (anthralin)
- Protopic (tacrolimus)
- Elidel (pimecrolimus)
Topical corticosteroids, the most commonly used psoriasis treatment, work by reducing inflammation to relieve swelling, redness, and itching. Long-term use of corticosteroids can cause complications like thinning of skin. Vitamin D analogues and retinoids made from vitamin A) are also common treatments, which work by slowing skin cell growth to reduce plaques. These include Dovonex, Taclonex, Enstilar, Vectical, and Tazorac3. Anthralin also reduces skin cell growth, but can take longer to work. Protopic and Elidel are calcineurin inhibitors that are sometimes used off-label to treat psoriasis.
Read more about prescription topical treatments for psoriasis.
What are systemic medications?
Systemic medications are usually prescribed for people with moderate-to-severe psoriasis that is not controlled well enough with topical treatments4. They are very powerful medicines taken by mouth or through an injection. They can cause some serious side effects, so healthcare providers will talk with patients about the risks and benefits before beginning treatment with systemic medications.
Non-biologic systemic medications generally work to improve psoriasis symptoms by affecting the way the person’s immune system works and reducing the amount of inflammation, which is the root cause of psoriasis symptoms. These include:
Read more information about non-biologic systemic medications for psoriasis.
What are targeted biologic medications?
Biologic therapies are also systemic medications, but they work by targeting more specific substances in the immune system that contribute to inflammation1. These include:
- Cosentyx (secukinumab)
- Enbrel (etanercept)
- Humira (adalimumab)
- Remicade (infliximab)
- Stelara (ustekinumab)
- Taltz (ixekizumab)
- Tremfya (guselkumab)
Read more about systemic biologic medications for psoriasis.