Topical Corticosteroids

Topical corticosteroids are a very common treatment for psoriasis. For a lot of people, they may be the first treatment your doctor suggests. Topical means it goes directly on the skin. Corticosteroids are similar to the hormones our bodies naturally make. Many people will call these treatments topical steroids.^1-3

How do topical corticosteroids work?

Psoriasis is an autoimmune condition. It is caused by the immune system mistakenly attacking the body, which causes inflammation. This inflammation triggers the over-production of new skin cells, which in turn cause plaques. Plaques are patches of thickened, red, and scaly skin that develop from the buildup of skin cells.^2,3

We do not know exactly how topical corticosteroids treat psoriasis. But corticosteroids do reduce inflammation and cell growth, which are the main parts of psoriasis. They also can suppress the immune response that leads to psoriasis.^2,3

Using topical corticosteroids can have several useful effects:^1-3

• Reduced swelling
• Reduced itching
• Reduced redness
• Less plaque buildup

Some people find that their skin completely heals after using corticosteroids. But these results may not happen for everyone or last forever.³

Examples of topical corticosteroids

There are many different types of topical corticosteroids for psoriasis. Some are even available over the counter. But stronger drugs require a prescription. Examples of topical corticosteroids include:^2,3

• Hydrocortisone
• Clobetasol propionate
• Betamethasone dipropionate
• Fluocinonide
• Flurandrenolide
• Amcinonide
• Halobetasol propionate
• Halcinonide
• Desoximetasone
• Triamcinolone acetonide

Topical corticosteroids are available in many different forms and strengths. The specific forms and strengths available will depend on the drug you use. Your doctor will decide the strength based on your symptoms. For example, you may use a lighter strength on your face. But thick plaques may need a higher strength. Possible forms of corticosteroids include:^2,3

• Creams
• Ointments
• Gels
• Foams
• Lotions
• Solutions
• Shampoos

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. Possible side effects of topical corticosteroids include:^1,3

• Skin thinning
• Changes in skin color
• Bruising more easily
• Stretch marks
• Red skin
• Visible blood vessels
• Skin irritation

Side effects from topical corticosteroids are more common on sensitive skin. This includes the face, groin, or breast skin. The risk of side effects is also higher for stronger corticosteroids, especially if they are used for a long time.¹

If you stop using a steroid after using it for a long time, your psoriasis may flair. To prevent this, you may reduce how often you use a corticosteroid once your symptoms are controlled. For example, you might use it every day for 3 weeks, then switch to only weekends for maintenance.^1,3

These are not all the possible side effects of topical corticosteroids. Talk to your doctor about what to expect when taking topical corticosteroids. You also should call your doctor if you have any changes that concern you when taking topical corticosteroids.

Other things to know

Your doctor will help you decide which topical corticosteroids may be right for you.

Do not apply corticosteroids around your eyes unless your doctor specifically tells you to. Only use a small amount of your topical treatment at a time. Only use it where you have symptoms. Do not use a corticosteroid for longer than your doctor advises.^1,3

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.