Topical Treatments for Psoriasis

Psoriasis is an autoimmune condition. It is caused by the immune system mistakenly attacking the body. The body then makes too many new skin cells, which build up to form plaques. Plaques are patches of thick, red, scaly skin. Psoriasis is typically treated with topical treatments.¹

How do topical treatments work?

Topical treatments are treatments that you apply directly to your skin or scalp. Topical treatments try to stop the excess growth of skin cells and remove scales. The specific way they work depends on the product. Topical treatments come in many forms, including:^1,2

• Creams
• Ointments
• Foams
• Lotions
• Shampoos

Examples

Examples of topical treatments include:^1-5

• Corticosteroids
• Vitamin D analogues
• Retinoids
• Calcineurin inhibitors
• Salicylic acid
• Coal tar
• Anthralin
• Drugs that target specific processes

What are corticosteroids?

Topical corticosteroids are the most common treatment for psoriasis. They work by controlling the body’s inflammatory response. Controlling inflammation decreases skin swelling, redness, and itching. Corticosteroids come in many strengths. Mild strengths are available over the counter. But strong corticosteroids require a prescription. Over time, corticosteroids can stop working.^1-3

Examples of corticosteroids include:^1-3

• Hydrocortisone
• Halobetasol
• Triamcinolone
• Clobetasol
• Desoximetasone

What are vitamin D analogues?

Vitamin D analogues are synthetic forms of vitamin D. Examples of vitamin D analogues include calcipotriene and calcitriol. They work by slowing down extra skin cell production. Vitamin D analogues may also be combined with steroids.^1-3

What are retinoids?

Retinoids work by slowing skin cell growth. Tazarotene is a retinoid that has been shown to be effective for treating psoriasis. It is available as a cream or gel. Tazarotene is not recommended if you are:^1,3,6

• Pregnant
• Breastfeeding
• Planning to become pregnant

What are calcineurin inhibitors?

Calcineurin inhibitors reduce rashes and scale buildup. Examples include tacrolimus and pimecrolimus. Calcineurin inhibitors are used off-label and may be helpful for psoriasis symptoms where the skin is delicate, like around the eyes. It is typically not safe to use steroids or retinoids on delicate skin.^1-3

What is salicylic acid?

Salicylic acid helps soften and remove psoriasis scales. It is a type of treatment called a keratolytic. This is also known as a peeling agent or scale lifter. Salicylic acid comes in prescription and over-the-counter strengths. It may be paired with other topical treatments because it helps the skin absorb medicine.^1,7

What is coal tar?

Coal tar is a product that comes from making coal. It helps slow skin cell growth and reduce inflammation and itching. It is available in prescription or over-the-counter strengths. Coal tar products can be messy and stain clothes, bedding, or light hair. Coal tar is not recommended if you are:^1,7

• Pregnant
• Breastfeeding
• Planning to become pregnant

What is anthralin?

Anthralin is a synthetic version of a natural substance that comes from araroba trees. It removes scales, slows cell growth, and can make skin smoother. It can stain your skin or nails, so use gloves or wash your hands after applying it. Anthralin is not recommended if you are:^1,3,6

• Pregnant
• Breastfeeding
• Planning to become pregnant

What are drugs that target specific processes?

Some drugs treat psoriasis by activating or limiting specific processes in the body. These processes may be involved with the inflammation that causes psoriasis. Examples of these drugs are:^4,5

• Vtama® (tapinarof) – A type of drug called an aryl hydrocarbon receptor agonist
• Zoryve® (roflumilast) – A type of drug called a phosphodiesterase-4 inhibitor

What are the possible side effects of topical treatments?

Side effects can vary depending on the specific drug you are taking. Possible side effects include skin that:^1-5

• Is irritated, dry, or itchy
• Looks discolored or red
• Stings or burns
• Sunburns more easily

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

Other things to know

Your doctor will help you decide what type of topical treatments may be right for you.

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.