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Topical Treatments for Psoriasis

Reviewed by: HU Medical Review Board | Last reviewed: January 2024

Psoriasis is an autoimmune condition caused by the immune system mistakenly attacking the body. This triggers the over-production of new skin cells which make plaques. Plaques are patches of thick, red, and scaly skin that develop from the buildup of skin cells. Psoriasis is typically treated with topical treatments.1

How do topical treatments work?

Topical treatments are treatments that are applied to the skin or scalp, such as creams or ointments. Topical treatments try to stop the excess growth of skin cells and remove scales. The specific way they work depends on the treatment that is used. Topical treatments come in many forms, including creams, foams, lotions, and shampoos.1,2

Examples of topical treatments

Examples of topical treatments include:1-3

  • Corticosteroids
  • Vitamin D analogues
  • Retinoids
  • Calcineurin inhibitors
  • Salicylic acid
  • Coal tar
  • Anthralin

What are corticosteroids?

Topical corticosteroids are the most commonly used treatment for psoriasis. They work by controlling the body’s inflammatory response. This in turn decreases the swelling, redness, and itching of the skin. Corticosteroids come in a range of strengths. Mild strengths are available over the counter, while strong corticosteroids require a prescription. Over time, corticosteroids can stop working.1-3

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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 controlling the extra skin cell production. Vitamin D analogues may be combined with steroids.1-3

What are retinoids?

Tazarotene is a retinoid that has been shown effective for treating psoriasis. It is typically used twice per day and is available as a cream or gel. It works by slowing skin cell growth. Tazarotene is not recommended if you are pregnant, breastfeeding, or planning to become pregnant.1,3,4

What are calcineurin inhibitors?

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

Calcineurin inhibitors are not recommended if you are pregnant, breastfeeding, or planning to become pregnant. They also may increase your risk for skin cancer. They are not recommended for long-term use.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 or over-the-counter strengths. It may be paired with other topical treatments because it helps the skin absorb medication.1,5

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 pregnant, breastfeeding, or planning to become pregnant.1,5

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.1,3,4

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:1-4

  • Irritated skin
  • Stinging or burning feeling on your skin
  • Dry or itchy skin
  • Discolored or red skin
  • Increased sensitivity to sunlight

These are not all the possible side effects of topical treatments. Talk to your doctor about what to expect when taking topical treatments. You also should 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.