Topical Treatment of Psoriasis

Psoriasis is a common skin condition that causes scaly, red patches to appear on the skin. While there are several different forms of psoriasis, most can be treated with topical applications that help the pain, itching, and redness subside.

Topical Corticosteroids

Topical corticosteroid can slow the spread of further psoriasis plaque and is available in ointment, cream and lotion form. According to the American Academy of Family Physicians, the type of treatment prescribed often depends on the size of the psoriasis lesions. The lowest-potency treatments (such as Cortizone or Cortaid) are used on delicate skin, such as the face or groin, while the highest-potency treatments (such as Temovate or Cormax) are used for thick, recurring plaque.

Calciopotriene

Topical calcipotriene, a form of vitamin D, is often prescribed with a topical corticosteroid. The two medications work with corticosteroids to control the spread of psoriasis. Calcipotriene is available in cream, ointment, or solution form. Once calciopotriene is initially applied, it may take 6- to 8-weeks to work, according to the American Academy of Family Physicians. However, once the creams have been applied twice daily for four weeks, the lesions should begin to flatten. At this point, calciopotriene should be applied twice daily; the corticosteroid treatment should only be applied twice per week. Over time, the corticosteroids will be used less and less. The calciopotriene will be applied less frequently as well. The goal is to ultimately reduce any topical applications; however, a patient should not immediately stop using the medications, as this could cause immediate flare-ups.

Coal Tar

Particularly useful for scalp psoriasis, coal tar is a black fluid that keeps psoriasis from synthesizing, or further spreading. Coal tar is available as an ointment, cream, lotion, shampoo, bath oil, or soap. For the scalp, it can be applied as a shampoo. Coal tar can be used in competition with calciopotriene and topical corticosteroids to treat psoriasis.

While it has very few side effects, coal tar is both messy and has a distinct, strong smell and can stain material. It is best applied at night.