NYU Langone dermatologists treat many people who have psoriasis with topical medication, which is applied to the affected areas of the skin. Some of these medications are available over the counter; others require a prescription. Topical medications may reduce the size and number of lesions and alleviate symptoms such as itching, burning, and swelling.
Based on the appearance of your skin, your doctor determines if one or a combination of topical medications is right for you. Topical medication is usually most effective for people with mild to moderate psoriasis, meaning lesions cover less than 10 percent of their bodies. Our experts provide instructions on how much of the medication to apply and when.
If topical medication relieves your symptoms, your doctor may recommend you use it for years, as part of a long-term treatment plan. Throughout treatment, he or she monitors how well the medication is working during periodic follow-up visits. Your doctor also looks for any side effects, such as thinning skin at the site of application. If you have side effects, your doctor may adjust how often you apply the medication or prescribe a different type.
Topical medication may lead to dry skin, which can exacerbate psoriasis symptoms. Doctors often recommend using an over-the-counter moisturizer, as well.
Corticosteroids are prescription medications that reduce inflammation, which causes itching, swelling, and redness. They also prevent the body from overproducing new skin cells and slow the formation of new lesions.
Corticosteroid creams and gels are available in varying potencies. Your dermatologist may recommend a low potency for sensitive areas of skin, such as the face and genitals, and a higher potency for very thick lesions or those that don’t respond to less potent forms. Corticosteroid shampoos are available for people with scalp psoriasis or dandruff.
The side effects associated with long-term use of topical corticosteroids include thinning skin and discoloration. Your dermatologist determines how long you should use topical steroids and may recommend other forms of treatment for long-term use.
Topical medication chemically related to but distinct from vitamin D inhibits the growth of skin cells and may reduce the number of new psoriasis lesions. Your dermatologist may recommend this medication in addition to other forms of treatment, such as light therapy, to enhance their effectiveness.
Coal tar is a substance derived from coal that can slow skin cell growth and reduce the redness, swelling, and itching of psoriasis. This medication is available over the counter or by prescription as a cream, ointment, foam, or shampoo.
Some people find topical coal tar medication effective, but it may leave a dark stain on clothing or bedding. Medication with coal tar also makes the skin more sensitive to sun exposure; doctors recommend you apply a broad-spectrum sunscreen of SPF 30 or higher whenever you spend time in the sun.
Salicylic acid is an ingredient in many over-the-counter and prescription creams, gels, and shampoos used to treat psoriasis. It may improve the appearance of skin by removing dead skin cells, including the white or silver scales of plaques.
Anthralin is a synthetic form of a natural substance found in the bark of the South American araroba tree. When applied as a topical medication, anthralin slows the growth of skin cells. Your dermatologist may recommend this medication when psoriasis is resistant to other topical treatments. Anthralin may be used in combination with another topical therapy, such as corticosteroids.
Anthralin is available by prescription in varying strengths. Your doctor determines which strength is right for you based on the appearance of your skin and other symptoms.
Your doctor may recommend a calcineurin inhibitor if psoriasis affects sensitive areas of the body, such as eyelids or genitals. The medication blocks calcineurin, a protein that plays a role in skin inflammation.
Your doctor may recommend a topical retinoid cream or gel to improve the appearance of psoriasis, including thickened fingernails and toenails. Retinoids, derived from vitamin A, reduce inflammation and slow down cell turnover—the rate at which new cells replace old ones—helping nails remain healthy and appear less chalky and thick.