There are many different treatments for psoriasis, including topical therapy, systemic therapy, and light therapy. The severity of the condition and personal preference will affect which treatment combination is best for a person.
Treatment options help manage symptoms and prevent the condition from worsening.
This article explains the different types of medical and over-the-counter treatments available for psoriasis and how they work. It also answers some frequently asked questions (FAQs).
According to the American Academy of Dermatology Association (AAD), there is no best treatment for psoriasis. However, a person can work with a dermatologist to determine which options are best for them.
Treatment aims to:
- relieve symptoms
- improve the skin
- prevent the condition from worsening
- treat any nail changes, if they are present
- manage and reduce joint pain, if a person has psoriatic arthritis
Topical creams can help alleviate symptoms.
Emollients
Emollients are an important treatment option for psoriasis. They provide intense moisture to support dry skin, which can help prevent irritation. They can also help improve the function of other topical medications.
However, they do not work by themselves. Instead, a person will need to use these alongside other treatment options for psoriasis.
Corticosteroids
Suitable for mild or moderate psoriasis, corticosteroids can help:
- reduce inflammation
- reduce scaling
- reduce itching
- slow the growth of skin cells
They are available in different strengths. A person can purchase mild corticosteroids without a prescription. A dermatologist can prescribe stronger corticosteroids, depending on a person’s treatment needs.
Synthetic vitamin D
Applying synthetic vitamin D can help:
- slow the growth of skin cells
- remove the scales
- flatten thick psoriasis
- treat nail and scalp psoriasis
The AAD notes that a dermatologist may combine this medication with topical corticosteroids if a person needs stronger medication.
Synthetic vitamin D is suitable for treating psoriasis in most people, including children. A person may notice an improvement in symptoms after 2 weeks.
Topical calcineurin inhibitors (TCIs)
It is important to note that this medication was originally intended to treat eczema. However, a dermatologist may prescribe TCIs off-label.
TCIs can treat psoriasis that affects more delicate skin areas, such as the face, neck, and body folds.
Although TCIs have a good safety record, they are newer medications and long-term safety is unknown.
Salicylic acid
Salicylic acid is a keratolytic agent that helps remove the rough scale associated with psoriasis. It is available in a variety of over-the-counter (OTC) treatments.
A dermatologist may recommend salicylic acid alongside corticosteroids.
This medication is not suitable for treating psoriasis in children. Pregnant people should speak with a dermatologist before using salicylic acid.
Topical retinoids
Retinoids are derivatives of vitamin A. They are useful for maintaining psoriasis at a manageable level. It helps normalize the level of cell turnover in the skin of a person with psoriasis.
Topical retinoids help:
- slow the growth of skin cells
- reduce thick psoriasis
- reduce inflammation
- reduce swelling
- reduce scaling
- treat nail psoriasis
A combination of topical retinoids and corticosteroids can provide effective results and may result in longer remission.
Roflumilast cream
This cream can help treat mild, moderate, and severe psoriasis. It is also suitable to treat psoriasis that affects the skin folds, or inverse psoriasis.
It can help treat psoriasis in both children and adults and is safe to apply once a day, as long as a person needs it.
Tapinarof cream
Tapinarof cream can treat mild, moderate, and severe psoriasis in adults.
People may notice that their psoriasis improves after 12 weeks of use.
Coal tar
The AAD notes that coal tar is present in many psoriasis treatments. It is cheaper than other treatment types, and a person can use it long term.
It can help:
- treat plaque-type psoriasis
- reduce itching and scaling
- treat scalp psoriasis and psoriasis affecting the soles and palms
A dermatologist may suggest coal tar as a stand-alone treatment or alongside other medications in a treatment plan.
Anthralin
Anthralin is a type of cream that reduces the inflammatory processes that trigger psoriasis. A doctor may prescribe anthralin in the form of short-contact anthralin therapy (SCAT), where treatment is of high concentrations.
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Phototherapy exposes a person’s skin to ultraviolet light under medical supervision.
There are two main types of phototherapy — ultraviolet light B (UVB) and ultraviolet light A (UVA). The AAD notes that most people undergo UVB phototherapy.
UVB phototherapy can help:
- slow growth of skin cells
- reduce itching and inflammation
- suppress an overactive immune system
People should not apply salicylic acid before undergoing phototherapy treatment. Salicylic acid can decrease the efficacy of UVB phototherapy.
If a person’s condition requires stronger treatment, a dermatologist may suggest medications that work throughout the body.
There are a variety of oral and injectable medications that help alleviate symptoms of psoriasis:
- Apremilast: This medication works to suppress inflammatory processes that cause psoriasis, which helps reduce the thickness and redness of plaques.
- Cyclosporine: This medication is used in adults to treat psoriasis that is extensive or disabling. It also works quickly. However, it is not suitable for everyone as it suppresses the immune system.
- Biologics: These medications target only the specific components of the immune system responsible for psoriasis symptoms. These are newer medications that can cause fewer side effects than other medications. A doctor will administer these medications through injection.
- Oral retinoids: Retinoids can help slow the rapid skin cell growth that causes psoriasis. These medications do not suppress the immune system.
There are many ways to help manage symptoms of psoriasis at home, including over-the-counter treatments that a person can buy.
A person can use emollient creams at home to help treat psoriasis. Some treatments contain active ingredients, such as coal tar, hydrocortisone, and salicylic acid.
These ingredients are often in the forms of:
- ointments
- shampoos
- creams
- bath solutions
A doctor or dermatologist will create an individualized treatment plan. This will help create the most effective way to relieve a person’s symptoms.
Some things a dermatologist may consider include:
- the type of psoriasis a person has
- where on the body psoriasis occurs
- how severe the psoriasis is
- any other medical conditions
People should also discuss any potential risks and side effects with a dermatologist.
A person will not be able to treat psoriasis using natural remedies alone. However, when used alongside medical treatment options, they may be able to help relieve symptoms.
It is important that a person checks with their dermatologist prior to starting any natural treatments alongside their current treatments.
Herbal remedies may have dangerous interactions with medications that a person is not aware of. For example, those taking cyclosporine should avoid a herb called St. John’s Wort.
Herbal remedies may also be inappropriate for people with certain conditions, such as high blood pressure.
The National Psoriasis Foundation notes that the following integrative approaches may be beneficial for psoriasis:
- massage
- aloe vera
- apple cider vinegar
- dead sea salts, or Epsom salts
- colloidal oatmeal
- turmeric
However, more research is necessary to confirm the safety and efficacy of natural treatment options.
The following are FAQs about treatment for psoriasis.
What is the best treatment for psoriasis?
The best treatment for psoriasis will vary between different dermatologists and between individuals. The treatment will depend on the type and severity of the psoriasis, and which part of the body it affects.
What clears psoriasis fast?
Psoriasis is a lifelong condition that typically comes and goes. Forming a treatment plan with a healthcare professional can help to relieve a psoriasis flare. Lifestyle changes, such as avoiding known triggers, may also help.
What are triggers for psoriasis?
Triggers vary depending on the individual. However, common psoriasis triggers include:
- stress
- skin injury, including tattoos and piercings
- dry or cold weather
- excessive or frequent alcohol consumption
- smoking
- infection, such as earache or bronchitis
What food should people with psoriasis avoid?
Following a specific diet will not necessarily cure psoriasis. However, foods that
- alcohol
- saturated fatty acids
- simple sugars
- red meat
While no cure for psoriasis yet exists, there are many treatments to help manage symptoms. These include topical creams and lotions, phototherapy, and other types of medications.
A person can work with their dermatologist to determine the best treatment combination for their symptoms.
