Psoriasisis usually treated with a combination of self-care interventions, medications, and ultraviolet (UV) light therapy.
Psoriasis treatment requires an individualized approach based on thetype, location, and severity of psoriasis you have.
Hydrocortisone cream should not be used on the face or genitals unless so directed by your healthcare provider.
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Numbing Creams
Someanti-itch creamswork by temporary numbing nerve receptors in the skin.
Antihistamines
Oralantihistamineswork by blocking chemicals, called histamines, that trigger allergy symptoms.
In doing so, they may help reduce itchiness.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
It works by dissolving scales so that they can be washed or brushed away easily.
This makes it easier for medications applied to the skin to be absorbed.
Studies report treatment success in more than half of people treated with coal tar for 12 weeks.
Side effects of coal tar are minimal and may include skin irritation and redness.
Coal tar has a pungent, resiny odor and can permanently stain fabrics if splashed or splattered.
This can help loosen plaques without pain or bleeding.
Prescriptions
Topical prescription medications are considered the mainstay of moderate to severe psoriasis treatment.
They may be used on their own or incorporated into combination therapies.
They are used when topical drugs are unable to control psoriasis on their own.
Some suppress the entire immune system, while others target specific parts of the immune response.
They come in a variety of formulations and are chosen based on the severity and location of the lesions.
Options include:
Topical corticosteroids can cause side effects if not used as directed.
That said, they have none of the long-term side effects of topical steroids.
These drugs are especially gentle and can even be applied to the face and groin.
Despite longstanding concerns, research has never confirmed that calcineurin inhibitors increase cancer risk.
The evidence has not been found and their use is considered safe.
Tazorac (tazarotene) is the topical retinoid approved for the treatment of plaque psoriasis.
It works best when combined with other psoriasis medications.
Tazorac should not be used during pregnancy since it can harm a fetus.
Tazorac is available as a cream, gel, or foam.
Anthralin is still sometimes used as an alternate option if other medications fail to provide relief.
Psoriatec may cause redness and burning but doesn’t damage the skin, even with long-term use.
It is also less expensive than some of the newer psoriasis treatments.
It works by activating aryl hydrocarbon receptors located in the skin to reduce inflammation.
Common side effects include itching, folliculitis, skin rash, and headache.
Cyclosporine is known to causehigh blood pressure, liver damage, and kidney impairment.
Periodic blood tests are needed to avoid treatment complications.
Biologics
Biologic drugsare medications derived from living cells cultured in a lab.
Most of the biologics are delivered by injection or IV infusion (given through a vein).
Oral retinoids are also ideal for people with immunosuppression who aren’t candidates for methotrexate or biologics.
Unlike other oral medications, Soriatane can be taken with biologic drugs.
Soriatane should never be used during pregnancy due to the risk of birth defects.
Nail Psoriasis
The same treatments that work for skin psoriasis also work for nail psoriasis.
Nail removal may be needed to remove badly deformed nails so that new ones can grow.
PDE4 Inhibitors
Otezla (apremilast) is an oral medication classified as a PDE4 inhibitor.
It is approved for the treatment of moderate to severe psoriasis, as well as active psoriatic arthritis.
Otezla works by blocking an enzyme known asphosphodiesterase4 (PDE4), which promotes inflammation within cells.
Specialist-Driven Procedures
Psoriasis is not treated surgically.
UV light therapy, also called phototherapy, uses the same principle.
Controlled bursts of UV light can slow skin cell production and help achieve remission.
Phototherapy is highly effective in treating psoriasis, either alone or in conjunction with topical or systemic drugs.
Phototherapy Types
Phototherapyhas immunosuppressive and anti-inflammatory effects beneficial to people with psoriasis.
Potential side effects include burning, itching, redness, and sunburn (particularly in fair-skinned people).
The treatment also poses a slightly increased risk of skin cancer over an extended time.
In more severe cases, home remedies for psoriasis can complement other treatments.
Skin Care
Establishing adaily bathingand moisturizing routine can help minimize scaling and relieve persistent itching.
Overheating the skin promotes inflammation and the risk of flares; over-soaking the skin increases skin dryness.
So use water warm rather than hot.
Also, limit showers to five minutes and baths to 15 minutes, and avoid vigorous scrubbing.
A washcloth is usually all you gotta slough off loose scales.
Daily shampooing is a good way to gently buff plaques from the scalp.
Itch Relief
Pruritis(itchiness) is an especially irritating aspect of psoriasis.
Itching can further inflame the skin.
Stress Management
Stress is a major trigger of psoriatic flares.
They include:
Guided imagery involves thinking about a calming scene to relieve stress.
Adding OTC medications can help during flares.
Moderate or severe psoriasis needs more and is typically treated with prescription medications and light therapy.
Response to treatments varies widely from person to person.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
American Academy of Dermatology Association.What psoriasis treatments are available without a prescription?
National Psoriasis Foundation.Over-the-counter topicals.
Domagaa A, Szepietowski J, Reich A.Antihistamines in the treatment of pruritus in psoriasis.pdia.
2017;5:457-463. doi:10.5114/ada.2017.71112
U.S. Food & Drug Administration.Code of federal regulations title 21.
Results from a double-blind, randomized, vehicle-controlled study.J Cosmet Dermatol.
2023 Jul;22(7):2050-2053. doi:10.1111/jocd.15693
DermNet.Topical steroid.
Drugs for plaque psoriasis.Med Lett Drugs Ther.
2018;31(6):e12728.
2018;93(3):385-390. doi:10.1590/abd1806-4841.20186723
U.S. Food & Drug Administration.Tazorac.
U.S. Food & Drug Administration.VTAMA (tapinarof) cream.
Ogdie A, Coates LC, Gladman DD.Treatment guidelines in psoriatic arthritis.Rheumatology (Oxford).
2020 Mar 1;59(Suppl 1):i37-i46.
doi:10.1093/rheumatology/kez383
National Psoriasis Foundation.Biologics.
American Academy of Dermatology Association.8 ways to stop baths and showers from worsening your psoriasis.
National Eczema Association.Managing itch.
National Psoriasis Foundation.Herbs and natural remedies.
American Academy of Dermatology Association.Are triggers causing your psoriasis flare-ups?
