Psoriasis Treatment

Medically reviewed by:

Dr Dan Bunstone - Medical Officer

Updated: Aug 18, 2021

Next review: Aug 18, 2022

Although it cannot be cured, psoriasis treatments can usually help you manage the condition day-to-day.

The type of psoriasis you have and how severe it is will dictate what type of treatment you need, as a treatment for one person does not always work for another. This can mean that sometimes it is a case of ‘trial and error’, which in turn means it can sometimes take a while to work out the best treatment for you.

Regular reviews with a doctor, or your dermatologist if you have one, are important to make sure you find the most suitable treatment for you.

Psoriasis treatments include topical treatments, which includes creams, gels or ointments that can be applied to the affected skin. They are available from a GP.Phototherapy is another option, where the skin is exposed to a type of ultraviolet (UV) light - a specialist will need to prescribe this type of treatment. Or there are systemic treatments - these are injected or oral medicines that treat psoriasis throughout your whole body. You’ll need to see a specialist for this type of treatment.

Let’s take a look at these treatments in more detail.

Topical psoriasis creams are a psoriasis home treatment that, in many cases, is all that is needed to keep the condition under control.

Creams include:

Emollients and moisturisers

These are available to buy from pharmacies, supermarkets or other high street stores. Some may be prescribed by a GP. They can help to make your skin feel more comfortable and help with the dryness and scaling that psoriasis can cause. They are usually recommended together with another topical treatment, as they help your skin absorb other treatments more easily

Steroid creams

Also known as topical corticosteroids, these usually work quite quickly. They reduce inflammation and can help to reduce itchiness. Different steroid creams are available, and these should be used as directed by a doctor and only for the suggested amount of time, as using them too much can cause skin thinning and lead to more common flare ups.

Calcineurin inhibitors

Calcineurin inhibitors block the chemical calcineurin to help reduce the inflammation, which caused the redness and itching. These might be prescribed when steroid creams haven’t worked, or if you have side effects to steroids. They may also be prescribed to treat sensitive areas of, such as around the eyes.

Vitamin D-based topical applications

Vitamin D gels, creams lotions or ointments work by slowing down the production of new skin cells and encouraging normal skin cell growth. These medicines may be prescribed for use alongside steroid creams and because they do not contain steroids, they can be used for a long time.

Vitamin A-based topicals

Used on well-defined plaques of psoriasis, Tazarotene can be used for up to 12 weeks. However, as Vitamin A can make you more sensitive to UV light, you can’t use phototherapy, and must limit the time you spend in the sun, or under any other kind of UV light.

Coal tar

Coal tar is possibly the oldest form of treatment for psoriasis, particularly for scalp psoriasis. These days it is usually less messy than the traditional form of the treatment, but it does have a strong smell. The thick oil helps to reduce inflammation, itchiness and any scales. It may be used in conjunction with phototherapy (see below) as it can make your skin more sensitive to the light.

Dithranol

Dithranol is a short-term treatment and it works by restoring normal skin development. Dithranol can be used in conjunction with phototherapy (see below) as it can make your skin more sensitive to the light. Often, this treatment is carried out in hospital.

Also known as ultraviolet (UV) light therapy, phototherapy can be used to treat psoriasis and it is usually carried out in a hospital or specialist centres.

Many people report their psoriasis improves when in the sunshine, and this treatment has a similar effect. The skin is exposed to different types of light:

Ultraviolet B (UVB) – This may be used if topical treatments have not helped.
Psoralen plus ultraviolet A (PUVA) – You will need to take a psoralen tablet or have psoralen applied to your skin before the light is used, which makes it more sensitive to the light. It may be used if other treatments have not worked, or if your psoriasis is severe.

You may be prescribed oral or injected medications if your psoriasis is severe or isn't responding to other treatments.

These medicines have to be prescribed by a dermatologist as they have potential risks associated with their use. They will usually only be prescribed after topical or phototherapy treatments have not worked.

Systemic medications include:

Methotrexate
Acitretin
Cyclosporin
Etanercept
Adalimumab
Ustekinumab
Infliximab

Other drugs are available – a specialist will be able to recommend the most suitable for you and explain how the treatment is administered and whether there are any side effects.

Dr Dan Bunstone - Medical Officer

Topical psoriasis treatments

Phototherapy treatment

Systemic psoriasis treatment

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