The following information is from the National Institute of Health website1.
Topical Treatments for Psoriasis
Treatments applied directly to the skin may improve its condition. Doctors find that some patients respond well to ointment or cream forms of corticosteroids, vitamin D3, retinoids, coal tar, or anthralin. Bath solutions and lubricants may be soothing, but they are seldom strong enough to improve the condition of the skin. Therefore, they usually are combined with stronger remedies.
Corticosteroids. These drugs reduce inflammation and the turnover of skin cells,
and they suppress the immune system. Available in different strengths, topical
corticosteroid are usually applied to the skin twice a day. Short-term treatment is
often effective in improving, but not completely eliminating, psoriasis. Long-term
use or overuse of highly potent (strong) corticosteroids can cause thinning of the
skin, internal side effects, and resistance to the treatment's benefits. If less than
10 percent of the skin in involved, some doctors will prescribe a high-potency
corticosteroid ointment. High-potency corticosteroids may also be prescribed for
plaques that don't improve with other treatment, particularly those on the hands or
feet. In situations where the objective of treatment is comfort, medium-potency
corticosteroids may be prescribed for the broader skin areas of the torso or limbs.
Low-potency preparations are used on delicate skin areas.
Calcipotriene. This drug is a synthetic form of vitamin D3 that can be applied to
the skin. Applying calcipotriene ointment twice a day controls the speed of turnover
of skin cells. Because calcipotriene can irritate the skin, however, it is not
recommended for use on the face or genitals. It is sometimes combined with
topical corticosteroids to reduce irritation. Use of more than 100 grams of
calcipotriene per week may raise the amount of calcium in the body to unhealthy
levels.
Retinoid. Topical retinoids are synthetic forms of vitamin A. The retinoid
tazarotene is available as a gel or cream that is applied to the skin. If used alone,
this preparation does not act as quickly as topical corticosteroids, but is does not
cause thinning of the skin or other side effects associated with steroids. However,
it can irritate the skin, particularly in skin folds and the normal skin surrounding a
patch of psoriasis. It is less irritating and sometimes more effective when
combined with a corticosteroid. Because of the risk of birth defects, women of
childbearing age must take measures to prevent pregnancy when using tazarotene.
Coal tar. Preparations containing coal tar (gels and ointments) may be applied
directly to the skin, added (as a liquid) to the bath, or used on the scalp as a
shampoo. Coal tar products are available in different strengths, and many are sold
over the counter (not requiring a prescription). Coal tar is less effective than
corticosteroids and many other treatments and, therefore, is sometimes combined
with ultraviolet B (UVB) phototherapy for a better result. The most potent form of
coal tar may irritate the skin, is mess, has a strong odor, and may stain the skin or
clothing. Thus, it is not popular with many patients.
Anthralin. Anthralin reduces the increase in skin cells and inflammation. Doctors
sometimes prescribe a 15 to 30 minute application of anthralin ointment, cream, or
paste once each day to treat chronic psoriasis lesions. Afterward, anthralin must be
washed off the skin to prevent irritation. This treatment often fails to adequately
improve the skin, and it stains skin, bathtub, skin, and clothing brown or purple. In
addition, the risk of skin irritation makes anthralin unsuitable for acute or actively
inflamed eruptions.
Salicylic acid. This peeling agent, which is available in many forms such as
ointments, creams, gels, and shampoos, can be applied to reduce scaling of the
skin or scalp. Often, it is more effective when combined with topical
corticosteroids, anthralin, or coal tar.
Clobetasol propionate. This is a foam topical medication, which has been
approved for the treatment of scalp and body psoriasis. The foam penetrates the
skin very well, is easy to use, and is not as messy as many other topical
medications.
Bath solutions. People with psoriasis may find that adding oil when bathing, then
applying a lubricant, soothes their skin. Also, individuals can remove scales and
reduce itching by soaking for 15 minutes in water containing a coal tar solution,
oiled oatmeal, Epsom salts, or Dead Sea salts.
Lubricants. When applied regularly over a long period, lubricants have a soothing
effect. Preparations that are thick and greasy usually work best because they seal
water in the skin, reducing scaling and itching.
Light Therapy
Systemic Treatment
Combination Therapy and Psychological Support
Promising areas of Psoriasis Research
1 http://www.niams.nih.gov/Health_Info/Psoriasis/default.asp
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