April 17, 2014
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Psoriasis


Know your psoriasis treatment options

You have many options for treating your mild psoriasis. When discussing treatment options with your doctor, it's important to consider which treatment would be best for you. Factors to consider include:

  • the risks and benefits of using the medication
  • how the medication is given
  • convenience of using the medication
  • whether you have tried medications already
  • cost

Talk to your doctor about the most appropriate psoriasis treatment for you. With effective treatment and management, psoriasis lesions can be cleared.

Topical psoriasis medications

One of the most common approaches to treating mild psoriasis is the use of topical medications - creams, ointments, and lotions that are applied directly to your skin.

Topical medications are effective at clearing psoriasis lesions. You should always use topical medications as directed by your doctor or pharmacist.

Topical medication treatment options for mild psoriasis include:

  • corticosteroids
    • Topical corticosteroids work by decreasing inflammation, redness, and itchiness.
    • They are usually applied sparingly to psoriasis lesions once or twice a day. Different strengths and formulations are used for different parts of the body. Usually, less potent corticosteroids are used for thin-skinned or sensitive areas (e.g., face, skin folds, groin, breasts). Stronger corticosteroids are used for thicker skin (e.g., palms, soles).
    • There are many topical corticosteroids. Some of these include: amcinonide (Cyclocort® and generics), betamethasone dipropionate (Diprosone® and generics), betamethasone valerate (Betaderm®, Valisone®, and generics), clobetasol propionate (Dermovate® and generics), desoximetasone (Topicort® and generics), hydrocortisone (Emo Cort® and generics), and prednicarbate (Dermatop®).
       
  • vitamin A derivatives
    • Vitamin A derivatives, or retinoids, such as tazarotene (Tazorac®), are believed to work by slowing down skin cell growth.
    • A thin layer is applied once a day to the affected areas. Tazarotene is used on the body (not the face or skin folds).
       
  • vitamin D derivatives
    • Vitamin D derivatives work by controlling the abnormal growth of cells to help flatten lesions and remove scales.
    • They are usually applied twice a day to the affected areas of the body (not the face or skin folds). When used with a topical corticosteroid, calcipotriol (a vitamin D derivative) and the corticosteroid should be applied once daily, at different times of the day (e.g., one in the morning and the other in the evening).
    • Vitamin D derivatives include calcipotriol (Dovonex®), which is a synthetic form of vitamin D, and calcitriol (Silkis™), a naturally occurring active form of vitamin D. These are not the same as the vitamin D you find in vitamin supplements taken by mouth. Calcipotriol is also available in combination with betamethasone as an ointment (Dovobet®) or a scalp gel (Xamiol®).
       
  • anthralin
    • Anthralin, also known as dithranol, works by slowing the growth of skin cells that cause psoriasis lesions.
    • It is usually applied once a day and can be applied to the body and scalp. It can be prepared into a compounded mixture by a pharmacist.
       
  • salicylic acid
    • Salicylic acid is a peeling agent that works by shedding the outer layers of the skin, helping to soften and remove psoriasis scales.
    • It is usually applied once or twice a day to the body or once or twice a week to the scalp.
    • It is available without a prescription combined with other topical medications such as coal tar (e.g., Targel SA, Polytar AF®) and corticosteroids (e.g., Diprosalic®, Nerisalic®), or it can be prepared into a compounded mixture by a pharmacist.
       
  • coal tar
    • Coal tar (e.g., Targel, Doak Oil™) works by helping to slow the growth of skin cells and reducing inflammation, itching, and scaling.
    • It is usually applied once a day to the affected areas of the body for 2 hours or scalp for 5 to 10 minutes (not in folds of skin). Some formulations can also be added to bath water.
    • It is available without a prescription, or it can be prepared into a compounded mixture by a pharmacist.

Like other medications, topical psoriasis medications may have side effects. To learn more, see "Topical medications for psoriasis" or speak to your pharmacist or doctor.

This is not a complete list of all side effects, warnings and precautions. For detailed and current information for each medication, see the Consumer Information section of the approved Product Monograph, which can be found on the Health Canada website.

Keep in mind that even if topical medications do not clear up your symptoms, there may be other treatment options that will better control your mild psoriasis. You may want to consider asking your doctor for a referral to a dermatologist who specializes in psoriasis.

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