Topical Therapy for Psoriasis

There are numerous topical products that help control the mild variety of psoriasis and these include:

Topical corticosteroids: Corticosteroids are potent drugs and are often prescribed for psoriasis. They work best for mild to moderate psoriasis. They act as anti inflammatory drugs and slow the cell turn over. In addition, the drugs also relieve the itch, redness and swelling. The topical corticosteroids range in potency based on their concentration. The higher concentration topical steroids should never be used on the face. They are best used to treat psoriatic plaques and patches on the feet and soles. Only low concentration topical steroids should be used on the face. To get the best out of corticosteroids and reduce the side effects, only use them during acute outbreaks of psoriasis.

Vitamin D analogues: We now have synthetic topical drugs derived from vitamin D. The drugs reduce the inflammation and prevent the rapid cell turnover which is typical of psoriasis. Calcipotriene (Dovonex) is available as a prescription cream, ointment or solution. The topical paste can either be used alone or in combination with other corticosteroids or phototherapy.

Anthralin: Anthralin (derived from tree bark) has been used to treat psoriasis for many decades. The chemical stops the rapid cell multiplication and reduces the redness. Anthralin (Dritho-Scalp or Psoriatec) is a useful agent for mild psoriasis but is real messy to use and stains everything in sight. Most individuals prefer not to use it for this reason. Most Anthralin products are only used for short term therapy for facial psoriases. The cream is washed off at night. It may be combined with light therapy

Topical Retinoids: Topical Retinoids are frequently used to treat psoriasis. Tazarotene (Tazorac) was designed specifically for the treatment of psoriasis. Like other vitamin A derivatives, it reduces the rapid cell turn over in skin cells. When applied to the skin, it can cause irritation. Further, the drug has also been associated with serious toxicity to the fetus in pregnancy, so all females of child bearing age should discuss the pros and cons of using topical Retinoids with their physician.

Calcineurin inhibitors: Currently, calcineurin inhibitors (tacrolimus and pimecrolimus) are only approved for the treatment of atopic dermatitis, but reports indicate that these drugs may also be useful for psoriasis as well. These drugs act by suppressing the immune system and prevent the characteristic plaque build up in psoriasis. The agents are only used for short term intervals as they have the potential to cause skin cancers.

Coal tar: This thick paste derived from coal has been used to treat psoriasis for many years. The paste is applied for a few minutes and reduces the redness and itching in psoriasis. It should be avoided on the eyes and nose. How it works is not understood. Besides being messy, it also stains clothes and skin. The product also has a disagreeable odor. Coal tar is frequently used in combination with light therapy.

Moisturizers: Most lotions, ointments or moisturizers do not heal psoriasis but only relieve the itch and dryness. They may help prevent the dryness that also occurs with the other therapies.

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