Topical Treatment for Psoriasis.

Topical treatment involves use of psoriasis creams and psoriasis ointments for local application over the affected area of the skin. This treatment is suitable for mild form of psoriasis.

However, use of baths solutions, moisturizers, mineral oil and petroleum jelly as topical treatments for psoriasis will help soothe the psoriatic skin and reduce the skin dryness which normally accompanies skin psoriasis.

Psoriasis Cream.

1) Bath Salts.  

These are quite safe and can be helpful in a number of cases. Epsum salt soaks can be used or soaking in high mineral waters like of the Dead sea in the middle east will be helpful.

2) Moisturizers for Psoriasis.

They help in reducing the itching, scaling, dryness and cracking of the skin which accompanies psoriasis. Moisturizers in an ointment base are more useful than those in cream base. These moisturizers, available as over the counter and on prescription, should contain salicylic acid, lactic acid, glycolic acid and urea in therapeutic concentration for better effect.

Brand names include Salex (salicylic acid), Amlactin and Lac-Hydrin(both lactic acid). These can be applied once or up to thrice a day to good effect. Avoid their use on eyelids, face and the genitals. Other moisturizers such as Vaseline or Crisco may help in reducing the dryness of the skin.

3) Salicylic Acid Preparations.

Available  both as over the counter and on prescription, salicyclic acid reduces the scaling of the skin and helps in sloughing of the dead skin cells. Salicyclic acid is available in the form of medicated shampoos and scalp lotions (for scalp psoriasis).

4) Topical Corticosteroids.

These are recommended for mild to moderate form psoriasis. These are anti-inflammatory creams which reduce the inflammation on the affected skin. These creams slow down the excessive cell turnover and reduce itching. Mild corticosteroid creams are recommended for skin covering the face, skin folds, underarms and the groin.

Stronger preparations are prescribed for more resistant and thickened forms of psoriasis and for skin covering the elbows and the knees. Application is recommended once or twice daily. Overuse is cautioned as it can cause thinning of the skin and damage. Resistance too can develop. Psoriasis corticosteroid creams are therefore recommended only for active outbreaks.

5) Vitamin D Analogues|Calcipotriene.

This is synthetic form of vitamin D and not the same as that, which is given for oral use. Calcipotriene (Donovex) is a prescription vitamin D cream. Other types of vitamin D analogues include calcipotriol, calcitriol and tacalcitol. These slow down the production of skin cells and reduce inflammation.

These are one of the most common types of topical treatments indicated in mild to moderate psoriasis and are often used along with phototherapy or other topical corticosteroid creams. Taclonex is one such preparation which combines vitamin D and corticosteroids.

They are effective in certain cases and have the advantage that they do not cause skin thinning as corticosteroids creams do. Over usage can result in its absorption leading to increased calcium levels. It is therefore recommended not to use them over 20% of the skin.

6) Anthralin.

Anthralin or Dithranol reduces skin cell over activity by normalizing the activity of the DNA in the skin cells. It smoothens the skin by getting rid of the scales. It is available as cream, ointment or paste. It has a slow mode of action in controlling psoriasis taking up to several weeks.

Its disadvantage lies in the fact that besides skin irritation, it causes staining of the skin, clothes and the bed sheets or anything it comes in contact with. It is therefore recommended for use over open skin and for a short period of 10 to 30 minutes only. The treated area is covered with tube gauze and surrounding skin is covered with soft white paraffin for protection.

7) Topical Retinoids.

These are also used in the treatment of Acne and sun burnt skin. Tazarotene (Tazorac, Awage)  is specifically indicated for treating moderate plaque psoriasis. It contains a compound similar to vitamin A and acts by slowing down the over production of the skin cells and also reduces skin inflammation. It does this by normalizing the activity of the DNA of the skin cells.

Side effects include skin irritation and increased sensitivity to sunlight. Sun screens are advised if you have to venture out into sunlight after this has been applied. Although risk of congenital birth defects are minimal with these topical applications, its use during pregnancy and breast feeding is not recommended. Similarly its use in children is restricted.

Coal Tar.

This is probably the oldest treatment being used for psoriasis. It is a thick black or brown oil obtained as a byproduct during the manufacture of petroleum products and coal. It is supplied as Coal Tar Topical Solution. It reduces the itching and scales and also has an anti inflammatory action. The mechanism of action is not known.

Side effects are few but the biggest disadvantage is that it is messy, stains the clothes and has a strong odor resembling that of napthalene. Over the counter, it is available as shampoos, ointments, soaps and oil. Higher concentrations require a prescription. Brand names include Denorex and Psoriacin among others.

9) Calcineurin Inhibitors

Calcineurin inhibitors (tacrolimus and pimecrolimus) are used in the treatment of atopic dermatitis. They have also been found to have some success in certain types of psoriasis. Their action is believed to be by disruption of T cells and consequently reducing the scales and inflammation. They are to be used only if prescribed by your doctor.

Side effects include skin irritation. Their use does not cause thinning of the skin but long term use has been associated with skin cancer and lymphoma.

Related posts:

1. Topical and Systemic Treatments for Mild and Severe Scalp Psoriasis.
2. Retinoids – Oral and Topical Treatments..
3. Treatment of Psoriasis.
4. Oral and Injection Treatment for Psoriasis.
5. Symptoms of Psoriasis.
6. Phototherapy or Light Therapy for Psoriasis.
7. Statistics for Psoriasis.
8. Risk Factors That Can Give You Psoriasis.