Topical Treatments for Chronic Plaque Psoriasis: What Works Best?
Published: Jul 20, 2024
When it comes to managing chronic plaque psoriasis, topical treatments are often the first line of defense. These medications applied directly to the skin can help reduce inflammation, slow skin cell growth, and relieve symptoms.
Contents
Topical Corticosteroids: The Go-To Option
Topical corticosteroids are the most commonly prescribed treatment for chronic plaque psoriasis. They work by reducing inflammation and slowing skin cell growth. These medications come in various strengths, from mild to super-potent. Your doctor will recommend the appropriate strength based on the location and severity of your psoriasis. While effective, long-term use can cause side effects like skin thinning, so they're typically used for short periods or intermittently.
Vitamin D Analogs: A Gentler Approach
Vitamin D analogs, such as calcipotriene and calcitriol, are another important topical treatment. These synthetic forms of vitamin D slow skin cell growth and help remove scales. They're often used alone for mild psoriasis or in combination with topical corticosteroids for more stubborn cases. Vitamin D analogs are generally well-tolerated and can be used for longer periods than topical corticosteroids.

Newer Topical Options
Recent years have seen the introduction of new topical treatments for psoriasis. These include tapinarof, a non-steroidal cream that reduces inflammation, and roflumilast, which works by inhibiting an enzyme involved in inflammation. These newer options provide alternatives for people who don't respond well to or can't use traditional treatments. They may also have fewer side effects than some older medications.
Combination Therapy: A Powerful Approach
Often, a combination of topical treatments works better than a single medication alone. For example, using a topical corticosteroid with a vitamin D analog can be more effective than either treatment on its own. Some products come as fixed combinations, making application easier. Your doctor may also recommend using different treatments on different days of the week to maximize benefits and minimize side effects.
Frequently Asked Questions
Many people see improvement within 2-4 weeks of consistent use.
It depends on the specific medication; always follow your doctor's instructions.
Some OTC products can help, but prescription treatments are often more effective.
They can't cure psoriasis, but can effectively manage symptoms for many people.
Your doctor may recommend other options like light therapy or systemic medications.
Finding Your Best Treatment
With numerous topical options available, finding the right treatment for your psoriasis may take some trial and error.
References
- Elmets CA, et al. J Am Acad Dermatol 2021; 84:432.
- Mason AR, et al. Cochrane Database Syst Rev 2013; :CD005028.
- Lebwohl MG, et al. JAMA 2022; 328:1073.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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