Psoriasis Treatment: Topicals
Medicated topicals are usually a first-line treatment for mild psoriasis
During maintenance intervals between psoriatic flare-ups, patients typically purchase skin moisturizers, ointments, and emollients to keep their skin healthy. Creams and ointments applied to skin generally act to soothe and nourish the skin, seal in moisture, prevent cracking, and act as anti-bacterial/ anti-fungal agents.
Over-the-Counter (OTC) drugs include:
- Salicylic Acid
- Coal Tar
Over-the-counter (OTC) medicated topical treatments, purchased from stores without a prescription, may include either salicylic acid or coal tar which aid in reducing scale. Both salicylic acid and coal tar are classified as OTC monograph drugs by the FDA, meaning a manufacturer can add these ingredients to their OTC topical in amounts described by the FDA without having to file a new drug application. OTC monograph drugs used in products as directed by the FDA allow the manufacturer to make certain claims such as “reduces inflammation”. OTC monograph drugs become monographs because of their proven, long time use in the market.
For most mild psoriasis, the first line of treatment is a prescription-based medicated topical. Active ingredients may include:
- Synthetic and naturally-derived Vitamin D3 forms
- Vitamin A derivatives
- Steroids (e.g. corticosteroids)
Vitamin A and D3 topical preparations are utilized to slow skin cell growth by modulating the immune system of the skin over which they are applied. Both have various side effects which may include itching, rash, and skin irritation.
Anthralin is a derivative of the South American Araroba tree. It is utilized to slow skin cell growth in psoriasis.
Corticosteroid preparations range from “mild” to “super-potent” depending on concentration and type. Corticosteroids affect inflammatory responses in the body, and are used to reduce swelling and redness of the skin over which they are applied. Corticosteroid use typically creates side effects (e.g. skin thinning, irritation, bruising, etc.). Abrupt discontinuation of corticosteroid use is linked with psoriasis flare-ups.