|  | Conditions & Treatments | Rashes

Topical Treatments for Psoriasis: Creams, Ointments & Selection Guide

Topical therapy is first-line for mild-moderate psoriasis (≤10% BSA).

Classes & Examples

  1. Corticosteroids: Hydrocortisone (low), triamcinolone (mid), clobetasol (super-high). Anti-inflammatory, antipruritic. Limit potent steroids to 2–4 weeks (atrophy, striae).
  2. Vitamin D analogs: Calcipotriene, calcitriol. Slow keratinocyte proliferation. Combine with steroids for synergy.
  3. Retinoids: Tazarotene. Normalizes differentiation. Irritating; avoid in pregnancy.
  4. Calcineurin inhibitors: Tacrolimus, pimecrolimus. For face/folds/genitals (no atrophy). Off-label for psoriasis.
  5. Anthralin: Short-contact therapy. Stains, irritates. Less used.
  6. Salicylic acid: Keratolytic; removes scale, enhances penetration of other topicals.
  7. Coal tar: Anti-inflammatory, antipruritic. Messy, odor. OTC/shampoo.
  8. Newer: Roflumilast (PDE4 inhibitor), tapinarof (aryl hydrocarbon receptor agonist) — non-steroidal, safe for long-term.

    9. Selection Principles

    • Potency matched to site (face/folds: low potency/TCI; palms/soles: super-high).
    • Vehicle: ointment > cream > lotion > foam > spray (occlusion).
    • Combination products (calcipotriene/betamethasone) improve adherence.

    Dermatologist tailors regimen. Rotate to minimize side effects.

Rashes - Related Articles