Most patients with psoriasis covering only a small portion of their bodies can usually get their condition under control with topical treatment -- creams, gels, or other medications applied directly to the skin. There are several different types of topical treatments available.
The most common drugs used in a topical preparation are corticosteroids. (These steroids are not to be confused with the type of steroids that make you grow muscles.) The mildest of these, hydrocortisone is available over-the-counter in a 1% strength. Psoriasis, however, is often too stubborn to treat with OTC hydrocortisone alone. Cortisone creams come in many strengths (classes), and higher strengths require a prescription. The stronger the cortisone, the lower the class. Class 1 steroids are exponentially stronger than class 7 steroids.
Strong steroid creams have side effects that are not to be underestimated. They can cause stretch marks to develop in closed areas, such as the armpits and groin, and tend to thin the skin over time. Covering large areas of the body with strong steroids can suppress the body's natural cortisol production, reducing your ability to cope with stresses like infection, injury or surgery. Always ask your doctor exactly where you are and are not supposed to apply any topical.
We can lump anything that's not a steroid into this group.
- Immune modulating drugs, such as Protopic (tacrolimus) and Elidel (pimecrolimus), reduce inflammation without the side effects of steroids.
- Vitamin D-derived Dovonex (calcipotriene) normalizes cell growth.
- Tazorac (tazarotene) is a retinoid (vitamin-A like) drug which normalizes cell growth and maturation.
Not Just Greasy Ointments Anymore
Topical drugs for psoriasis come in a dizzying variety, including ointments for dry areas, creams for moist areas, watery liquids, oils, gels and foams for hairy areas, tapes for thickened areas, and sprays for large areas. Whatever area of your body you need to treat, you can be sure there is a product designed just for it.