What are the best topical psoriasis medications?

Table of Content:
Prescription creams and ointments | Psoriasis pills | Psoriasis injections | Over the counter creams for psoriasis

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Psoriasis medications have evolved significantly in recent years with the development of newer treatments that offer more targeted and effective approaches. These psoriasis medications, often referred to as immunomodulatory drugs and biologic medications, specifically address the immune system dysregulation underlying psoriasis. 

Dr. Alpana Mohta, a board certified dermatologist, says that while biologics and systemic medications have been at the forefront of treating moderate to severe psoriasis, topical medications and lifestyle changes continue to be essential for managing mild to moderate forms of the condition. 

This dermatologist’s guide dives into the different types of medications used to treat psoriasis including over-the-counter, topical, oral and injectable medications. This guide aims to help you and your online dermatologist make an informed decision over your psoriasis treatment plan.

Do you need a prescription to get psoriasis medication?

Yes, most psoriasis medication require a doctor’s prescription. The type of medication (oral, topical or injectables) you get will depend on the severity of your symptoms.

What type of psoriasis medicine can you get via Miiskin?

Via Miiskin and most other telehealth platforms, you can only get a prescription for topical medications. Oral medications and biologics need an in-person consultation with a dermatologist.

How to get a prescription for a topical psoriasis medication?

You can have a consultation via Miiskin with an independent, board-certified dermatologist. Consultation prices are $55 – $69 and prescription refills are $30 – $39. You will get your prescription in 1-2 business days.

What are the best prescription creams and ointments for psoriasis?

Many individuals with psoriasis prefer to try a psoriasis cream or ointment, before taking oral medications, since topical treatments have less and milder side-effects. Dr. Alpana Mohta gives a comprehensive list of the best psoriasis creams available.

Topical steroids

Topical corticosteroids are often the first-line treatment for mild to moderate psoriasis. They can help reduce inflammation and control symptoms. However, long-term use should be avoided on the face due to the risk of skin thinning¹.

Topical calcineurin inhibitors

Two psoriasis creams often prescribed by dermatologists are tacrolimus ointment and pimecrolimus cream,  topical immunomodulators that can be used on the face, they help control inflammation without the risk of skin thinning associated with steroids².

Topical Vitamin D analogs

Topical creams containing vitamin D analogs, such as calcipotriene cream, can be effective in managing facial psoriasis by slowing down the growth of skin cells³.

Coal tar

Coal tar creams for psoriasis can help alleviate itching and scaling, but they have a strong odor and may be less cosmetically acceptable for use on the face.

Zithranol 

Zithranol (having anthralin as the active ingredient) is a topical cream highly efficient in the treatment of psoriasis. It has been used for many years to manage symptoms, particularly in the form of a cream, ointment, or paste applied directly to the affected skin areas⁵.

Vtama

Vtama cream (having tapinarof as the active ingredient) functions as an anti-inflammatory agent by modulating the activity of certain proteins involved in the skin’s inflammatory response. The FDA recently approved its use as a safe and effective treatment option for patients aged 12 and above. The recommended concentration for Vtama is 1% cream, and it’s applied once daily to the affected skin areas*. 

*This medication is very expensive and requires a pre-approval for insurance 

Zoryve

Zoryve (having roflumilast as the active ingredient) is another recently FDA-approved topical cream for psoriasis treatment, functions as a phosphodiesterase-4 (PDE-4) inhibitor. Its mechanism involves suppressing inflammatory cytokines, thereby reducing inflammation associated with psoriasis. It comes in a concentration of 0.3% in cream or ointment form.*

*This medication is very expensive and requires a pre-approval for insurance 

Over the counter treatment for psoriasis

Over the counter treatment for psoriasis can help manage mild to moderate symptoms and provide relief from itching and scaling. However, it is important to note that while over the counter creams can be beneficial, they may not be as effective as prescription medications for more severe cases of psoriasis. Here are some OTC creams to manage mild symptoms of psoriasis.

• Moisturizers with ceramides, glycerin and hyaluronic acid
• White soft paraffin and liquid paraffin
• Coal tar products
• Salicylic acid
• Lactic acid
• Urea
• Hydrocortisone
• Capsaicin cream
• Aloe vera gel
• Oatmeal baths
• Calamine
• Camphor
• Menthol

The takeaway

Although psoriasis is a chronic and autoimmune condition by using stress-coping techniques, identifying and managing your triggers, and adequate treatment, you can more less stay symptom-free most of the time. Talk to your online dermatologist, or find a dermatologist in your area to get the treatment plan for you. 

Did you know that psoriasis can also affect the face, causing redness and scaling? For more details on managing facial psoriasis, check out our in-depth article “Psoriasis on face: What is it and how to get rid of it?“

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