What topical medications are used to treat psoriasis?

Patients with limited disease (usually ,20% of their body surface) can often be managed on topical agents alone. Although systemic corticosteroids generally should not be used, topical and intralesional corticosteroids are a first-line treatment. For plaques, medium- to high-potency corticosteroids used daily can result in a rapid response, often controlling the inflammation and itching. Unfortunately, the relief is often temporary, and tolerance can occur. Side effects include atrophy and telangiectasias, especially if high-potency topical preparations are used on the face or intertriginous areas (see also Chapter 54).

Coal tar preparations can also be effective, especially if used with topical corticosteroids. Anthralin, a synthetic derivative of chrysarobin, a tree bark extract, is effective in daily, short applications for chronic plaque psoriasis, but its irritant qualities often worsen inflammatory psoriasis.


Calcipotriene (Dovonex), a vitamin D3 analog, is an effective treatment for localized psoriasis, but its cost and the possibility of systemic absorption resulting in changes in calcium homeostasis preclude its use in extensive disease. Calcipotriene should be limited to a maximum dosage of 100 gm/wk. A newer and potentially more effective treatment is the combination of calcipotriene and the corticosteroid, betamethasone diproprionate (Taclonex).

Menter A, Gottlieb A, Feldman SR, et al: Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics, J Am Acad Dermatol 58:826–850, 2008.