Psoriasis is a common and commonly misunderstood disorder. Its not simply itchy, dry skin; according to the National Psoriasis Foundation (NPF), its caused by an immune-system dysfunction that brings on inflammation. Normally, a persons skin cells grow and shed in about a month, but for a person with psoriasis, that process is sped up, taking only about 3 or 4 days, and the result is a build-up of skin cells causing scales and plaque. About 8 million Americans deal with its discomfort every day, says the NPF.
Psoriasis is not curable, but thankfully its very treatable, says Mona Gohara, MD, associate clinical professor of dermatology at the Yale School of Medicine. Theres no need to endure the psychological or physical discomfort that may come along with this conditionseek treatment for it. There are a range of possible treatments, from topical creams and lotions to prescription oral medications. If you start at the bottom of therapeutic pyramid with creams, this may be enough to quell the irritation, says Dr. Gohara.
Some creams and lotions that can ease the dryness and itch are available over the counter; with others, youll need a prescription from a doctor. It takes a bit of trial and error to find what topical treatment may work best for you. Here, some guidance to the most common types of creams and lotions for psoriasis.
This is the active ingredient (approved by the FDA for treating psoriasis) in treatments that can help banish scales by softening them and making the outer layer of skin shed. You can find salicylic acid in many forms (not just lotions/creams/ointments, but also foams, soaps, gels, patches, and more). These treatments are designed to work in combo with others, because getting rid of the scales can help other treatments do their work more efficiently. If its a strong version, salicylic acid can irritate the skin and make hair more likely to break off, and that can lead to temporary hair loss, says the NPF.
The NPF says that these are the most frequently used treatments for psoriasis. Theyre designed to quell inflammation and pump the brakes on the growth of skin cells (this helps sidestep the buildup that produces scales). Steroid treatments come in different strengths; mild ones are available over the counter (OTC) and stronger types require a prescription. Generally, the stronger ones are needed for elbows, knees, and other hard to treat areas. These are powerful meds with potential side effects (thin skin, broken blood vessels, and more) and should be used carefully under a medical doctor's supervision. Also,the use of topical steroids on brown skin can create lightening, which may take time to repigment, says Dr. Gohara. Its always important to apply steroids directly on, not all around, lesions or areas of concern.
The NPF advises not to use a topical steroid for longer than three weeks without consulting a doctor, as well as to avoid stopping the use of one suddenly because that can cause a flare-up of your psoriasis. Another reason to use these under the care of a physician: Topical steroids can be absorbed via the skin and have an impact on internal organs when used for a long period of time or over a wide area of skin.
These prescription treatments also come in various forms not just creams, lotions and ointments, but also gels, foams, and more. In some medications, vitamin D is combined with a steroid. Like other treatments, meds with vitamin D slow down the pace of your skin cells' growth. (Depending on the specific medication, side effects can include skin irritation, stinging, burning, itching or excessive calcium in the urine.) One advantage of vitamin D creams is they dont run the risk of causing skin atrophy a very real side effect of chronic topical steroid use, says Dr. Gohara. But they can be more irritating. Generally, systemic side effects are rare, yet hypercalcemia is a theoretical risk, and your doctor may opt to have you get blood tests.
Vitamin A treatments
A topical retinoid, vitamin A is the active ingredient in prescription medication that comes in the form of a cream, gel, or foam. It also works by slowing the growth of skin cells. When using it, the plaques of psoriasis may turn bright red before clearing up. Side effects here also include skin irritation; the medication increases the risk of sunburn as well, so its critical to use sunscreen to protect your skin when using these meds.
Coal tar
This ingredient is found in different strengths in various treatment forms, including shampoo. It can be found in OTC products in its weaker strength and by prescription for stronger versions. Like other products, coal tar slows the growth of skin cells, but it can be stinky and irritating, and can stain your bedding and clothes (as well as blond hair).
Heres one of the challenging things about treating psoriasis: Your body can build up a tolerance to a certain medications, so something that seemed magical in its ability to bring you relief could suddenly stop working. On the other hand, a treatment that didnt work for you years ago could suddenly work wonders.
Thats why trial and error is a necessary part of psoriasis treatment. Finding the right treatment for psoriasis is much like finding the right partner. It may take some 'dating' until the right one finally comes along, says Dr. Gohara. Some may work for a bit, but then efficacy fizzles. Topical steroids are the most common culprit of this phenomenon, although it may happen with other topical or systemic medication as well.
According to the National Psoriasis Foundation, its key to moisturize daily it can lessen the itchy redness. They recommend that you use fragrance-free products and soaps that moisturize rather than dry you out, skip the way-hot shower (keep it lukewarm), and rub on moisturizer right after showering. The NPF recommends these OTC creams, based on information theyve heard from dermatologists while emphasizing that none of them are stand-ins for treatment from a healthcare provider. Still, theyre all deeply moisturizing and may improve some pesky symptoms such as flaking and itching:
Anti-Itch Concentrated Lotion with Calamine and Triple Oat Complex
This creamhas anti-inflammatory and antioxidant ingredients.
Moisturizing Cream for Psoriasis
CeraVe developed this with dermatologists to moisturize skin and rebuilt the skin barrier.
Hydra Therapy, Itch Defense Moisturizer
A shea butter lotion, it's designed to be used right after a shower.
Psoriasis Medicated Treatment Gel
$43.98
This gelhas salicylic acid to work on scales, itching, and dryness.
Skin Calming Intensive Itch Relief Lotion
With menthol and oatmeal, the lotion is especially good for nighttime itching, according to the manufacturer.
Ultimate Multi-Symptom Psoriasis Relief Cream
$28.82
A soothing cream with salicylic acid and a bunch of moisturizers.
Intense Skin Repair Body Lotion
Lubridermamazon.com
The manufacturer says this deeply moisturizing lotion lasts for 24 hours to help repair skin.
Medicated Moisturizing Psoriasis Cream
A salicylic acid cream that also contains aloe and shea butter.
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