Psoriasis - Topical Medications

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Application. Apply anthralin only to the psoriasis plaques. Rub in the cream well, and wipe off any excess. Wash off only with lukewarm water, not soap. Using hot water will trigger the staining action. A technique called short-contact anthralin therapy (SCAT), also called minute therapy, is useful for local areas of psoriasis. In such cases, anthralin is applied for only 10 minutes to an hour.

Topical Retinoids

Retinoids are related to vitamin A. They are used for various skin disorders. Tazarotene (Tazorac) was the first topical retinoid found to be effective for mild-to-moderate psoriasis. It is available in cream or gel form.

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Unlike steroids, retinoids do not cause thinning of the skin or tolerance to the drug. Only a very small amount is needed on each lesion. Retinoid gel can be used on the scalp and nails, but it is not recommended for the genital areas or around the eyes. The gel should be used on only 20% of the body at any time; the cream can be used on up to 35% of the body.

Combining topical retinoids with other psoriasis treatments, such as topical steroids, works better than using the drug by itself.

Side Effects. Tazarotene may cause dryness and irritation of healthy skin. Applying zinc oxide and moisturizer around the treated area can protect healthy skin.

At levels high enough to be effective for treating psoriasis, tazarotene can cause severe skin irritation on treated areas. This medicine is usually used in combination with other treatments, allowing patients to use a lower dose. Mixing the drug in equal amounts with petroleum jelly (Vaseline) at first, and then gradually increasing the amount of tazarotene may help the skin areas become less sensitive. The skin can become very red while it is actually improving.

Vitamin A derivatives (drugs related to vitamin A) have been associated with birth defects and should not be used by women who are pregnant, who wish to conceive, or who are nursing.

Salicylic Acid

Salicylic acid applied to the skin helps remove scaly plaque and enhance the actions of other medications. It should not be used to cover wide areas of the body, because it can cause nausea and ringing in the ears. Combinations with high-potency steroids, such as mometasone furoate, clobetasol propionate, and betamethasone, are proving to be very helpful.

Occlusive Tapes

Watertight (occlusive) tapes or wrappings may help heal psoriasis. Occlusive tapes are particularly useful for psoriatic cuts on the palms and soles. In such cases, the tape should be applied across the cuts until they heal.

Occlusive tapes retain sweat, which helps restore moisture to the outer skin layer and prevent scaling. They also protect against abrasions and irritation.