Topical Treatments

Bath & shower solutions: Oils, oilated oatmeal, Epsom salts or Dead Sea salts

Help remove scale and soothe itching caused by dryness.

Rash or irritation

Speak to your healthcare provider or read the product information.

Use according to package directions, or speak to your doctor or pharmacist.

Moisturizers: Many different types and brands available

Reduce redness and itching due to dryness, and help keep the skin lubricated.

Rash or irritation

Use daily especially during the winter when the air in the home can be dry.

Keratolytics: Creams, gels, lotions, ointments, shampoos & soaps. Both non-prescription and prescription strengths.

Helps improve the appearance of skin by removing the scales, and allows other topical medications to penetrate the skin better. A commonly used keratolytic agent is salicylic acid which can be used alone or with other agents.

Can cause skin irritation if left on too long or if comes into contact with normal skin. Often used with topical steroids, anthralin or coal tar. Speak to your healthcare provider or read the product information.

Typically applied twice daily for several weeks.

Tars: Shampoo and topical solutions

Helps slow the rapid proliferation of skin cells and reduces inflammation, itching and scaling. Used on limited psoriasis, or well-defined lesions.

May smell, may stain clothing and sheets. Allow tar to air dry on skin. Can irritate and redden the skin, cause tar acne, stinging and pigment changes. Sometimes used with steroids or phototherapy treatment.

Apply directly to the lesion typically for 2 or more hours. As a shampoo, apply in direction of hair growth and typically leave on 5-10 minutes. In the bath, soak for 15-30 minutes.

Anthracene Derivatives: dithranol

Helps treat inflammation and itching and limits growth of skin cells. Can be used on the skin or scalp, alone or with other treatments. It is a synthetic version of a substance found in the bark of the araroba tree of South America.

No known long-term side effects. Can be messy and stain unaffected skin. May temporally discolour gray or white hair. Must be fresh to work properly. Not for use on face, groin or around eyes. Do not use past expiration date.

Use gloves to apply to lesion, rub in well and wipe off any excess. There are two types of anthralin therapy.

1. Conventional therapy: applied once (sometimes twice) a day to dry skin or scalp; if used overnight it must be removed in the morning by bathing or shampooing.

2. Short contact anthralin therapy: applied once a day to dry skin or scalp and allowed to remain on the affected area for only 10 to 30 minutes, or as prescribed by a physician, then removed. Strengths of 1% or higher are generally used for short contact therapy and cream may be preferred for scalp administration.

Topical Retinoid: tazarotene (Tazorac ®)

A Vitamin A derivative, the exact mechanism is unknown but it appears to slow the growth of skin cells and reduce inflammatory markers. Used on most parts of body including face, hairline and scalp.

Clear, odorless, non-staining, fast-drying. Can cause itching, irritation and burning on unaffected skin. Not for genital area or around eyes or mucous membranes. May make skin more sensitive to sunlight. Not recommended for pregnant women.

Typically once per day. Apply thinly and allow to dry before bed.

Topical steroids:
Some examples: prednicarbate (Dermatop®), desoximetasone (Topicort®), clobetasol propionate (Dermovate®)

Anti- inflammatories and can reduce the swelling and redness of lesions. Slow down the growth of skin cells.

Skin damage (thinning, easy bruising, redness), rebounds in psoriasis if the medication is discontinued suddenly, red spots on the skin and change in skin pigmentation. Long term use of high potency corticosteroids is not recommended. Do not apply to unaffected skin and do not use more than prescribed. It is very important to follow the prescription exactly, and not to stop treatment suddenly.

Apply directly to the lesion, usually 1-2 times per day.

Vitamin D analogs: calcipotriene, also called calcipotriol (Dovonex ®)

Slows down skin cell growth, flattens lesions and removes scale. Does not decrease inflammation.

Most common are related to the irritation of the skin lesions. Not recommended for use on the face. Odorless, non-staining. Not for use on face or around eyes. Can be used long term. Can be used with other topicals, or phototherapy. Monitoring of calcium levels is recommended if used for severe, extensive psoriasis.

Typically twice per day.

Combination Therapy: calcipotriol – betamethasone (Dovobet®) (Xamiol®), Diflucortolone-Salicylic acid (Nerisalic®)

A combination of topical steroid to reduce inflammation and relieve itch, along with either a vitamin D analogue to slow down excessive production of skin cells, or salicylic acid to loosen dry, scaly skin.

Skin irritation including: burning, dryness, itching, redness, and stinging. Speak to your healthcare provider if side effects persist or are severe.

Calcipotriol-Betamethasone: Ointment or gel applied once daily and gently rubbed in.

Diflucortolone-Salicylic acid:

Cream applied as a thin film 1-2 times daily.