Commonly Used Topical Treatments

Non-Prescription

TREATMENT

DIRECTIONS FOR USE

BENEFITS

SIDE EFFECTS*

Bath and shower solutions

TREATMENT

  • Oils
  • Oatmeal
  • Epsom salt
  • Dead Sea salt

DIRECTIONS FOR USE

  • Use according to package directions

BENEFITS

  • Helps remove scales
  • Soothes itching

Most common side effects include:

  • rash or irritation.
  • Speak to your healthcare provider or read the product information.
Moisturizers

TREATMENT

  • Many different types and brands available

DIRECTIONS FOR USE

  • Use daily

BENEFITS

  • Reduces redness and itching
  • Helps keep the skin lubricated (or smooth and moist)

Most common side effects include:

  • rash or irritation.
Keratolytics

TREATMENT

  • Creams
  • Gels
  • Lotions
  • Ointments
  • Shampoos
  • Soaps

DIRECTIONS FOR USE

  • Typically applied twice daily for several weeks
  • Often used with topical steroids, anthralin, or coal tar

BENEFITS

  • Helps remove scales
  • Allows other topical medications to penetrate (or soak in) better

Most common side effects include:

  • skin irritation if left on too long or if it comes into contact with normal skin.
  • Speak to your healthcare provider or read the product information.
Tars

TREATMENT

  • Shampoos
  • Topical solutions

DIRECTIONS FOR USE

  • Used on limited psoriasis or well-defined lesions (sores)

On skin:

  • Apply directly to the lesion, typically for 2 or more hours
  • Allow tar to air dry

As a shampoo:

  • Apply in direction of hair growth
  • Is typically left on for 5 to 10 minutes

In the bath:

  • Soak for 15 to 20 minutes

BENEFITS

  • Helps slow skin cell growth
  • Reduces inflammation (swelling or puffiness), itching, and scaling

Most common side effects include:

  • Irritated and reddened skin, tar acne, stinging and pigment (colour) changes.
Anthracene derivatives

TREATMENT

  • Dithranol
  • 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 or twice a day
  • If used overnight, it must be washed away and removed in the morning

2. Short contact therapy

  • Applied once a day
  • Allowed to remain on the affected area for only 10 to 30 minutes, or as prescribed

BENEFITS

  • Helps treat inflammation and itching
  • Limits growth of skin cells

Most common side effects include:

  • staining unaffected skin, temporary hair discolouration.

Prescription

TREATMENT

DIRECTIONS FOR USE

BENEFITS

SIDE EFFECTS*

Topical retinoids

TREATMENT

  • Tazarotene (TAZORAC)

DIRECTIONS FOR USE

  • Apply thinly and allow to dry, typically once per day, only in areas affected
  • Apply to no more than 20% of body surface area

Not for use in:

  • pregnant women — retinoids may cause fetal harm (i.e., harm to the unborn baby)

Do not use on:

  • genital area
  • around eyes or mucous membranes

BENEFITS

It appears to:

  • slow the growth of skin cells
  • reduce inflammatory markers

Most common side effects include:

  • Itching, burning/stinging, redness, worsening of psoriasis, irritation, skin pain, rash, skin peeling, irritant contact dermatitis, skin inflammation, cracked skin, bleeding, and dry skin.
  • May make skin more sensitive to sunlight.
Topical steroids
  • Prednicarbate (DERMATOP)
  • Desoximetasone (TOPICORT)
  • Clobetasol propionate (DERMOVATE)
  • Apply directly to the lesion (sore), usually 2 to 3 times per day
  • Do not apply to unaffected skin
  • If no response after 1 week, discontinue use
  • Discontinue use as soon as lesions have healed

Not recommended for:

  • long-term use (specifically the high-potency corticosteroids)
  • Can reduce swelling and redness
  • Slows down the growth of skin cells

Follow the prescription exactly. Most common side effects include:

  • dryness, acne, rash around the mouth (perioral dermatitis), allergic contact dermatitis, and an itchy rash called miliaria.
  • May also cause local burning, irritation, itching, change in pigmentation (skin colour), infection, abnormal hair growth, skin damage (thinning, easy bruising, redness, "spider veins").

Other side effects:

stinging, cracking, hair bumps (folliculitis), and numbness in the fingers.

Vitamin D analogues:
  • Calcipotriene, also called calcipotriol (DOVONEX)
  • Typically twice per day
  • May be used with other topicals

Not recommended for:

  • use on the face or around eyes
  • Slows down skin cell growth
  • Flattens lesions
  • Removes scales

Most common side effects include:

  • local irritation, which is usually mild and temporary.

Other side effects:

Rare cases of allergic reaction have been reported. Use of calcipotriol can lead to high blood calcium levels, but this is usually related to using more than the weekly maximum. Serious side effects which occurred very rarely include fatigue, depression, mental confusion, anorexia, nausea, vomiting, constipation, increased urination and in some patients, cardiac arrhythmias.

Combination therapy
  • Calcipotriol- betamethasone (DOVOBET, XAMIOL)
  • Diflucortolone- salicylic acid (NERISALIC)

Calcipotriol - Betamethasone:

  • Ointment or gel applied once daily and gently rubbed in
  • Use up to 4 weeks

Diflucortolone - Salicylic acid:

  • Cream applied as a thin film 2-3 times daily during the first week, then 1-2 times daily during subsequent weeks - not to exceed four weeks total

A combination of:

  • Topical steroid – to reduce inflammation and relieve itch

And either a:

  • Vitamin D analogue – to slow down excessive production of skin cells

Or:

  • Salicylic acid – to loosen scaly skin

Most common side effects for DOVOBET and XAMIOL include:

  • itching, burning, dryness, irritation, peeling and redness.

Other side effects for DOVOBET and XAMIOL :

Rare cases of allergic reaction to calcipotriol have been reported. Worsening of psoriasis can occur. Side effects from calcipotriol are generally local and include dryness, itching, burning, irritation, thinning of the skin, spider veins, stretch marks, various types of skin rashes and red, swollen hair follicles. If applied to the face, an acne-like rash and swelling can occur. In rare cases, adrenal glands may stop working properly. Rare and serious side effects include pustular psoriasis, adrenal effects and skin thinning. Very rare serious side effects include allergic reaction and high blood calcium levels).

 

Most common side effects for NERISALIC include:

  • side effects generally related to the steroid, including: burning, itching, irritation, dryness, swollen hair follicles (folliculitis), abnormal hair growth, acne, loss of skin colour, mouth rash (perioral dermatitis), allergic contact dermatitis, skin softening, secondary infection, thinning skin, "spider veins", stretch marks, and tiny red rash.

Other side effects:

Hypothalamic-pituitary-adrenal axis suppression has also been reported following topical corticosteroid therapy.

*Always speak to your doctor and read the product information before trying a new treatment. Please refer to the product information for each treatment for warnings, precautions and treatment considerations.The lists above do not include an exhaustive list of side effects. Your healthcare professional can provide the complete list. Also, speak to your healthcare provider if side effects persist or are severe.

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