There’s no cure for psoriasis , but treatment can help you feel better. You may need topical, oral, or body-wide (systemic) treatments. Even if you have severe psoriasis, there are good ways to manage your flare-ups. You may be able to get rid of your symptoms completely.
Psoriasis Treatment by Type
Scalp psoriasis treatment
If you have scalp psoriasis, your doctor may start your treatment with products you can apply on your scalp, such as shampoos, creams, lotions, or gels. These products may contain active ingredients such as corticosteroids, salicylic acid, coal tar, clobetasol propionate, tazarotene, and anthralin.
If your case is severe or stubborn, your doctor may prescribe stronger medicines you take by mouth, such as acitretin (Soriatane), cyclosporine (Gengraf), or methotrexate (Rheumatrex, Trexall). You may also get injection medicines such as adalimumab (Humira), etanercept (Enbrel), or ustekinumab (Stelara).
Sometimes, your doctor may recommend phototherapy, a treatment using ultraviolet (UV) light to treat your symptoms.
Nail psoriasis treatment
Nail psoriasis can be hard to treat because standard psoriasis treatments don’t often work or could take time to work. For example, treatments applied to your nails may require at least six months of regular use, once or twice a day, to work.
You and your doctor may have to try different treatments before identifying a regimen that works for you.
Some treatments you might undergo include:
- Corticosteroid creams, ointments, or nail polish
- Injectable medicines such as adalimumab, etanercept, or ustekinumab
- Medicines you take by mouth, including apremilast, cyclosporine, or methotrexate
- UV light therapy
- Laser therapy, targeting the blood vessels under your nails
- Vitamin D-based medicines, including calcipotriol and tazarotene, to treat symptoms such as buildup under the nails and nail discoloration. You’ll apply these to your nails.
Inverse psoriasis treatment
For inverse psoriasis, your dermatologist will suggest mild treatment because the folds of skin in your genital area, under your breasts, or armpits are sensitive. These treatments will manage or relieve symptoms such as itching, pain, and burning. They can also improve the look of the affected skin.
Medicines you may need to treat inverse psoriasis include:
- Mild corticosteroid creams that may be used with calcitriol ointment
- Stronger corticosteroids that you’ll use for a short while
- Mild coal tar
- Creams or ointments with ingredients such as calcipotriene, pimecrolimus, or tacrolimus
- Medicines you take by mouth such as acitretin, apremilast, and methotrexate
- Injection medicines such as adalimumab, etanercept, and infliximab
- Phototherapy
Plaque psoriasis treatment
Many of the standard psoriasis treatments work for plaque psoriasis, too, as this is the most common type of psoriasis. Depending on your case, your dermatologist may recommend treatments to apply to your skin. These medicines may have active ingredients like anthralin, coal tar, corticosteroids, synthetic vitamin D, and salicylic acid. You’ll likely use these medicines only if your case is mild.
In more severe cases, your doctor may recommend injection medicines like adalimumab and etanercept, drugs you take by mouth like apremilast and cyclosporine, and phototherapy.
Other psoriasis types and treatment
To treat other types of psoriasis, including guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis, your doctor will consider a few things, including:
- What kind of psoriasis you have
- How serious it is
- Where it is on your body
- Side effects that may come with the treatment
Based on the answers to the above questions as well as your preferences and lifestyle, you and your doctor will work together to find a treatment plan that works for you.
Some treatment options your doctor will explore with you may include:
- Creams, ointments, lotions, foams, solutions, or other products you apply to your skin
- Immunosuppressants such as methotrexate
- Phototherapy
- Oral retinoids such as acitretin
- Biologics such as adalimumab (Humira) and brodalumab (Siliq)
Most Common Psoriasis Treatments
The most common psoriasis treatments are medications you rub directly on your skin. Along with a good moisturizer, they’re usually the first thing your doctor will suggest, especially for mild to moderate psoriasis. There are over-the-counter (OTC) and prescription options.
Topical treatments for psoriasis come as ointments, creams, solutions, or foam and include:
Psoriasis treatment creams
Steroid creams slow down immune cells in your skin. They can ease swelling and redness. Mild steroid creams are available OTC, but you’ll need a prescription from your doctor for something stronger. Steroids come with side effects and should be used with caution on sensitive areas like your face or genitals. They can burn or thin the skin. Use them exactly the way your doctor tells you.
Other topical psoriasis treatments
Salicylic acid. This can soften and thin scaly skin but can also irritate your skin if left for too long. It might weaken your hair follicles and cause temporary hair loss, too. The body can absorb salicylic acid if you put it on large patches of skin.
Calcipotriol (calcipotriene). This is a strong form of synthetic vitamin D and is known to control overactive skin cells. Your doctor might pair it with a steroid cream.
Roflumilast (Zoryve). It's a steroid-free cream that can be used once daily to relieve plaques. Because it is a PDE-4 inhibitor, it can block the enzyme that causes inflammation.
Tapinarof (Vtama). It's a new steroid-free topical cream that is an aryl hydrocarbon receptor agonist. It is approved to treat plaque psoriasis in adults. You apply it once a day. It can be used on sensitive body areas and is safe for long-term use.
Tazorac (Tazarotene). It's available in gel, cream, or foam and is applied once or twice daily. It is not recommended for people who are pregnant, breastfeeding, or intending to become pregnant.
Immunomodulators. These aren’t steroids, but they change how your immune cells work. Options include pimecrolimus and tacrolimus. Your doctor might give you these to use on sensitive areas such as your face, groin, or skin folds.
Coal tar ointment and shampoo. Coal tar is known to ease psoriasis-related inflammation, itching, and scales. But it can cause side effects such as skin redness and dryness. It can also make your skin more sensitive to UV light. Coal tar is not recommended for pregnant and breastfeeding people. Ask your doctor how to use it.
Prescription retinoid. These are ointments made with synthetic vitamin A. Your doctor might tell you to take them along with a steroid. That can lower your odds of skin irritation caused by the retinoid.
Over-the-counter psoriasis treatment
If your psoriasis is mild, you can use OTC treatments, which you can get without a prescription at drug stores, pharmacies, grocery stores, convenience stores, or online retailers.
Treatments with active ingredients. These OTC psoriasis treatments usually contain ingredients that help improve your symptoms. Examples include coal tar or corticosteroids like hydrocortisone. These ingredients help:
- Reduce itching, flaking, redness, swelling, scaling, and inflammation
- Slow down how quickly the skin cells grow
Moisturizers. Regardless of how severe your psoriasis is, you may benefit from regularly using a moisturizer, which you can get over the counter. It helps reduce dryness and scaling and promotes skin healing. You can use the moisturizer once daily or more if your skin is drier than usual. When choosing a moisturizer, look for thicker options such as a heavy cream, ointment, or oil. Also, choose one without fragrance and one you can be sure you’ll stick with.
Scale softeners. Scale softeners that contain salicylic acid, lactic acid, or urea can also be purchased over the counter. These products can soften and remove scaling and reduce swelling. They may be great for you, especially if you have plaque psoriasis. But be sure to follow the instructions on the product. Otherwise, they might not work well or cause more skin problems such as itching, redness, and dryness.
Anti-itch treatments. Many anti-itch treatments for psoriasis are also available over the counter. These products often contain calamine, camphor, hydrocortisone, or menthol. Though they help relieve psoriasis itching, they can also make your skin irritated and dry. To help with this, look for moisturizing options or use a moisturizer along with the anti-itch treatment.
Phototherapy for Psoriasis
Sunlight has been used to treat skin conditions for thousands of years. Now doctors use machines to shine UV rays directly on your skin.
Light therapy can slow down fast-growing skin cells in people who have psoriasis. It’s usually something a dermatologist will do in their office a few times a week. But there are some at-home kits you can use. Ask your doctor about them.
Types of phototherapy for psoriasis include:
Narrowband UVB therapy. This is a targeted form of ultraviolet B (UVB) light. You stand in a light box or your doctor passes a brush or comb over the affected areas. It’s safe for children, people who are pregnant or breastfeeding, and those with a weakened immune system or ongoing illness.
Broadband UVB therapy. This sends out a wider range of UVB light. It’s not used as much as narrowband UVB therapy because it's not as effective.
Excimer laser therapy (XTRAC laser). Excimer laser therapy helps get rid of the red patches by exposing them to targeted UVB rays.
Psoralen + UVA (PUVA). This mixes a drug called psoralen with ultraviolet A (UVA) light. You can take psoralen by mouth or sit in a bath. It makes your skin more sensitive to light, which boosts the amount of UVA light your skin can absorb. This combo works well for psoriasis. But it’s an older treatment that’s not used as much as narrowband UVB therapy.
Phototherapy can cause short- and long-term side effects. It may make you feel like you have sunburn and raise your risk of getting skin cancer. It’s not recommended if:
- You’ve had skin cancer.
- You have a medical condition that raises your chances of getting skin cancer.
- You have a medical condition or take medicine that makes you more sensitive to UV light.
Systemic Psoriasis Treatments
Immunosuppressants. If other treatments don’t work or if you have moderate to severe psoriasis, your doctor might give you drugs to slow down your entire immune system. You’ll take them by mouth or get them via an injection. They can make it harder to fight off infections and cause other unwanted side effects.
Some immunosuppressants used to treat psoriasis include:
- Methotrexate. This is only for people with serious symptoms. It can raise your odds of liver disease and lung or kidney problems. Your doctor will give you lab tests every so often to make sure your organs are healthy.
- Cyclosporine. Most often used for serious psoriasis, it can cause high blood pressure or kidney problems. You may also have sensitive skin or muscle and joint pain.
- Enzyme inhibitors. A newer drug called apremilast can target and slow inflammation in certain immune cells. It’s a pill you take twice a day. It’s generally considered safe, but tell your doctor if you have any mood changes. It can raise your chance of depression or suicidal thoughts.
- Oral retinoids.Acitretin is a synthetic form of vitamin A. You take it by mouth. Experts aren’t sure why it helps with psoriasis. They think it’s because retinoids affect how fast skin cells grow.
Oral retinoids are often used to treat pustular psoriasis. But they can cause unwanted side effects, including hair loss and liver or bone problems. Your doctor may lower your dose once your symptoms get better.
It’s not safe to take acitretin if you’re allergic to retinoids. Oral retinoids can also lead to birth defects. Don’t take these drugs if:
- You’re pregnant, want to get pregnant, or are breastfeeding.
- You have serious liver or kidney disease.
- You have high triglycerides.
Systemic biologic psoriasis treatments
These are newer drugs made from living organisms. Biologics are divided into groups: tumor necrosis factor (TNF) inhibitors, interleukin (IL)-23 inhibitors, IL-17 inhibitors, and IL-12/23 inhibitors. Each type targets specific immune cells or proteins that cause psoriasis. Unlike immunosuppressants, they don’t affect your whole immune system.
You’ll likely get this treatment through a shot or IV.
Biologics work best for moderate to serious psoriasis and psoriatic arthritis. But they can be expensive. These drugs are generally considered safe, but more research is needed on their long-term effects. Your doctor will help you decide if they’re right for you.
Biologics used to treat psoriasis include:
- Adalimumab (Humira)
- Brodalumab (Siliq)
- Certolizumab-pegol (Cimzia)
- Deucravacitinib (Sotyktu)
- Etanercept (Enbrel)
- Golimumab (Simponi) and Abatacept (Orencia) -- for psoriatic arthritis
- Guselkumab (Tremfya)
- Infliximab (Avsola, Inflectra, Remicade)
- Ixekizumab (Taltz injection)
- Risankizumab (Skyrizi)
- Secukinumab (Cosentyx)
- Tildrakizumab (Ilumya, Ilumetri)
- Tofacitinib (Xeljanz)
- Ustekinumab (Stelara)
Home Remedies for Psoriasis
Many people try herbs, vitamins, or other at-home remedies to ease symptoms. Just remember what works for someone else might not work for you. It’s best to talk to your doctor before you change or add something to your treatment plan. They’ll let you know what’s safe.
Here are some commonly used natural psoriasis treatments:
Salt baths. These might lift some of your scales and help you itch less. Add Dead Sea or Epsom salts to warm water. Soak for 15 minutes. Apply moisturizer after your bath so your skin doesn’t get too dry.
Colloidal oatmeal. Some people say their skin is less red and itchy when they soak in an oatmeal bath or apply a paste to their skin. There’s not much evidence to show it treats psoriasis.
Aloe vera. A cream with 0.5% aloe might lessen your scales and ease redness for a short time. You can use it up to three times a day.
Apple cider vinegar. This is sometimes used to ease itching from scalp psoriasis. You can use it a few times a week. Make sure you mix more parts water than vinegar. Otherwise, the vinegar can burn your skin. Avoid any open wounds.
Healthy diet. There’s no meal plan specifically for psoriasis. But if you’re overweight or obese, your symptoms might get better if you lose excess weight. Experts think that’s because certain cells, such as the ones in your belly, worsen inflammation. That makes it harder for the immune cells in your skin and body to work the right way.
Keep your doctor in the loop about your condition. They may need to update your care plan over time. That might mean switching to a different topical drug or trying a mix of psoriasis treatments.
Takeaways
Psoriasis has no cure, but many treatments are available today to relieve symptoms such as itching and dryness and improve the look of your skin. You can get these treatments over the counter, and you may only need to use those you apply to your skin. In moderate-to-severe cases, your dermatologist may recommend prescription options. You might also have to be on more than one treatment for the best result. You may have to experiment for a while before you find a treatment plan that works for you. Talk to your doctor before considering home remedies such as apple cider vinegar as a long-term way to manage your psoriasis.
Psoriasis Treatment FAQs
Can I live a normal life with psoriasis?
Yes, you can live a normal life with psoriasis, especially if you consistently use a treatment that works for your symptoms.
Can I marry a person with psoriasis?
Yes, you can marry a person with psoriasis. The condition isn’t contagious.
Which treatment is best for psoriasis?
The best treatment for psoriasis depends on the type you have, how serious it is, and your symptoms. You’ll likely start with topical treatments with corticosteroids.
Is psoriasis 100% curable?
No, psoriasis isn’t fully curable, but treatment can help manage symptoms such as itching, redness, swelling, and scaling.
How does psoriasis start?
Psoriasis can start at any time. It starts when your immune cells become too active, causing rapid production of skin cells. Triggers can include infections, medicines for treating conditions such as heart disease or malaria, taking too much alcohol, stress, smoking, and obesity.
