Topical Treatments

Topical Steroids:

Topical steroids remain the mainstay in the treatment of psoriasis. It is a “cortisone” which is analogous to a naturally produce hormone in our body. It functions by decreasing inflammation in the skin. (That is why it is used to treat all of inflamed skin conditions like eczema and poison ivy). The benefits of topical steroids are generally they can work quickly and if used in small locations, generally there have little internal side effects.

The down sides of topical steroids include thinning of the skin, development of enlarged blood vessels and stretch marks. In addition, it is not practical to used topical steroids for people who have multiple plaques since there is some concern of absorptions when steroids are used in too large of an area. Finally, some people notice that the topical steroids slowly stops working over time

Vitamin D derivatives

Currently there are two vitamin D derivates available to treatment psoriasis: calcipotriene (Dovonex) and calipotriol (Vetical). It functions by forcing rapidly dividing cells ( as in psoriasis ) mature and slow it growth. The benefits are they are relatively safe and do not cause thinning of the skin. The down side is that they are not generally as effective as topical steroids and there is a slight concern that if you overuse it, it can lead to high calcium levels in your blood (that is what Vit D does internally). Some people also do get some mild irritation at times


Currently the only FDA approved treatment for psoriasis is tazarotene (Tazorac). It is a vitamin A derivation that functions by peeling the thick scale of psoriasis and again forced the rapidly dividing cells to mature. The benefits as with the Vitamin D derivates are that they do not cause thinning. The main downside is that they can be quite irritating to the skin due to the peeling effects of the medication.