The Best Creams to Treat Psoriasis

The Best Creams to Treat Psoriasis

Topical creams—both over-the-counter and prescription—can help manage psoriasis symptoms such as dry, itchy skin. The best psoriasis creams may help keep the skin hydrated, reduce inflammation, and slow the rapid production of skin cells.

Learn more about what creams can help with psoriasis, skin care tips, and other treatment options.

Choosing the Best Cream for Psoriasis

The best cream for psoriasis depends on the location, type, and severity of the psoriasis patches. Choose a cream free of irritants, including fragrances and ingredients you are allergic to. Ask your healthcare provider or a medical professional specializing in psoriasis treatment for recommendations.

Topical creams are typically used to treat mild-to-moderate psoriasis and to manage symptoms. For more severe cases, systemic prescription or combination therapies may be necessary.

Over-the-Counter Creams for Psoriasis

Over-the-counter (OTC) creams to treat mild psoriasis may contain:

• Salicylic acid

• Ceramides

• Anti-itch ingredients

• Mild corticosteroids

• Vitamins

• Oils

• Amino acids

• Coal tar

These ingredients lock in moisture, treat itching, exfoliate the skin, protect the skin barrier, and more.

Anti-Itch Psoriasis Cream 

Itchiness is one of the most common complaints of people with psoriasis. Common ingredients in anti-itch creams are:

• Calamine

• Camphor

• Hydrocortisone

• Menthol

A combination of these tends to work best against itching. Hydrating the skin while also applying anti-itch creams is also recommended.

Moisturizers and Emollients

Skin hydration is especially important in maintaining healthy skin and treating psoriasis.

A moisturizer is a product that helps hydrate and protect the skin barrier, relieve dryness, and clear your skin. Although the word "emollient" is sometimes used interchangeably with "moisturizer," an emollient is a specific type of ingredient added to moisturizers to help soften the skin.

Moisturizing creams are typically used daily and can be applied to damp skin for maximum hydration. They can be used several times a day if needed. Heavy creams, ointments, and oils usually work best and are very soothing. Because they can be messy, consider limiting their use until bedtime.

Salicylic Acid Creams

Salicylic acid is used to soften skin scales and reduce their thickness. It is important to use products containing this ingredient as directed. Too much can irritate the skin, causing dry, red, and itchy skin. Try applying salicylic acid creams 15 minutes after a warm bath.

Corticosteroid Creams

Corticosteroids help reduce inflammation and treat troublesome psoriasis patches. They are not meant to be used daily. You may find them in OTC creams or foams. They can also be found in shampoos used to treat scalp psoriasis.

Lower-potency corticosteroids like hydrocortisone may be added to other ingredients in lotions and creams. These weaker concentrations of corticosteroids are usually meant to be used on more sensitive areas of the skin, such as the face and skin folds.

Coal Tar

Coal tar is an active ingredient that may reduce itching and flaking, redness, swelling, and scaling. It can be found in products such as:

• Creams

• Ointments

• Shampoos

• Bath solutions

Coal tar can irritate your skin, so before using it on larger parts of your body, start by testing a small amount on a small area of skin.

Psoriasis Cream Prescription Options

You may need stronger medications to treat psoriasis flares. A primary care provider or dermatologist (medical doctor specializing in conditions of the skin, hair, and nails) may recommend prescription topical drugs, alone or in combination, such as:

• Prescription-strength corticosteroids

• Retinoids

• Vitamin D analogues

Some of these medications should not be used on certain areas of the skin or by people who are pregnant or may become pregnant. For this reason, it is important to talk to your healthcare provider about which medication is appropriate to treat your psoriasis.

Stronger Corticosteroid Creams

Stronger topical corticosteroids should be used as directed by a healthcare provider. Some steroids are meant to be used on different areas of the body and are chosen based on the severity of your psoriasis, its location, and your preference and age. Your healthcare provider will likely recommend using these medications:

• As often as instructed (to receive full benefits)

• Only on certain parts of your skin

• Only for as long as prescribed

Some prescribed topical steroid creams include:

• Clobetasol 0.05%

• Triamcinolone 0.1%

• Hydrocortisone 2.5%

Note that the percentage after the name of a steroid does not indicate how strong it is in relation to other steroids, as steroids differ in their strengths. For example, clobetasol 0.05% is stronger than hydrocortisone 2.5%. Once your corticosteroid treatment ends, you may need a maintenance routine using vitamin D analogues, topical retinoids, and calcineurin inhibitors.

Tazarotene

Retinoids are precursors to vitamin A and can be used to treat psoriasis. They come in oral and topical forms.

The topical form is Tazorac (tazarotene), which is used to decrease scales, lessen redness and swelling, and treat psoriasis on the nails.A combination cream that includes a steroid, called Duobrii (halobetasol, tazarotene), is also available.

Retinoids are very effective in treating psoriasis. However, they can have side effects and should not be used by certain people. These side effects include:

• Increasing sun sensitivity and risk of sunburn

• Irritation

• Redness

Pregnant people should not use retinoids as they can affect fetal development.

Vitamin D Analogues

Vitamin D analogues bind to vitamin D receptors, inhibiting skin cell growth and enhancing differentiation.Vitamin D analogues include:

• Vectical (calcitriol)

• Dovonex and Sorilux (calcipotriene)

These are often used in conjunction with steroids, and combination creams are available including:

• Taclonex (betamethasone, calcipotriene)

• Wynzora (betamethasone dipropionate, calcipotriene)

Anthralin

Anthralin treats psoriasis by slowing down the replication of skin cells and, therefore, reducing skin plaques. It is not meant to treat severe psoriasis. Brand names for anthralin topical cream include:

• Drithocreme

• Dritho-Scalp

• Psoriatec

• Zithranol

• Zithranol-RR

Anthralin is an older topical medication that is not used very often due to its potential for temporarily staining skin and permanently staining clothing and fabric. However, it can be used if other treatments do not work.

Calcineurin Inhibitors

Calcineurin inhibitors can be used as an alternative to corticosteroids as they do not thin your skin the way steroids can. They include:

• Protopic (tacrolimus ointment)

• Elidel (1.0% pimecrolimus cream)

Tacrolimus is the stronger of the two.

The Food and Drug Administration (FDA) has approved these medications to treat eczema but not psoriasis. When prescribed for psoriasis, they are being prescribed off-label, meaning for conditions or at doses not yet approved by the FDA but that have been shown to be helpful.

Phosphodiesterase-4 (PDE-4) Inhibitors

The FDA approved Zoryve (roflumilast) cream in 2022 to treat plaque psoriasis. It blocks a molecule involved in cell energy production and the inflammatory process. As it isn't a steroid, it can be used on the face.

Aryl hydrocarbon receptor (AhR) agonists

The FDA approved Vtama (tapinarof) cream in 2022. It is a nonsteroidal cream that binds to a cell receptor and modulates the inflammatory reaction. However, exactly how it works for psoriasis is unknown.

What Should You Not Put on Psoriasis?

Certain substances can trigger psoriasis or contribute to a flare-up. If you have psoriasis, avoid hot showers, use gentle cleansers instead of soap, and avoid fragranced lotions.

Before applying lotions, creams, soap, or sunscreens, consult a healthcare provider for recommendations.

Alternatives for When Topical Treatment Doesn’t Work

Topical treatments are usually the first line of therapy when treating psoriasis and can be used in conjunction with other treatments such as:

• Ultraviolet (UV) phototherapy

• Biologics

• Oral medications

Talking to Your Healthcare Provider About Treatment

Psoriasis can affect your quality of life, especially if it's recurrent or difficult to treat. A healthcare provider can explain the different topicals and help you choose a treatment that works best for you, which may help you stick to the treatment plan.

You can also learn how to avoid triggers and get other helpful recommendations for managing your psoriasis symptoms.

If you have been trying topicals with no success, discuss adjusting your treatment plan with your healthcare provider. Your provider may recommend a new topical, oral medications, biologics, or other options.

Summary

Psoriasis is a chronic inflammatory skin condition requiring topical ointments, creams, moisturizers, and medications for treatment, management, and prevention.

The best treatment for you depends on your age, the severity of the psoriasis, and the location on your body. Your provider will consider these factors when creating a treatment plan.