Psoriasis Medication: Prescription Ointments & Pills

Updated in November 2023

Psoriasis medication, such as betamethasone, calcipotriol, acitretin or adalimumab, for example, may be prescribed by the dermatologist for mild to severe psoriasis. They help to relieve symptoms such as red, dry patches on the skin, itching or flaking. 

These remedies can be used in the form of ointments, tablets or injections, according to the dermatologist's recommendation. The doctor can advise the best treatment approach for each case according to the type, location of the lesions and the severity of the psoriasis symptoms. Learn more about the symptoms of psoriasis and what can cause it.

In addition to using psoriasis medication as prescribed by your doctor,  it is also important to moisturize your skin daily, especially the affected areas. You should also avoid very abrasive products that cause skin irritation and excessive dryness.

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Topical remedies (creams and ointments)

Topical psoriasis medications, such as creams, ointments, lotions or shampoos, are normally indicated for the treatment of mild to moderate psoriasis, and should be used as prescribed by a dermatologist.

Some topical psoriasis medications are:

1. Corticosteroids

Topical corticosteroids, such as hydrocortisone, clobetasol or triamcinolone, help reduce skin inflammation and relieve redness, itching, swelling or peeling. 

These remedies can be used in the form of ointments, creams or hair solution, and must be prescribed by a dermatologist, as the type of corticosteroid to be used depends on the region of the skin to be treated, such as the arm, face, scalp or legs.

The doses and duration of topical corticosteroids must be prescribed by the doctor on a case-by-case basis.

Contraindications: people who are allergic to the components, with skin lesions caused by viruses, fungi or bacteria, people with uncontrolled rosacea or perioral dermatitis.

Possible side effects: the most common side effects of topical corticosteroids are itching, pain, burning sensation in the skin, thinning of the skin, stretch marks or acne.

2. Moisturizers and emollients

Emollient creams and ointments can be prescribed by the dermatologist to be used daily, mainly for maintenance treatment after the use of corticosteroids. They help to prevent new attacks in people with mild psoriasis.

These creams and ointments usually contain urea in concentrations that can vary between 5% and 20% and/or salicylic acid in concentrations between 3% and 6%, depending on the skin type and the amount of scaling on the skin.

2. Calcipotriol

Calcipotriol is an type of vitamin D, which at a concentration of 0.005% is indicated for the treatment of psoriasis on the scalp or mild to moderate psoriasis vulgaris on the body. It helps to reduce the formation of psoriatic plaques on the skin.

In most cases, the dermatologist prescribes calcipotriol in the form of a gel or ointment, together with a topical corticosteroid, such as betamethasone.

Contraindications: calcipotriol should not be used by children or adolescents under 18 years of age, by people who are allergic to the components of the formula or anyone with high levels of calcium in their blood.

Possible side effects: The most common side effects of calcipotriol are skin irritation, rash, tingling, keratosis, itching, erythema, and contact dermatitis.

4. Immunosuppressants

Topical immunosuppressants, such as tacrolimus or pimecrolimus, are medications prescribed by a dermatologist that act by reducing the action of the immune system. They help to alleviate the symptoms of psoriasis, such as redness or itching of the skin.

These medications can be used in the form of an ointment, and unlike corticosteroids, immunosuppressants can be applied to areas with thinner skin, such as the face, neck or groin, after hydration. However, sun exposure should be avoided after its application.

Contraindications: topical immunosuppressants should not be used by people allergic to any of the components in the formula. Furthermore, children, pregnant or breastfeeding women should only use immunosuppressants if recommended by their doctor.

Possible side effects: immunosuppressants can cause side effects such as a burning or stinging sensation in the skin, or itching.

Systemic medications (tablets or injection)

Psoriasis medications in the form of tablets or injections are usually prescribed by a dermatologist in cases of severe or generalized psoriasis when topical treatment has not been effective in controlling symptoms.

The main systemic medications for psoriasis that may be prescribed by your doctor include:

1. Acitretin

Acitretin is a retinoid in tablet form, generally indicated to treat severe forms of erythrodermic psoriasis or pustular psoriasis, in which pus forms along with psoriasis patches. This type of condition can be localized to one spot or generalized throughout the body.

Acitretin tablets can be found in doses of 10 mg or 25 mg, sold only with a medical prescription.

Contraindications: Acitretin should not be used by people allergic to the components of the formula, pregnant women and women who wish to become pregnant in the next few years, breastfeeding women and people with severe liver or kidney failure.

Possible side effects: the most common side effects of acitretin are headache, dryness and inflammation of the mucous membranes, dry mouth, thirst, appearance of mouth ulcers, gastrointestinal disorders, cheilitis, itching, hair loss, peeling all over the body, muscle pain , increased cholesterol and triglycerides in the blood and generalized edema.

2. Methotrexate

Methotrexate is prescribed by a dermatologist for the treatment of severe psoriasis, or when topical treatment has not been effective. It acts by reducing the proliferation and inflammation of skin cells.

This remedy is available in pharmacies or drugstores in the form of 2.5 mg tablets, but it can also be found in hospitals in the form of 50 mg/2mL ampules for injection. It should strictly be taken as prescribed by a dermatologist.

Contraindications: this medicine should not be used by people allergic to methotrexate, pregnant and lactating women, or in cases of cirrhosis, alcoholic disease, active hepatitis, liver failure, severe infections, immunodeficiency syndromes, aplasia or medullary hypoplasia, levels low blood platelets, anemia or acute gastric ulcer.

Possible side effects: the most common side effects of methotrexate are severe headache, stiff neck, vomiting, fever, redness of the skin, increased uric acid, reduced sperm count in men, mouth ulcers, inflammation of the tongue and gums, diarrhea, reduction in white blood cell and platelet counts, kidney failure and pharyngitis.

3. Cyclosporine

Cyclosporine in the form of tablets is an immunosuppressive medicine recommended by dermatologists for the treatment of moderate to severe psoriasis. It acts by decreasing the action of the immune system, which helps to reduce the symptoms of psoriasis.

The treatment of psoriasis with cyclosporine must be carried out with medical supervision and regular examinations to assess the health of the kidneys and monitor blood pressure. Duration should not exceed 1 year of treatment.

Contraindications this medicine should not be used by people with severe or unstable high blood pressure, active infections or cancer.

Possible side effects: the most common side effects of cyclosporine are kidney disorders, high blood pressure and weakening of the immune system.

4. Biological agents

Biological agents may be prescribed by the dermatologist for the treatment of psoriasis when other treatment options have not been effective in reducing skin inflammation and relieving the symptoms of moderate to severe psoriasis.

Some examples of biological agents that may be indicated for the treatment of psoriasis are:

  • Adalimumab
  • Etanercept
  • Infliximab
  • Ustekinumab
  • Secukinumab
  • Certolizumab pegol

These medication are generally used in hospital settings, through injections or IV, administered by a nurse, under medical supervision.

Contraindications: biological agents should not be used by people who are allergic to the components of the formula, or in cases of heart failure, demyelinating disease, recent history of cancer, active infection, use of live attenuated vaccines and pregnant women.

Possible side effects: the most common side effects of biological agents are injection site reactions, infections, tuberculosis, skin reactions, neoplasms, demyelinating diseases, headache, dizziness, diarrhea, itching, muscle pain and tiredness.