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Managing Psoriasis with Topical Treatments


Understanding Topical Treatments
Topical treatments are medications applied to the skin to help soothe irritation, scaling, and redness from psoriasis. They can be creams, gels, or shampoos. A dermatologist can help you find the topical treatment that's best for you.

Steroidal Topical Treatments
Topical corticosteroids are medications used to reduce inflammation and redness in psoriasis. These steroids come in different strengths, from super potent to mild. Your doctor will choose the best strength based on the severity of your psoriasis.

Side Effects of Steroids
Steroidal treatments can cause side effects, especially if used long-term or on large areas. These may include skin thinning, changes in skin color, and increased sensitivity to light. Your doctor can help you minimize side effects.

Nonsteroidal Topicals
Nonsteroidal topicals are creams and ointments without corticosteroids. Ingredients like vitamin A and D3 slow skin cell growth and reduce scaling. These treatments are useful when steroids are not effective or you can't use them long term.

Side Effects of Nonsteroidals
Nonsteroidal treatments can also have side effects such as skin irritation, stinging, and increased sun sensitivity. Some may cause more serious issues like raised calcium levels or infections.

Topical Retinoids
Retinoids are vitamin A-based treatments that slow skin cell growth and reduce psoriasis symptoms. They come in gels or creams. Retinoids can cause irritation and increase the risk of sunburn, so you'll need to wear sunscreen.

Coal Tar Treatments
Coal tar is another option, especially for scalp psoriasis. It helps reduce scaling and can be used in shampoos or ointments. However, coal tar has a strong odor and can stain clothes. It's also important to use sunscreen when applying coal tar.

Vitamin D Analogues
If you have mild or moderate psoriasis, your doctor may mention vitamin D analogues as a possible treatment. Also known as synthetic vitamin D, this isn't the same as vitamin D supplements. Vitamin D analogies have been changed to affect your psoriasis differently. They help slow skin cell growth and reduce scaling.
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Bruce E. Strober, MD, PhD, associate director of dermatopharmacology, Department of Dermatology, New York University School of Medicine; co-director, Psoriasis and Psoriatic Arthritis Center; consultant for Amgen, Biogen, Genentech, Fujisawa, and 3M.
Jeffrey M. Weinberg, MD, director, Clinical Research Center, St. Luke's-Roosevelt Hospital Center, New York City; assistant clinical professor of dermatology, Columbia University College of Physicians and Surgeons; consultant for Amgen and Genentech.
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