Psoriasis treatment depends on the type, severity, location, and individual health needs of each person. Dermatologists may begin with topical medicines for mild disease and consider phototherapy, oral medications, or biologic therapies when psoriasis is more extensive or difficult to control. Common topical options include corticosteroids, vitamin D analogues, and other prescription treatments.
For many people with mild psoriasis, medication applied directly to the skin is an important first approach. Topical corticosteroids are commonly used to reduce inflammation, redness, scaling, and itching.
Other topical options may include:
Vitamin D analogues can be particularly useful for slowing excessive skin-cell growth and reducing thick plaques.
When topical treatment isn't sufficient, dermatologists may consider phototherapy, which uses controlled exposure to specific types of ultraviolet light.
Phototherapy can be used for certain forms of psoriasis affecting:
Treatment is performed according to a specific schedule established by a healthcare professional.
People with moderate-to-severe psoriasis may need medication that works throughout the body. Options include medicines such as methotrexate, apremilast, cyclosporine, and acitretin, depending on the individual's circumstances.
Systemic treatment may be considered when:
These medications require medical supervision because their risks and monitoring requirements differ.
Biologics are an important treatment option for many people with moderate-to-severe psoriasis or psoriatic arthritis. They work by targeting specific parts of the immune system involved in inflammation.
Several biologic classes are available, including medicines that target:
Dermatologists typically evaluate a person's medical history and may perform screening tests before starting a biologic because infection risk and other safety considerations need to be assessed.
There is no single psoriasis treatment that works best for everyone. A dermatologist may consider:
Some patients may need a combination of treatments rather than one therapy alone.
OTC treatments may be useful for very mild psoriasis, while moisturizers can benefit people with psoriasis more generally. Products containing ingredients such as hydrocortisone or coal tar may help selected patients, but stronger or more extensive psoriasis often requires professional treatment.
The four major approaches dermatologists may consider are topical treatments, phototherapy, systemic medications, and biologic therapies. Treatment is selected according to the individual's psoriasis severity, symptoms, affected areas, overall health, and response to previous therapies. If psoriasis is persistent, widespread, painful, or affecting the joints, a dermatologist can help determine which treatment approach is most appropriate.