Plaque psoriasis (psoriasis vulgaris) is the most common form of psoriasis and treatment options include topical therapy, light therapy, and oral or injected medications.
Topical treatments for plaque psoriasis include:
Corticosteroids: These are frequently prescribed for mild to moderate plaque psoriasis and are available as oils, ointments, creams, lotions, gels, foams, sprays, and shampoos. Mild forms (such as hydrocortisone) are typically used on the face but stronger products such as triamcinolone (Trianex) or clobetasol (Cormax, Temovate) may be used on smaller, harder-to-treat areas. Long-term use can thin the skin
Vitamin D analogues: Synthetic forms like calcipotriene and calcitriol slow skin cell growth, and may be used alone or with corticosteroids
Retinoids: Tazarotene (Tazorac, Avage), applied daily, reduces skin cell growth but isn't recommended during pregnancy and it may cause skin irritation and increased sensitivity to light
Calcineurin inhibitors: Tacrolimus (Protopic) and pimecrolimus (Elidel) may be useful as steroid-sparing agents on sensitive sites where the skin is thinner (such as the face, flexures, or genital areas); but they are not effective for treating chronic plaque psoriasis elsewhere (unless under occlusion).
Additional topical ingredients may be used alone or in combination with other ingredients including:
Salicylic acid: Reduces scaling, available in shampoos and solutions
Coal tar: Diminishes scaling, but can be messy, stain clothing and bedding, with a strong odor. Not recommended during pregnancy or breastfeeding
Anthralin: A tar cream that slows cell growth, removing scales, usually applied for a short duration due to potential skin irritation. Stains almost everything. Applied for a short time then washed off.
Narrowband ultraviolet B (NB-UVB) can be used to treat plaque psoriasis and is most effective when used two to three times per week.
Oral or injected medications may be given regularly or only used for short periods and may include:
Steroids, such as triamcinolone, may be injected directly into persistent psoriasis patches
Retinoids, such as acitretin and others in pill form can reduce skin cell production. Side effects may include skin and muscle soreness and they are not recommended during pregnancy.
Biologics: These injected drugs alter the immune system in a way that interrupts the disease cycle and improves signs and symptoms of moderate to severe disease, but they can increase the risk of infection. Examples include apremilast (Otezla), etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), secukinumab (Cosentyx), ixekizumab (Taltz), guselkumab (Tremfya), tildrakizumab (Ilumya) and certolizumab (Cimzia). Etanercept, ixekizumab, and ustekinumab are also approved for use in children.
Methotrexate: Weekly oral dose to decrease skin cell production, with ongoing monitoring required. Should be stopped at least 3 months before conception and should not be used while pregnant or breastfeeding.
Cyclosporine: Suppresses the immune system for severe psoriasis, but should not be used continuously for more than a year. Increases the risk of infection. Not for use during pregnancy and breastfeeding.
Drugs used to treat Plaque Psoriasis
The medications listed below are related to or used in the treatment of this condition.
For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity
Activity is based on recent site visitor activity relative to other medications in the list.
Rx
Prescription only.
OTC
Over-the-counter.
Rx/OTC
Prescription or Over-the-counter.
Off-label
This medication may not be approved by the FDA for the treatment of this condition.
EUA
An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access
Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.
Pregnancy Category
A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N
FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
M
The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U
CSA Schedule is unknown.
N
Is not subject to the Controlled Substances Act.
1
Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2
Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3
Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4
Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5
Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X
Interacts with Alcohol.
Further information
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