Psoriasis treatment options

Understand available treatments and what may be right for you.

There's no cure for psoriasis. But treatment can stop your skin cells from growing so quickly, which reduces the patches of dry, raised rash. These patches also are called plaques. Treatment also can remove scales and smooth your skin.

Your health care provider can recommend a treatment plan based on your symptoms and where you have psoriasis patches on your body.

Having a basic understanding of treatment options can help you have a better conversation with your health care provider. Here's an overview of psoriasis treatment options.

Types of treatments

Psoriasis can be treated with medicine applied to the skin, light exposure, pills and injections.

Creams, ointments and other products for the skin

Your health care provider might recommend medicated creams, ointments, gels, called topical therapy. These are applied to the skin to help ease the symptoms of mild psoriasis. For more-moderate psoriasis, these products might be used with other treatments. Options include:

  • Corticosteroids. Low-potency versions are used on sensitive areas, such as the face. Stronger versions are used for thick plaques on the hands or when other treatment fails. Long-term use or overuse of strong corticosteroids can thin the skin. Salicylic acid might be used with this therapy to help remove dead skin cells.
  • Coal tar. Coal tar has been a staple of treatment for many decades. Coal tar is a byproduct of making coal products. It reduces scaling, itching and inflammation. Tar products come in shampoo, cream and other forms. They can be messy. Salicylic acid might be used with coal tar to remove dead skin cells.
  • Anthralin. Anthralin, another tar product, removes scales. It can irritate the skin and stain anything it touches.
  • Vitamin D analogues. These treatments are used for mild to moderate psoriasis. Calcipotriene (Dovonex) and calcitriol (Vectical) are synthetic forms of vitamin D available as cream ointments. They might irritate the skin and shouldn't be used on the face or groin area. Combining a vitamin D analogue with a corticosteroid ointment or cream may work better than either treatment alone.
  • Retinoids. These treatments, such as tazarotene (Tazorac, Avage), are vitamin A derivatives. They might irritate the skin and increase sensitivity to sunlight. Tazarotene isn't recommended for people who are pregnant. If you're breastfeeding, talk to your health care provider.
  • Calcineurin inhibitors. These medicines, such as tacrolimus (Protopic) and pimecrolimus (Elidel), are sometimes effective in treating psoriasis in selected cases. They can reduce inflammation and plaque buildup. They may be most useful on skin where a more potent corticosteroid can't be used. But they aren't recommended for long-term or continuous use because of a potential increased risk of skin cancer and lymphoma.

Light therapy

Light therapy involves exposing your skin to ultraviolet (UV) rays, which can reduce scaling and inflammation. This method also is called phototherapy. Options include:

  • Sunlight. Brief, daily exposure to small amounts of sunlight might improve psoriasis. But intense sun exposure can worsen symptoms and damage skin.
  • Artificial UVB light. Controlled doses of UVB light from an artificial light source might improve mild to moderate psoriasis symptoms.

    UVB phototherapy can treat single patches, widespread psoriasis and psoriasis that doesn't improve with topical treatments. It is often combined with topical treatments. Short-term side effects might include rash, itching and dry skin.

    Narrow band UVB therapy might work better than UVB phototherapy, requiring fewer treatments to get good responses. But narrow band UVB therapy might cause more-severe and longer lasting burns.

    Excimer laser therapy focuses a controlled beam of UVB light onto areas of mild to moderate psoriasis. This treatment helps control scaling and inflammation. Side effects can include rash and blistering.

  • Artificial UVA light. UVA light penetrates deeper into the skin than does UVB light. Psoralen plus ultraviolet A (PUVA), also called photochemotherapy, involves taking a light-sensitizing medicine before exposure to UVA light. The medicine, called psoralen, makes the skin more responsive to UVA exposure. This treatment consistently improves skin and is used for more-severe cases of psoriasis. Short-term side effects include nausea, rash, blistering, burning, itching and sensitivity to sunlight. Long-term side effects include dry and wrinkled skin, freckles, and increased risk of skin cancer.

Pills and injections

If you have moderate to severe psoriasis, or if other treatments don't work, your health care provider might prescribe pills or injections. Because of severe side effects, some medicines are used for only brief periods and are alternated with other treatments. Options include:

  • Retinoids. These pills, such as acitretin, might reduce the production of skin cells if you have severe psoriasis that doesn't improve with other treatments. Symptoms usually return once therapy is discontinued. Side effects might include lip inflammation and hair loss. Acitretin isn't recommended for people who are pregnant, breastfeeding or might become pregnant within three years.
  • Methotrexate. This medicine can be taken by mouth or injected. It suppresses inflammation. Methotrexate might cause upset stomach, loss of appetite and fatigue. When used for long periods, it can cause severe liver damage and lower levels of red and white blood cells and platelets. It's important to avoid alcohol while taking methotrexate. People need to stop taking methotrexate at least three months before attempting to conceive. This medicine is not recommended for those who are pregnant or breastfeeding.
  • Cyclosporine. This medicine — usually taken by mouth for psoriasis treatment — suppresses inflammation. It's similar to methotrexate in effectiveness. It also increases the risk of infection and other health problems, including cancer, kidney problems and high blood pressure. These medicines aren't recommended for those who are pregnant, intend to become pregnant or are breastfeeding.
  • Biologics. Several biologics are used to treat moderate to severe psoriasis. Options include infliximab (Remicade), etanercept (Enbrel), adalimumab (Humira), certolizumab (Cimzia), ustekinumab (Stelara), risankizumab-rzaa (Skyrizi), tildrakizumab (Ilumya) and ixekizumab (Taltz).

    Biologic medicines are injected, either by you or by a health care provider. They are for people who don't respond to traditional therapy. Because these medicines have strong effects on the immune system, they might increase your risk of life-threatening infections, such as tuberculosis.

Psoriasis treatment choices are complicated. As with any medicine, side effects may occur. Talk with your health care provider to determine which treatment is right for you.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Feb. 15, 2023 See more In-depth

See also

  1. 5 signs a psoriasis support group is right for you
  2. 6 ways to manage itchy skin when you have psoriasis
  3. Arthritis
  4. Arthritis pain: Do's and don'ts
  5. Can psoriasis make it hard to sleep?
  6. Dry skin
  7. Ease stress to reduce your psoriasis flares
  8. Exercising with arthritis
  9. Ground flaxseed
  10. Gluten sensitivity and psoriasis: What's the connection?
  11. Hand exercises for people with arthritis
  12. How to heal cracked heels
  13. How to heal cracked skin at thumb tip
  14. How to trim thickened toenails
  15. Is the Mediterranean diet good for psoriasis?
  16. Joint protection
  17. Living better with psoriasis
  18. Psoriasis-related health risks
  19. Mayo Clinic Minute: Fingernails are clues to your health
  20. Mayo Clinic Minute: Moisturizer tips from a dermatologist
  21. Photodynamic therapy
  22. Prednisone risks, benefits
  23. Pregnancy and breastfeeding when you have psoriasis
  24. Psoriasis
  25. Psoriasis and clinical trials
  26. Psoriasis and intimacy
  27. Psoriasis and your self-esteem
  28. Identifying what worsens your psoriasis
  29. Psoriasis: Get the most out of your treatment
  30. Psoriasis: How can I protect my skin during a workout?
  31. Psoriasis: What if I get psoriatic arthritis, too?
  32. Psoriasis: What to share with your doctor
  33. Relaxation techniques
  34. Scalp psoriasis vs. seborrheic dermatitis
  35. Skin biopsy
  36. Skin care tips
  37. Slide show: 5 ways to thrive with psoriasis through the holidays
  38. Slide show: Caring for your skin when you have psoriasis
  39. Types of psoriasis
  40. Alternative psoriasis treatments
  41. What are the risks of vaccinations for people living with psoriasis?
  42. What's the best way to manage scalp psoriasis?
  43. White patch on skin: A cause for concern?