Connect with others who understand.

sign up log in
Resources
About MyPsoriasisTeam

A Guide to Steroid Treatments for Psoriasis

Posted on February 18, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Amanda Agazio, Ph.D.

Steroids are a commonly used treatment of psoriasis and psoriatic arthritis (PsA). Psoriasis is a chronic inflammatory disease that affects the skin. About 1 in 3 people with psoriasis will also develop psoriatic arthritis, a form of the disease that affects the joints.

The steroids used to treat psoriasis and PsA are known as corticosteroids. Corticosteroids are synthetic versions of the natural hormone cortisol, which your body produces in response to stress. They are different from the anabolic steroids some people use to gain muscle mass.

How Are Steroids Used To Treat Psoriasis?

Corticosteroids are used to treat psoriasis because they can suppress the immune system and reduce inflammation. A reduced immune response can help relieve psoriasis symptoms by slowing the growth and buildup of skin cells. Topical treatments can also have vasoconstrictive effects, meaning they can reduce blood flow to the treated area. Reduced blood flow is thought to contribute to reduced inflammation, as well.

Both local and systemic steroids may be used to treat psoriasis. Local steroids include topical creams, ointments, and shampoos applied to the affected skin. For psoriatic arthritis, local steroids may also take the form of injections directly into the joint area. Systemic steroids, which circulate throughout the body, are generally taken by mouth. However, some systemic steroid treatments also include intramuscular (into a muscle) and intravenous (into a vein) injection.

Topical steroids have generally been shown to be highly effective for psoriasis. They may be more effective than treatments such as Psoriasin (coal tar) or retinoids. The use of systemic steroids is also considered effective.

Topical (Local) Steroids

Topical steroids are available in four different potency (strength) levels: mild, moderate, potent, and very potent. For example, hydrocortisone is a mild topical steroid that is available over the counter. Stronger steroids are available by prescription only, such as Elocon (mometasone) Luxiq (betamethasone), and Kenalog (triamcinolone acetonide).

Systemic Steroids

Systemic steroids are generally used in the short term to gain control of severe psoriasis. There has been some controversy over the use of systemic steroids for psoriasis. Some health care practitioners believe that discontinuing systemic steroids may lead to psoriasis flares. However, data from a recent study suggests that the risk for flares following systemic steroids is low.

Side Effects of Corticosteroids

Corticosteroids can be effective for treating psoriasis, but using them — especially long-term — can result in side effects. Side effects may vary with the dosage and strength of the steroids and are more likely to occur with systemic steroids than topical steroids.

If you use topical steroids, watch for side effects such as:

  • Thinning skin
  • Stretch marks
  • Skin-color changes
  • Easier bruising
  • Dilated blood vessels on the surface of the skin

Watch dermatologist Dr. Raja Sivamani explain some of the side effects of using topical steroids for psoriasis.

The potential side effects of systemic corticosteroids may include:

  • Muscle weakness
  • Increased appetite
  • Weight gain
  • Mood changes
  • Bruising more easily
  • Swelling in the face
  • Blurred vision
  • Irritation of the stomach
  • Increased body-hair growth
  • Acne
  • Swelling due to water retention
  • Difficulty sleeping

More serious side effects can include:

If you notice any of the above changes while using steroids to treat your psoriasis, talk to your doctor immediately.

Precautions When Using Steroids

Most steroids are recommended for short-term use, but some people may need to be on them for longer periods of time. When you’re using steroids to treat psoriasis, your doctor should monitor your body weight, blood pressure, blood sugar, vision, and bone density.

If you’re taking systemic steroids, your doctor will likely recommend that you avoid individuals who are sick or have active infections. Systemic steroid use may put you at risk for severe infection from chicken pox, shingles, or the measles if you’re not already immune. You should also consult your doctor before receiving any vaccines while on systemic steroids. Because steroids suppress the immune system, a vaccine may not be as effective. The use of live-virus vaccines is also a concern for people taking steroids.

If you’re stopping long-term use of systemic steroids, work with your doctor to do it gradually over time. A sudden discontinuation of systemic steroids may lead to a serious condition called an adrenal crisis, which occurs because the body can’t make enough cortisol to make up for the sudden withdrawal from the steroid. Side effects of an adrenal crisis include nausea, vomiting, and shock.

Knowledge Is Power

Living with psoriasis and identifying effective treatment options for the disease can be challenging. Understanding the benefits and side effects associated with corticosteroid usage can help you make informed decisions about your own treatment. Steroids are just one option for treating psoriasis, and there are many other options to choose from. It’s important to have a conversation with your health care provider to determine what approach is best for managing your psoriasis.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 88,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

How have steroids worked for your psoriasis? Or do you have questions about using a corticosteroid? Share your experience in the comments below, or start a conversation on MyPsoriasisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Amanda Agazio, Ph.D. completed her doctorate in immunology at the University of Colorado Anschutz Medical Campus. Her studies focused on the antibody response and autoimmunity. Learn more about her here.

Related articles

Treatment for psoriatic arthritis (PsA) can help you reduce painful symptoms and control disease...

Treatments for Psoriatic Arthritis

Treatment for psoriatic arthritis (PsA) can help you reduce painful symptoms and control disease...
Retinoids are often used to treat psoriasis, a skin condition that causes inflammation and leads...

Your Guide to Retinoids for Psoriasis

Retinoids are often used to treat psoriasis, a skin condition that causes inflammation and leads...
If you have psoriasis, you understand the care that goes into selecting the right products for...

Does Coal Tar Help Psoriasis?

If you have psoriasis, you understand the care that goes into selecting the right products for...
Psoriatic arthritis (PsA) primarily causes joint pain and swelling, which can be reduced with...

Treating Psoriatic Arthritis and Skin Symptoms

Psoriatic arthritis (PsA) primarily causes joint pain and swelling, which can be reduced with...
Many people who have been diagnosed with psoriasis, a chronic skin condition that causes dry,...

Can Neem Oil Help Psoriasis?

Many people who have been diagnosed with psoriasis, a chronic skin condition that causes dry,...
Many MyPsoriasisTeam members have looked into home remedies that can ease the symptoms of...

Does Witch Hazel Help Psoriasis?

Many MyPsoriasisTeam members have looked into home remedies that can ease the symptoms of...

Recent articles

Diagnosed with psoriasis in 2010, Vanessa Scott has learned to manage her condition and overcome...

Living With Psoriasis: Managing Flare-ups and Embracing Life

Diagnosed with psoriasis in 2010, Vanessa Scott has learned to manage her condition and overcome...
Nearly 80 percent of people with psoriatic arthritis (PsA) had symptoms of skin psoriasis...

Psoriatic Arthritis Diagnosis and Tests

Nearly 80 percent of people with psoriatic arthritis (PsA) had symptoms of skin psoriasis...
Psoriasis occurs when something goes wrong with your immune system. Your immune cells become...

T Cells in Psoriasis: A Simplified Guide

Psoriasis occurs when something goes wrong with your immune system. Your immune cells become...
The risk for developing psoriasis is associated with many factors, including genetics and...

Psoriasis and Ethnicity: Is Race a Risk Factor?

The risk for developing psoriasis is associated with many factors, including genetics and...
Erythrodermic psoriasis affects an estimated 1 percent to 2.25 percent of people living with...

Erythrodermic Psoriasis: Symptoms and Photos

Erythrodermic psoriasis affects an estimated 1 percent to 2.25 percent of people living with...
Anemia is a common comorbidity (co-occurring condition) in people with psoriasis, psoriatic...

Psoriasis and Anemia: What’s the Connection?

Anemia is a common comorbidity (co-occurring condition) in people with psoriasis, psoriatic...
MyPsoriasisTeam My psoriasis Team

Thank you for subscribing!

Become a member to get even more:

sign up for free

close