There are now more effective treatments for psoriasis than ever before. Some treatments are approved by the U.S. Food and Drug Administration (FDA) for only the skin forms of psoriasis or plaque psoriasis, while others are approved to treat psoriatic arthritis (PsA). Some medications can treat multiple types of psoriatic disease.

Guidelines for psoriasis treatment generally recommend trying the safest treatments first and then — if those initial treatments fail — moving to more intensive treatments that may have more serious potential side effects. Guidelines also take into account the severity and extent (how much skin is covered) of psoriasis symptoms.

Psoriasis treatments can be categorized by the way they’re taken. Some treatments for skin psoriasis are topical — applied directly to the skin. Other treatments for psoriasis or psoriatic arthritis are taken:

• Orally (by mouth)
• Subcutaneously (injected into the tissue between the skin and muscle)
• Intravenously (through an IV into a vein)
• Intra-articularly (injected into affected joints)

Read on to learn more about six types of treatment for psoriasis and how they work to help symptoms.

1. Topical Treatments

The effects of topical treatments are limited mainly to the skin and won’t help psoriatic arthritis. Topical treatments for psoriasis can come in a variety of forms, including:

• Ointments
• Creams
• Sprays
• Foams
• Shampoos
• Lotions

Different forms of topical medication are better for different parts of the body or types of psoriasis. For instance, medicated shampoos work well for the scalp.

Some topical medications are available over the counter (OTC) without a doctor’s prescription. Coal tar and salicylic acid are two FDA-approved ingredients for treating psoriasis found in OTC products.

Corticosteroids

Corticosteroids (also simply called steroids) are among the most frequently used treatments for psoriasis. Corticosteroids are synthetic hormones that suppress immune system response.

Hydrocortisone, a milder steroid, is available at the drugstore. Most topical corticosteroids used for psoriasis require a doctor’s prescription. Examples include:

• Betamethasone
• Clobetasol
• Fluocinonide
• Triamcinolone

Steroids can cause side effects like skin thinning, acne, changes to skin tone, and more. Powerful topical steroids can be absorbed into the bloodstream and cause systemic problems (issues that affect the whole body), such as Cushing’s syndrome, a metabolic disorder that involves weight gain.

Nonsteroid Topicals

Several other topicals for psoriasis do not contain any steroids. They include:

Calcineurin Inhibitors

Calcineurin inhibitors, such as tacrolimus and pimecrolimus, work by reducing inflammation. These topicals can be used in sensitive areas like the face or genitals.

Roflumilast

Roflumilast (Zoryve) is a phosphodiesterase 4 (PDE4) inhibitor. It helps to reduce inflammation. It was approved to treat plaque psoriasis, including in areas where skin rubs together like the armpits.

Synthetic Vitamin D

Synthetic forms of vitamin D, also called vitamin D analogs, are another type of topical psoriasis treatment. Vitamin D derivatives such as calcipotriene (Dovonex) and calcitriol are believed to slow the growth of skin cells. Sometimes vitamin D is combined with a steroid, such as betamethasone/calcipotriene (Taclonex).

Tapinarof

This topical belongs to a drug class called aryl hydrocarbon receptor antagonists. It was approved for treating plaque psoriasis. Tapinarof (Vtama) works by modifying the immune system.

Topical Retinoids

Retinoids, such as tazarotene, work by slowing skin growth and reducing inflammation. Topical retinoids aren’t recommended for the face or genitals because of skin irritation.

2. Oral Medications

Oral medications are prescribed for psoriatic arthritis, for plaque psoriasis that covers a significant percentage of the skin, or when topical drugs fail to control plaque psoriasis.

Unlike topical medications, oral psoriasis medications can have side effects that go deeper than the skin. Oral medications’ effects — and side effects — can occur throughout the body. Some suppress the immune system and may require lab tests to monitor side effects on the kidneys and liver.

Conventional DMARDs

Some oral drugs prescribed for psoriatic disease are types of immunosuppressants called disease-modifying antirheumatic drugs (DMARDs). Examples include:

• Cyclosporine
• Leflunomide
• Methotrexate (Otrexup, Rasuvo, and Trexall)
• Sulfasalazine

JAK Inhibitors

Janus kinase (JAK) inhibitors also can be used to treat psoriasis and psoriatic arthritis. These oral drugs work on specific parts of the immune system to help relieve symptoms. Your doctor may suggest JAK inhibitors if other medications have been ineffective.

Three JAK inhibitors are FDA-approved for psoriasis and PsA:

• Deucravacitinib (Sotyktu) for psoriasis
• Tofacitinib (Xeljanz) for psoriatic arthritis
• Upadacitinib (Rinvoq) for psoriatic arthritis

Other Oral Treatments

Below are examples of other oral medications for psoriasis:

• Acitretin (Soriatane) is an oral retinoid that can be used to treat plaque psoriasis. It is sometimes combined with ultraviolet therapy.
• Apremilast (Otezla), a PDE4 inhibitor, is approved to treat mild to severe psoriasis and psoriatic arthritis.
• Oral corticosteroids are sometimes given for short periods during flare-ups of psoriasis or psoriatic arthritis, but these drugs may cause a rebound flare and should be used with caution.

3. Injected or Infused Medications

For moderate to severe psoriasis, a doctor may prescribe injected medications.

Steroids may be injected into joints or even into psoriasis lesions. Methotrexate is generally taken orally, but it can also be given as an injection.

Most injected medications are newer biologic drugs designed to suppress specific molecules of the immune system that are responsible for inflammation in psoriasis and psoriatic arthritis. Biologics are usually taken long term to control inflammation and prevent flares and joint damage in psoriatic arthritis.

FDA-approved biologics for psoriasis include:

• Abatacept (Orencia)
• Adalimumab (Humira)
• Bimekizumab-bkzx (Bimzelx)
• Brodalumab (Siliq)
• Certolizumab pegol (Cimzia)
• Etanercept (Enbrel)
• Golimumab (Simponi) (only for psoriatic arthritis)
• Guselkumab (Tremfya)
• Infliximab (Remicade)
• Ixekizumab (Taltz)
• Risankizumab-rzaa (Skyrizi)
• Secukinumab (Cosentyx)
• Spesolimab-sbzo (Spevigo)
• Tildrakizumab-asmn (Ilumya)
• Ustekinumab (Stelara)

Some of the treatments above are approved to treat both psoriasis and psoriatic arthritis.

Biosimilar drugs are also available as an alternative to some of these biologics. Biosimilars are medications that are very similar to already approved biologic drugs but usually cost less.

Biologic drugs might be taken every few weeks or every few months, depending on the medication. Biologics can be given at the doctor’s office or self-administered at home (after you receive information from your provider).

Like oral medications, injected medications can cause side effects throughout the body. Because biologics suppress aspects of the immune system, they may increase your risk of contracting infections.

Each psoriasis treatment has specific side effects and different levels of risk. Your dermatologist can help you understand the benefits and risks of each psoriasis medication based on your medical history and individual condition.

4. Light Therapy

Phototherapy, also called light therapy, uses different types of light to treat plaque psoriasis. Types of phototherapy include treatments with specialized ultraviolet light — ultraviolet B light (UVB) or ultraviolet A (UVA) light combined with psoralen (PUVA).

Laser treatment is a type of phototherapy that uses special lasers to treat affected skin and improve psoriasis symptoms.

Long-term light therapy may lead to an increased risk of certain types of skin cancer.

5. Lifestyle Changes

Making some lifestyle changes may help you get a better handle on your symptoms.

Moisturizing Regularly

Using moisturizers, creams, and ointments can help soothe itching and dryness and prevent your psoriasis from getting worse. Moisturizers help trap water in the skin and maintain the skin’s natural barrier. Regularly applying moisturizers can promote healing in skin affected by psoriasis. Thicker and greasier ointments may be more effective because they’re more protective of the skin barrier.

Changing Your Diet

No specific diet helps everyone with psoriasis, but many physicians and researchers recommend a balanced diet with plenty of fresh fruit and vegetables, whole grains, and unsaturated fats.

People with psoriasis have a higher risk of developing health conditions such as diabetes and heart disease. A balanced, nutritious diet can help lower the risk. Some people with psoriatic disease report reduced symptoms after adopting an anti-inflammatory diet, although no single diet has been shown to slow or cure psoriasis.

Exercising

Embarrassment, pain, stiffness, and swelling may prevent people with psoriasis from being active. However, lack of physical activity can contribute to the development of other health problems. Exercise can help you reduce your risk of conditions like heart disease or fatty liver disease and can help relieve stress and improve your mood.

Managing Stress

Stress is a common trigger for psoriasis flares, and reducing stress may have benefits for people with psoriatic disease. Some ways to find stress relief include:

• Practicing deep breathing
• Meditating
• Praying
• Practicing yoga or tai chi
• Connecting with family and friends
• Attending psychotherapy sessions
• Taking an antidepressant medication

6. Natural or Complementary Treatments

Some people with psoriasis have reported feeling better after trying various complementary or alternative therapies, such as acupuncture or acupressure. Natural treatments can’t replace clinically proven medications — no alternative treatments have been shown in studies to prevent psoriasis flares or delay disease progression.

Some natural treatments, such as nutritional or herbal supplements, can interfere with psoriasis medications or cause their own side effects. It’s important to talk to your doctor before trying alternative therapies.

Is There a Cure for Psoriasis?

Despite encouraging research, at present there’s no cure for psoriasis. The good news is that psoriasis is treatable, and recently developed medications may even lead to completely clear skin for some people. Talk to your doctor about the best treatment plan for you.

Meet Your Team

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

Which psoriasis treatments have been helpful for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.