The Best Creams and Lotions for Treating Psoriasis

Many people rely on topical creams, both over-the-counter and prescription, to help manage psoriasis symptoms, such as dry, itchy skin. These topical options may help keep the skin hydrated, reduce inflammation, and slow the rapid production of skin cells.

Learn more about what creams can help with psoriasis, skin care tips, and other treatment options.

Choosing the Best Cream for Psoriasis

The best cream for psoriasis depends on the location, type, and severity. Choose a cream free of irritants, including fragrances and ingredients you are allergic to. Recommendations from a medical professional specializing in psoriasis treatment are always a good idea.

Topical creams are typically used to treat mild-to-moderate psoriasis. You may need to use prescription or combination therapies for more severe cases.

Over-the-Counter Creams for Psoriasis

Over-the-counter (OTC) creams to treat mild psoriasis contain:

• Salicylic acid
• Ceramides
• Anti-itch ingredients
• Mild corticosteroids
• Vitamins
• Oils
• Amino acids
• Coal tar

These ingredients lock in moisture, treat itching, exfoliate the skin, protect the skin barrier, and more.

Anti-Itch Psoriasis Cream 

Itchiness is one of the most common complaints of people with psoriasis. Common ingredients in anti-itch creams are calamine, camphor, hydrocortisone, or menthol; a combination of these teds to work best against itch. Hydrating the skin while also applying anti-itch creams is also recommended.

Emollients and Moisturizers

Skin hydration is especially important in maintaining and treating psoriasis. Emollients and moisturizers protect the skin barrier, relieve dryness, and help clear your skin. These creams are typically used daily and can be applied to wet skin for maximum hydration.

Moisturizers can be used several times a day if needed. Heavy creams, ointments, and oils usually work best and are very soothing. But because they can be messy, you may consider using them before bed only.

Salicylic Acid

This ingredient is used to soften skin scales and reduce their thickness. It is important to use products containing this ingredient as directed. Too much can irritate the skin, causing dry, red, and itchy skin. Applying 15 minutes after a warm bath is also helpful.

Corticosteroids

Corticosteroids aim to reduce inflammation and treat a few patches of psoriasis. They are not meant to be used daily. You may find them in OTC creams, foams, or shampoos (to treat scalp psoriasis). Lower-potency corticosteroids may be added to other ingredients in lotions and creams. These weaker concentrations of corticosteroids are usually meant to be used on more sensitive areas of the skin, such as the face and skinfolds.

Coal Tar

Found in creams, ointments, shampoos, and bath solutions, coal tar is an active ingredient aimed to reduce itching and flaking, redness, swelling, and scaling. However, it could irritate your skin, so start with a small amount before putting it all over.

Psoriasis Cream Prescription Options

You may need stronger medications to treat psoriasis flares. A primary care provider or dermatologist (medical doctor specializing in conditions of the skin, hair, and nails) may recommend different prescription options or combinations of topicals, such as stronger corticosteroids, retinoids, and vitamin D analogues.

Stronger Corticosteroids

Stronger topical corticosteroids should be used as indicated by a healthcare provider. Some steroids are meant to use in different areas of the body and are chosen based on severity, location, preference, and age. You will likely be recommended to use the topicals:

• As often as instructed (to receive full benefits)
• Only on the skin that a healthcare provider recommends
• Only for as long as your healthcare provider prescribes

Once your corticosteroid treatment ends, you may need a maintenance routine using vitamin D analogues, topical retinoids, and calcineurin inhibitors.

Retinoids

Retinoids are precursors to vitamin A and can be used to treat psoriasis. It comes in oral and topical forms. The topical form on the skin is tazarotene, used to decrease scales, lessen redness and swelling, and treat psoriasis on the nails.

Retinoids are very effective in treating psoriasis. However, they can have side effects and should not be used by certain populations. They can increase sun sensitivity and result in sunburn. They can also produce irritation and redness around the psoriasis. Pregnant people should not use this as it can cause birth defects.

Vitamin D Analogues

Vitamin D analogues (calcitriol) are often used in conjunction with steroids. They bind to vitamin D receptors, inhibiting skin cell growth and enhancing differentiation.

Anthralin

Anthralin is an older topical medication that is not used very often due to its potential for temporarily staining skin and permanently staining clothing and fabric. However, it can be used if other treatments do not work. It treats psoriasis by slowing down the replication of skin cells and therefore reducing skin plaques. It is not meant to treat severe psoriasis.

Calcineurin Inhibitors

Calcineurin inhibitors can be used as an alternative to corticosteroids. They are used off-label for psoriasis because they do not thin your skin the way steroids can. This group of medications includes creams and ointments containing pimecrolimus and tacrolimus, the latter being the stronger of the two.

What Should You Not Put on Psoriasis?

Certain substances can trigger psoriasis or contribute to a flare-up. If you have psoriasis, avoid hot showers, use gentle cleansers instead of soap, and avoid fragranced lotions. Before applying lotions, creams, soap, or sunscreens, consult a healthcare provider for recommendations.

Alternatives for When Topical Treatment Doesn’t Work

Topical treatments are usually the first line of therapy when treating psoriasis and can be used in conjunction with other treatments such as ultraviolet (UV) phototherapy, biologics, and oral medications.

Talking to Your Healthcare Provider About Treatment

Psoriasis can affect your quality of life, especially if it's recurrent or difficult to treat. A healthcare provider can explain the different topicals and help you choose a regimen that works best for you, which may help you stick to the treatment plan. You can also learn how to avoid triggers and get other helpful recommendations for managing your psoriasis symptoms.

If you have been trying topicals with no success, then it is a good idea to discuss with a healthcare provider about adjusting your treatment plan. Your provider may recommend a new topical, oral medication, biologics, or other treatment options.

Summary

Psoriasis is a chronic inflammatory skin condition requiring topical ointments, creams, moisturizers, and medications for treatment, management, and prevention. The type of treatment regimen that will be best for you depends on your age, the severity of psoriasis, and the location on your body. It is always best to meet with a medical professional, so they can curate a plan that works for you.