Psoriasis – Topical Creams

Psoriasis is a skin disease that develops when the immune system sends faulty signals that tell skin cells to grow too quickly.  Since the body does not shed these excess skin cells, the skin cells pile up on the surface of the skin, causing patches of psoriasis to appear.

Treating psoriasis with topical ointments and creams is often the first line of defense, but it can be tricky.  Creams can irritate your skin and may become less effective over time.  You may find that one cream will work for a while, then stop working – another cream that never worked before may suddenly start helping.  Apart from being tricky, using topical treatments can be difficult. Coal tar remedies don’t smell great and many of the creams and ointments are greasy, and quite a few can stain clothing or skin.

When looking for the best cream to treat psoriasis, it really all depends on the severity of the symptoms and whether you use pharmaceutical preparations, or more natural ingredients. Topical creams and ointments are usually used for mild psoriasis, although they are often used in conjunction with other treatments for a multi-layered approach.

Types of Creams for Psoriais

Steroid Creams – Steroid creams, or corticosteroids, are one of the first treatment options for people with psoriasis. They work by reducing inflammation and slowing the growth and build-up of skin cells and come in all sorts of forms: creams, ointments, lotions, and foams.   Hydrocortisone is the mildest steroid cream and can be bought over the counter in 1% strength.  This low strength cream is best suited for use on the face. However, for more stubborn cases of psoriasis, a higher strength steroid cream can be obtained by prescription.  Steroid creams work quickly and effectively. However, long-term use should be avoided since they can cause side effects such as thinning and discoloration of the skin.

Although topical steroids may work very well at first, psoriasis can become resistant to them over time. Topical corticosteroids are now often used in combination with topical D derivatives, or topical A derivatives.

Vitamin D Derivatives – Vitamin D treatments act by slowing down the growth of skin cells and by promoting normal growth.

  • A Vitamin D analogue cream, called Calcitriol, has also been useful in psoriasis. The advantage of Calcitriol is that it does not make the skin thin, like topical steroids do.  This is not regular vitamin D and is not the same as taking regular vitamin D or rubbing it on the skin.
  • Dovonex is a form of Vitamin D that is sold as a cream, ointment, or solution and is safer than topical steroids for long-term use. Dovonex can irritate the skin, so it should only be used in small amounts. Take care not to get it on the healthy skin surrounding the psoriasis. Dovonex is toxic if ingested.

A special precaution with vitamin D analogue creams is that it should not be used on more than 20% of the skin in one person. Overuse may cause absorption of the drug and an abnormal rise in body calcium levels.

Tazorac and other RetinoidsThese are gels or creams derived from Vitamin A.  Retinoids come in different strengths to treat different types of psoriasis in different locations, including the scalp and nails. Usually, you would apply a small dab to each lesion once a day, before bed.

AnthralinThis is an effective drug for psoriasis that has been used for almost a century. It works by affecting the growth of skin cells in the patches of psoriasis. It also reduces inflammation. Anthralin works well, especially on hard to treat plaques, and it causes no serious side effects. The disadvantages are that it can irritate the skin and stains everything, including clothing, sheets, and even skin. For these reasons, it is seldom used.

Coal TarCoal tar products have been used as a topical treatment for psoriasis for hundreds of years. Tar shampoos can be helpful in treating psoriasis of the scalp, while other forms of coal tar can be applied to the skin. Coal tar products seem to slow down cell growth. Coal tar is safe to use, but can take anywhere from six to twelve weeks to work.

Salicylic AcidThis is used to remove the scales that appear on patches of psoriasis. It’s sold in lotions, gels, soaps, and shampoos. Salicylic acid is especially useful in combination with other topical treatments (except those containing Vitamin D since it neutralizes the benefits of the Vitamin D).  By removing the flakes of dead skin, salicylic acid allows these other medications to better penetrate the lesions.

Moisturizing Creams and LotionsThese are used to keep the skin hydrated and soft in order to help control flare-ups in mild cases of psoriasis. In general, the greasier the lotion, the more beneficial it will be. Moisturizing creams act as a moisture barrier to keep skin smooth and soft – look for creams and lotions that contain white soft paraffin, lanolin, petrolatum and aqueous cream.

Dead Sea Salt Cream – If you don’t like the idea of greasy emollients, try using a more natural cream containing Dead Sea salts – the newest sensation in the psoriasis treatment.

Dead Sea Salt creams not only offer relief from itching and irritation, they often contain Aloe Vera to help soften the skin.  There have been numerous studies that have shown that Dead Seal Salts can definitely help reduce some of the most severe symptoms, making the psoriasis barely detectable. Whether you choose to utilize this essential ingredient through creams, muds or bath products, you can be sure the natural elements of the salts will not only help reduce the occurrence of outbreaks but also makes them less severe.

Aloe Vera – Another ingredient to look for is Aloe Vera – it’s non-toxic and safe to use.  Aloe Vera keeps the skin moist, and controls mild cases of psoriasis.

A Cautionary Note:

Using topical treatments can be difficult. Coal tar remedies don’t smell good, and others can be greasy – some may even stain your clothing or skin. However, if you don’t like a particular treatment for any reason, don’t stop using it until you have an alternative treatment ready.  With psoriasis, any break in treatment may results in worsening of the condition.

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