[Medical Q&A] What are the topical medications for treating psoriasis?

Planner: Chinese Medical Association

Reviewer: Huang Kun, Chief Physician, First Affiliated Hospital of Chongqing Medical University

Topical medications are usually medicines applied to the skin. Common topical medications for psoriasis are as follows.

(1) Emollients: such as skin barrier repair cream, vitamin E ointment, lanolin, vaseline, etc., are the basic medications for local drug treatment.

(2) Topical glucocorticoids: such as beclomethasone dipropionate ointment, halometasone cream, hydrocortisone cream, etc. The appropriate preparation should be selected according to the type, location and age of onset of psoriasis.

(3) Vitamin D derivatives: such as calcipotriol ointment, tacalcitol ointment, etc. They are suitable for quiescent plaque psoriasis. Combining or alternating with hormone ointments can increase the efficacy and reduce the adverse reactions of hormones.

(4) Retinoic acid: such as 0.025% tretinoin cream, 0.1% tazarotene cream, etc. Suitable for quiescent plaque psoriasis on the trunk and limbs.

(5) Calcineurin inhibitors: such as 0.03% tacrolimus ointment, 1% pimecrolimus cream, etc. They are suitable for psoriasis on the face and skin folds and can be used as an alternative to glucocorticoids.

(6) Aryl hydrocarbon receptor agonists: such as 1% benvimod cream. They have a good effect on mild to moderate psoriasis vulgaris and can also be used for palmoplantar pustulosis.

(7) Keratin accelerators and de-essants: accelerators include 2% to 5% tar, 3% salicylic acid, 3% to 5% sulfur, etc.; de-essants include 5% to 10% salicylic acid, 10% sulfur, 20% urea, 5% to 10% lactic acid, etc. They can be used in combination with other topical medications to treat chronic plaque psoriasis.

(8) Compound preparations: such as calcipotriol betamethasone ointment, tazarotene betamethasone ointment, compound clobetasol propionate ointment, etc. They can reduce the local adverse reactions of single-ingredient preparations and improve the efficacy.