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 PsA 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.

Examples of corticosteroids include:

• Cortisone
• Clobetasol
• Fluocinonide
• Prednisone
• Prednisolone
• Methyl-prednisolone

Scientists believe corticosteroids work by blocking inflammatory responses within the body. Some OTC products contain hydrocortisone, a milder steroid, at a lower strength.

Stronger steroids — such as betamethasone (Luxiq), triamcinolone acetonide (Kenalog), and mometasone (Elocon) — are available by prescription only. These more potent steroids are reserved for more severe disease and can thin the skin over time.

Immunosuppressants and Synthetic Vitamin D

Other topical prescription medications for psoriasis include immunosuppressants and synthetic forms of vitamin D. Vitamin D derivatives such as calcipotriene (Dovonex) and calcitriol are believed to slow the growth of skin cells.

Topical immunosuppressants include tacrolimus (Protopic) and pimecrolimus (Elidel), which work similarly to steroid creams to suppress inflammation in the skin. Tapinarof, a topical immunosuppressant, was approved for the treatment of plaque psoriasis in adults in 2022. Roflumilast, a phosphodiesterase 4 (PDE4) inhibitor, was also approved in 2022 to treat plaque psoriasis.

Some topical treatments combine two drugs that work together to fight psoriasis. For example, betamethasone/calcipotriene (Taclonex) contains a steroid and a powerful form of vitamin D.

Side effects of topical psoriasis treatments usually affect just the skin. Some cause discoloration, sensitivity to light, or other skin reactions — especially when treatment first begins.

Certain topical psoriasis medications and stronger corticosteroids should be used for a limited time to avoid side effects, such as:

• Stretch marks
• Pigmentation changes
• Allergic reactions
• Skin atrophy (thinning of the skin that may cause depressions or wrinkles)

Used over large areas of skin for a long time, powerful topical steroids can be absorbed into the bloodstream and cause systemic problems such as:

• Cushing’s syndrome, a metabolic disorder that involves weight gain
• Muscle weakness
• High blood pressure
• High blood sugar

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.

Some oral drugs prescribed for psoriatic disease are types of immunosuppressants called disease-modifying antirheumatic drugs (DMARDs), such as:

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

Acitretin (Soriatane), an oral systemic retinoid used for severe psoriasis, may be combined with ultraviolet therapy. Oral corticosteroids may be given for short periods during flare-ups of psoriasis or PsA, but these drugs may cause a rebound flare and should be used with caution.

In recent years, new types of oral medications have been approved to treat psoriasis. Apremilast (Otezla), a PDE4 inhibitor, is approved to treat mild to severe psoriasis and PsA.

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 as of 2023:

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

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, such as screening for infections like hepatitis.

3. Injected or Infused Medications

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

Steroids may be injected into joints. To quickly reduce symptoms during flares, corticosteroids also can be given intravenously.

One of the most-used DMARDs in psoriasis, methotrexate, is usually given as a subcutaneous injection but can also be taken orally or, in rare cases, administered intravenously.

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 as maintenance drugs to prevent disease flares and permanent inflammation-related changes in joints.

FDA-approved biologics that are administered subcutaneously include:

• Adalimumab (Humira)
• Bimekizumab-bkzx (Bimzelx)
• Brodalumab (Siliq)
• Certolizumab pegol (Cimzia)
• Etanercept (Enbrel)
• Guselkumab (Tremfya)
• Ixekizumab (Taltz)
• Risankizumab-rzaa (Skyrizi)
• Secukinumab (Cosentyx)
• Spesolimab-sbzo (Spevigo)
• Tildrakizumab-asmn (Ilumya)
• Ustekinumab (Stelara)

Biosimilar drugs are also available as an alternative to certain biologics, such as ustekinumab-aauz (Otulfi) and ustekinumab-srlf (Imuldosa), biosimilars for ustekinumab. Biosimilars are medications that are very similar to already approved biologic drugs but usually cost less.

Biologic drugs might be given every few weeks or every few months, depending on the medication. More than 10 commercially available biologics for psoriatic disease 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 have systemic responses and can cause side effects throughout the body. Because biologics suppress aspects of the immune system, they may increase your risk of contracting infections and, in rare cases, developing certain types of cancer.

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.

Read more about specific medications in this list of treatments for psoriasis.

4. Light Therapy

Phototherapy, also called light therapy, uses different types of light to treat plaque psoriasis. Types of phototherapy include exposure to sunlight or medically supervised 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, osteoporosis, and heart disease. A balanced, nutritious diet can help lower the risk. Some people with psoriatic disease report reduced symptoms after adopting a gluten-free diet or an anti-inflammatory diet, although no single diet has been shown to slow or cure psoriasis.

Exercising

People with psoriasis and psoriatic arthritis are less likely to exercise than those without psoriasis. Embarrassment, pain, stiffness, and swelling lead many people with psoriatic disease to give up on exercise and become increasingly sedentary.

However, lack of physical activity can lead to increased stiffness and contribute to the development of other serious conditions, such as osteoporosis, heart disease, diabetes, and depression. Research has shown that for people with psoriatic disease, regular exercise can help keep joints flexible and reduce inflammation and stress.

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 relapses 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, more than 129,000 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.