Lotions, creams, and ointments for psoriasis
People living with psoriasis often use topical treatments that include lotions, creams, and ointments as part of their treatment routines and self-care regimens.
Psoriasis affects individuals differently, and so no one product suits everyone. A doctor or pharmacist can help most people find one that is suitable for them.
Knowing what to look for in a psoriasis treatment can help a person make an informed decision about the best lotion, cream, or ointment for them.
Why use lotions?
Creams and lotions can help improve the symptoms of psoriasis.
Lotions, creams, and ointments can be useful in treating mild psoriasis symptoms.
Reasons for using them are:
- They allow a person to apply medication directly to the affected area.
- They can soften the area, allowing other medications to enter the skin's deeper layers.
- They can ease dryness and cracking, which can reduce discomfort and the risk of infection.
Lotions, creams, and other topical ointments are often the first treatment for people with mild psoriasis because they may reduce the scaling, itching, and discomfort that can occur.
Both over-the-counter and prescription lotions can help.
While some people prefer lotions, it may be that creams and ointments are less irritating and more effective.
Some ingredients, such as tazarotene and topical calcineurin inhibitors, are only present in creams and ointments.
Which is the best lotion?
Many lotions are available, and psoriasis affects each person differently. It can take time to find the most suitable product or combination of lotions and other therapies to treat psoriasis.
Factors that can impact the choice of treatment include:
- the severity of the symptoms
- the type of psoriasis a person has
- what part of the body the symptoms affect
- the active ingredients in the product
- how the body responds to the product
- the strength of the ingredients
A doctor or pharmacist may advise a person to choose a cream rather than a lotion, as some ingredients are not available in lotion form.
Types of lotion
How the product affects a person will depend on its ingredients.
Various types of lotions, creams, and ointments are available, depending on their active ingredients and whether they are available over the counter or through prescription.
The following products and ingredients can help treat psoriasis:
- coal tar
- synthetic vitamin D
- salicylic acid
- calcineurin inhibitors
Natural ingredients, such as aloe vera and jojoba, may have a soothing effect, but no research supports their use in psoriasis. A doctor may advise a person to choose a thick, fragrance-free lotion that is suitable for sensitive skin.
Coal tar, pine tar, and salicylic acid also feature in soaps for psoriasis. Find out more here.
What are retinoids?
When a person applies them to a psoriasis plaque, retinoids enable the body to shed the excess skin that has built up. This helps reduce the inflamed and scaly appearance and calm the feeling of discomfort.
A doctor may recommend combining tazarotene with a corticosteroid.
The treatment can sometimes irritate the skin. If this happens, the American Academy of Dermatology (AAD) recommend first applying petroleum jelly around the skin patches, then applying the retinoid to the psoriasis only.
The Food and Drug Administration (FDA) have issued a warning about exposure to sunlight while using retinoids. A person should use sunscreen if they cannot avoid exposure to the sun and consider wearing protective clothing, as too much sun exposure can also worsen psoriasis symptoms in some people.
What is coal tar?
Coal tar products are available over the counter or by prescription.
They can help make the affected skin look healthier and slow down the growth of new skin cells. Coal tar is often an ingredient in lotions.
In some places, coal tar products carry a warning that they may cause cancer. However, these warnings stem from research into animals and industrial exposure.
The AAD note that there is no evidence of coal tar products leading to cancer when people use them for psoriasis.
A product may contain up to 5% coal tar. Using a stronger one does not necessarily mean it will be more effective, according to the AAD.
Some coal tar treatments need a prescription, but many are available over the counter.
What is synthetic vitamin D?
People with psoriasis can use lotions and creams containing synthetic vitamin D to slow the growth of new skin cells.
These can help:
- reduce the accumulation of skin cells
- flatten thick patches
- remove scales
Some lotions containing vitamin D may irritate a person's skin, but it is safe for most people to use, including children.
When people use them in excess on large areas of the body, it can increase calcium levels in the blood, increasing the risk of kidney stones and other problems. However, a person who follows the doctor's instructions is unlikely to experience adverse effects.
What is anthralin?
Anthralin slows the growth of new skin cells and helps reduce the swelling that can occur with psoriasis symptoms. People have been using anthralin to treat psoriasis for more than 80 years.
It is effective but can have some adverse effects, such as temporary discoloration of the skin and clothing and irritation and burning sensation on the skin. For these reasons, a doctor may not recommend its use.
Trials are currently underway to find new ways of preparing anthralin that will not have these disadvantages.
What is salicylic acid?
Salicylic acid helps remove the scaly appearance of psoriasis patches. It is a keratolytic agent, which means it can help the skin shed its outer layers.
People with psoriasis often use salicylic acid alongside other medicated creams because the salicylic acid allows the other creams to penetrate the skin more effectively.
Some products will need a prescription, but others are available over the counter.
What are corticosteroids?
A doctor can recommend a suitable strength corticosteroid, depending on:
- individual skin sensitivity
- symptom severity
- the area of the body needing treatment
Corticosteroids can have adverse effects if a person uses them for a long time. A doctor or pharmacist can advise on their application.
A product containing steroids may need a prescription.
What are calcineurin inhibitors?
Calcineurin inhibitors are not available in lotions but are in cream and ointment form. They need a prescription.
Calcineurin inhibitors include pimecrolimus and tacrolimus.
People with psoriasis may use calcineurin inhibitors when other medications are not working as well as a doctor hoped. They can help reduce and stop inflammation. Their primary use is for eczema, but a doctor may prescribe them "off-label" for psoriasis.
Doctors may recommend these medicines because they are safe to use on thin areas of the skin, such as the groin and face. These are areas that are not suitable for long-term topical corticosteroid use, due to the risk of adverse effects.
The ingredients in these medications can sometimes cause a burning or itching sensation. Anyone with concerns about worsening symptoms or unwanted side effects should speak to their doctor.
According to 2018 research, herbal ingredients that may help improve psoriasis when a person applies them to the skin include:
- Indigo naturalis
- tea tree oil
- turmeric, which contains curcumin
Not all of these will suit everyone, and some may have adverse effects. There is often not enough research to confirm that they are safe and effective for all to use.
In the case of Mahonia aquifolium (the Oregon grape), the National Psoriasis Foundation note that it may be effective in treating mild to moderate symptoms, but a person should only use it under a doctor's supervision.
Learn more here about how herbs might help with psoriasis.
What are moisturizers?
Moisturizers provide a boost of moisture to psoriasis patches. A moisturizer helps reduce dryness by trapping moisture.
Effective moisturizers for psoriasis tend to be greasy, such as petroleum jelly. Creams also work well.
People with psoriasis should apply moisturizer within 5 minutes of finishing a bath or shower each day. They should test the moisturizer first on a small area to check for skin reactions before applying to a wider area.
Which lotion should I use?
A person may need to try various lotions before finding the best one.
All of these lotions can help. Some may be more effective for more severe symptoms, and some have minor risks and potential side effects.
The most appropriate lotion will depend on the individual, how severe their symptoms are, and where they appear on the body.
A doctor may recommend trying several lotions to find a combination that works best for a person. Individuals can also combine a lotion with soap or another topical treatment. They should speak to a doctor about which ones are safe to mix.
A variety of creams for psoriasis are available for purchase online.
There is not always enough evidence to support the use of a particular lotion or cream, but a doctor can advise on which ones are likely to be safe.
A person should speak to their doctor if they:
- are unsure about which lotions to use
- experience severe or worsening symptoms
- are or may be pregnant or breastfeeding
Any prescription cream needs to pass specific quality standards, but there may be more uncertainty about lotions and creams that are available over the counter. This can apply to some herbal products, especially.
How does psoriasis affect black skin? Learn more here.
Lotions can be a safe and effective way to treat psoriasis. It is not possible to say which ones are best, as this will vary between individuals. A person may need to try a few different lotions before finding the one that works best for them.
Doctors also often combine lotions with other treatment options. It is likely that a person who uses lotions consistently to treat psoriasis will notice positive results.
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