People with mild psoriasis may benefit from over-the-counter (OTC) medicine, which they can get without a prescription. Some OTC medicines contain active ingredients, such as hydrocortisone or coal tar. OTC moisturizers may also benefit those with mild or severe psoriasis.
Psoriasis is a chronic immune disorder that causes skin rashes, which can vary in color from red or violet to dark brown or gray. These rashes may be itchy or painful and may feature silvery scales.
This article explores OTC medicines and other products for treating and easing psoriasis symptoms. It also looks at the various types of psoriasis, including its causes, diagnosis, and treatments.
A doctor or dermatologist will decide how to treat psoriasis according to the severity and location of the affected area. Treatments for mild psoriasis may include OTC and nonprescription medicine — people may benefit from the sole or combined use of these various options.
Ingredients in OTC products
Some OTC medications may include active ingredients such as coal tar and mild corticosteroids. We explore more details about these products and their main ingredients below.
Coal tar
Manufacturers include coal tar in OTC and prescription products for psoriasis, including creams, shampoos, ointments, and bath solutions. Doctors and dermatologists have recommended it as a beneficial treatment for psoriasis for years, which can help:
- reduce swelling, scaling, and redness
- reduce itching and flaking
- slow overproduction of skin cells
Mild corticosteroids
Corticosteroids may help reduce inflammation and itching. A person can buy solutions, ointments, and creams containing mild corticosteroids, such as hydrocortisone, without a prescription. Hydrocortisone is effective in treating a few small patches of psoriasis, although individuals with more severe symptoms will probably need a prescription corticosteroid.
Moisturizers
These products may help with skin healing and relieve skin dryness. Some moisturizers may partially seal water onto the skin, helping people with mild or severe psoriasis. Dermatologists recommend applying moisturizer once a day, or more often in cases of very dry skin. People should choose a heavy, fragrance-free ointment or cream instead of lotion.
Scale softeners
These products may help soften and remove scales, and they may be available OTC and with a prescription. They often contain salicylic acid to reduce swelling. Other scale-softening ingredients may include urea and lactic acid.
Anti-itch
Products with anti-itching ingredients, such as menthol, camphor, and calamine, can reduce itching.
There are alternative treatments for psoriasis, including the below.
Biologics
These medicines can target the overactive part of the immune system. Doctors administer them intravenously or as injections to people with moderate-to-severe psoriasis.
Prescription oral medicines
Doctors or dermatologists may prescribe oral medicines for psoriasis, such as apremilast, which can help reduce scales and redness, oral retinoids, which can reduce swelling and redness and stop the overproduction of skin cells, or methotrexate, which can suppress the overactive immune system.
Phototherapy
This therapy involves exposing parts of the skin to a certain type of UV light, which may help with:
- suppressing an overactive immune system
- reducing or stopping itching
- reducing inflammation
- slowing the growth of skin cells
Diet
A person can limit consumption of foods with a high glycemic index, such as carbohydrates. They can also eat more anti-inflammatory foods, including:
- nuts and seeds
- fruits and vegetables
- beans
- oily fish
- fiber
Psoriasis occurs due to issues in the immune system, which causes inflammation in the skin. It is a chronic autoimmune condition, meaning that once a person has psoriasis, they may have the condition for life.
An overactive immune system speeds up the growth of skin cells — while these cells normally grow and shed over the course of a month, new skin cells grow in 3–4 days. The skin cells do not shed but pile up and lead to the formation of scales and plaques, which may be painful or itchy. Psoriasis can develop anywhere on the skin, but it most commonly occurs on the knees, scalp, and elbows.
The condition presents as dark brown, gray, or violet patches with silvery scales on the skin of people of color. In contrast, it develops as red patches with silvery scales on white skin.
Conditions that have links with psoriasis
People with psoriasis are more likely to have certain other disorders. These include:
- celiac disease
- inflammatory bowel disease such as Crohn’s disease
- psoriatic arthritis
- pustulosis
- uveitis, an inflammation of the eye
- metabolic syndrome
Healthcare professionals sometimes misdiagnose psoriasis as other skin conditions. These include:
- Eczema: One study in Australia found that most children with psoriasis received a misdiagnosis by their doctors as having eczema. A dermatologist will generally be able to differentiate between the two.
Learn more about eczema. - Ringworm: This
fungal infection is known medically as tinea or dermatophytosis. Healthcare professionals call it ringworm because it causes a ring-shaped rash, which is often red and itchy.
Learn more about ringworm rash. - Pityriasis rosea: This condition causes a rash that may begin as an oval patch on the skin, usually followed by smaller bumps and patches. The rash can appear anywhere on the skin and is common on the chest, belly, and back. It sometimes accompanies flu-like symptoms and itching.
Learn more about psoriasis versus pityriasis rosea.
There are several different types of psoriasis, including the below.
Plaque psoriasis
Plaque psoriasis is the most common type, showing in up to 80% of people with the condition. Scaly plaques can appear anywhere on the body and present as raised, inflamed patches of skin, which may be red, violet, gray, or dark brown, with silvery scales. The plaques are usually itchy and painful.
Inverse psoriasis
This kind of psoriasis affects about a quarter of individuals with the condition. It usually occurs in folds of the skin, such as the genital area or under the arms or breasts. It typically causes dark, inflamed skin but does not cause plaques or scales. It can be itchy and painful.
Guttate psoriasis
Guttate psoriasis affects about 8% of people with psoriasis. It presents as small, round, red spots due to inflammation.
Pustular psoriasis
Pustular psoriasis is fairly rare and only affects around 3% of those with the condition. It can cause white, pus-filled bumps and reddened, inflamed skin. It can cover most of the body or only appear on certain areas such as the hands or feet.
Erythrodermic psoriasis
This is one of the rarest and most severe types of psoriasis, affecting about 2% of people with the condition. Symptoms include shedding large sheets of skin, severe pain and itching, intense redness, and dehydration. It can become life threatening.
The symptoms of psoriasis are due to inflammation. Symptoms vary but may include:
- dry, cracked skin that may bleed or itch
- thick, patchy skin that is red, violet, dark brown, or gray, with silvery scales that itch or burn.
- thick, ridged nails
Experts
Immune system
Normally, white blood cells attack viruses and bacteria to prevent people from getting sick. In psoriasis, these cells malfunction and attack the skin, causing the body to make more new skin cells much faster than usual. The extra skin cells pile up on top of each other on the surface, causing the redness and scaling associated with psoriasis. The condition is chronic and usually lifelong.
Learn more about how the immune system works.
Family history
If a person has a sibling, parent, or grandparent with psoriasis, they are at a higher risk of developing the condition.
Triggers
Common triggers for psoriasis include:
- stress
- dry, cold weather
- skin injury, such as severe sunburn
- excessive alcohol
- tobacco
- certain medication, including lithium and hydroxychloroquine
- some infections, such as strep throat
A doctor or dermatologist will diagnose psoriasis by performing a physical exam, looking at the skin, nails, and scalp for signs of the condition. They may also ask the person if they have any symptoms of psoriasis, such as joint problems or itchy skin, or a family history of the disorder. Additionally, they may remove part of the skin for a biopsy.
Psoriasis is a chronic autoimmune condition. A doctor or dermatologist may treat it using oral medicine, topical medicine, biologics, or phototherapy. OTC nonprescription medicine may be effective for people with mild psoriasis.
Common ingredients in OTC medicines for the treatment of psoriasis include coal tar, mild corticosteroids, scale softeners, such as salicylic acid, and anti-itch products, including menthol and camphor.
There are different types of psoriasis, including plaque, inverse, guttate, pustular, and erythrodermic. Symptoms typically include inflamed, dry skin with red, dark brown, violet, or gray patches and silvery scales.
Psoriasis may be due to malfunctions in the immune system, a family history of the condition, and certain triggers, including stress and cold, dry weather. A doctor or dermatologist may diagnose psoriasis by examining the skin, asking questions about symptoms, and performing a biopsy.