Psoriasis is a non-contagious inflammatory disease. The main symptoms are reddish, scaly patches of skin that may itch.

It is a chronic condition that is typically associated with flare-ups, followed by periods of milder skin problems or none at all. Various treatments can relieve the symptoms, but there is no cure for psoriasis.

Its severity can vary hugely. In some people, it is bothersome more than anything else, and they can cope with it quite well. Others feel that it has a major effect on their quality of life, since the treatment and skin care can take a long time. Many people are also unhappy about having visible reddened and scaly skin patches – especially if they are on exposed areas of their body. Sometimes the inflammation that is causing the psoriasis affects other parts of the body too, such as the joints or nails.

Topical steroids

Topical steroids reduce inflammation and slow the rapid production of skin cells. They are applied to the skin in the form of a cream, solution, ointment or – for the treatment of psoriasis on the scalp – a foam or shampoo.

There are great differences between corticosteroids in terms of the strength of their potency. Ultra-high-potency corticosteroids are often needed for the treatment of very scaly areas of skin and psoriasis on hair-covered areas of the scalp. Weaker corticosteroids are used on sensitive areas of the body, such as the face or in skin folds. The symptoms usually improve within one to two weeks of starting treatment.

Psoriasis flare-ups are often treated with stronger medications such as mometasone. These medications are generally applied to the affected areas of skin once or twice a day for the first three weeks. After that they are gradually applied less frequently – for instance, every other day in the fourth week, and every three days in the fifth week. Treatment with topical steroids is stopped gradually because an abrupt stop can make psoriasis come back again.

Studies have shown high-potency corticosteroids to be effective and after a few weeks without the corticosteroid treatment, about 10 out of 100 people had hardly any or no visible psoriasis plaques. With the corticosteroid treatment, about 45 out of 100 people had hardly any or no visible psoriasis plaques. In other words, the corticosteroids led to a clear improvement in psoriasis symptoms in 35 out of 100 people.

The choice of medication will depend on many different factors. Research has shown that treatment with topical corticosteroids is the most effective and is well tolerated. If a psoriasis treatment is needed for more than several weeks and you want to avoid the possible long-term side effects of steroids, treatment with a different medication such as calcipotriol may be more suitable.

References

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Psoriasis: Overview. 2013 Jul 31 [Updated 2017 May 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279447/

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Topical treatments for psoriasis. 2017 May 18.Available from: https://www.ncbi.nlm.nih.gov/books/NBK435705/