Numerous medications are used to treat psoriasis. They may be used in combination with each other or with phototherapy (controlled exposure to ultraviolet light) to increase their effectiveness or reduce the likelihood of side effects.

Medications commonly used to treat psoriasis include:

• Emollients. Topical medications that are widely available without a prescription. They help restore moisture and flexibility to skin affected by psoriasis. They also help reduce scaling, itching (pruritus) and inflammation. When psoriasis is very mild, emollients may be the only treatment needed. Mild moisturizers without heavy perfumes are typically better for treating psoriatic skin. Emollients are often used for mild psoriasis or in combination with other treatments for moderate to severe psoriasis.
  
  
• Salicylic acid. A topical compound that is widely used to treat psoriasis. It is frequently used in combination with other topical medications because it removes surface scales and enhances the penetration of other medications into the affected skin. Salicylic acid is available over-the-counter and by prescription.
  
  
• Coal tar. Among the oldest treatments for psoriasis and may be used for mild to moderate psoriasis that is not pustular. Modern preparations are much less messy and smelly than those of the past. Coal tar preparations are available both with and without a prescription. Although it is not known precisely how they work, these preparations seem to reduce the accelerated skin cell cycle characteristic of psoriasis. Coal tar also has anti-inflammatory properties and eases pruritus. It is available in many forms (e.g., bath oils, ointments, lotions, cleaning bars, shampoos) and may be used in conjunction with phototherapy.

        Coal tar preparations for psoriasis include:

• Topical corticosteroids. The most commonly used medications for localized areas of mild to moderate psoriasis. They are available in a wide range of forms and strengths and may be used to reduce the rapid growth of skin cells as well as inflammation and pruritus. They can be used on sensitive areas (e.g., skin folds, genitalia) for short periods of time. Corticosteroids can also be injected directly into an isolated lesion. Corticosteroids are typically not used for long-term psoriasis treatment, because prolonged use may actually worsen psoriasis. Topical corticosteroids are available over-the-counter and by prescription.
  
  Topical corticosteroids used in the treatment of psoriasis include:

Generic Name	Brand Name(s)
betamethasone	Alphatrex Betatrex Beta-Val Celestone Diprosone Dirolene Luxiq Maxivate
triamcinolone	Aristocort Flutex Kenalog Triacet
clobetasol	Temovate
fluocinolone	Derma-Smoothe/FS FS Shampoo Fluonid Flurosyn Synalar Synemol

• Anthralin. A topical prescription medication used to treat psoriasis by normalizing the growth rate of skin cells. It is also helpful in removing scales and smoothing the skin. In can be used both on the body and the scalp and may be used in phototherapy. However, anthralin may stain skin, hair and fabrics. A rather potent medication, it is generally used on thicker, harder-to-treat lesions, such as moderate to severe plaque or guttate psoriasis or mild lesions that are resistant to other treatments. Brand names for anthralin include Anthra-Derm, Drithocreme, Dritho-Scalp, Lasan and Micanol.
  
  
• Vitamin D analogs. Topical prescription medications derived from vitamin D. These medications may be used on sensitive areas (e.g., face, body folds) and do not typically thin the skin like corticosteroids may. They may also be used to treat psoriasis on the scalp and nails. Vitamin D analogs work by slowing down the rapid growth of skin cells. They are used to reduce lesions, remove scales and improve redness. They are odorless and do not stain. They may be used alone or in combination for mild to moderate plaque psoriasis or in combination with more potent treatments for severe psoriasis. They are often combined with corticosteroids and may produce results within two weeks of beginning therapy.
  
  Vitamin D analogs used to treat psoriasis include:

Generic Name	Brand Name(s)
calcipotriene (topical)	Dovonex
calcitriol (topical)	Calcijex Rocaltrol

• Retinoids. Prescription medications derived from vitamin A. Retinoids work by reducing rapid skin cell growth. Topical retinoids are odorless and colorless and may be used for mild to moderate plaque or nail psoriasis. They cause no long-term skin damage and can be used on sensitive areas (e.g., face, hairline, scalp). They may produce results in as little as two weeks, but optimal clearing may take up to 12 weeks. Oral retinoids may be used in severe cases of psoriasis (including erythrodermic and pustular psoriasis) that do not respond to other forms of treatment. They can be very effective, but may cause serious side effects.
  
  Retinoids used to treat psoriasis include:

Generic Name	Brand Name(s)
tazarotene (topical)	Tazorac
acitretin (oral)	Soriatane
isotretinoin (oral)	Accutane

Since it has been discovered that psoriasis is an autoimmune disease, prescription immunosuppressant medications have been used to treat moderate to severe forms of the disease. Among the most commonly used of these is the disease modifying antirheumatic drug (DMARD) methotrexate, which is used in the treatment of severe psoriasis that does not respond to other treatments. Available orally or by injection, this medication reduces rapid skin cell growth and typically produces results in four to six weeks. However, it may cause serious side effects and tests must be performed prior to use to check liver and kidney function.

The oral immunosuppressant cyclosporine may be used in low doses to treat severe psoriasis. Short term use of this drug is generally very safe and effective. However, it is not recommended to be taken for more than a year. Improvements may be seen in some patients after two weeks, but it usually takes 12 to 16 weeks to control the disease.

Many immunosuppressant medications are made from human or animal proteins. These biological agents are typically administered by injection and may produce results after about four weeks.

Certain topical immunosuppressants may be well-tolerated in the treatment of psoriasis on the face and in body folds. However, there may be a link between these medications and certain cancers (e.g., lymphoma, skin cancer). This matter is currently under investigation.

Immunosuppressants that may be used to treat psoriasis include:

Psoralens are topical and oral prescription medications that are only effective when used along with phototherapy, called PUVA. They are useful in treating mild to moderate psoriasis because they reduce the rapid growth of skin cells.

Psoralens used in psoriasis phototherapy include: