Scalp Psoriasis - Creams and Lotions
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Which creams or lotions (topical medications) have helped you treat scalp psoriasis?
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What creams or lotions are available for psoriasis?
Topical (skin applied) medications include topical corticosteroids, vitamin D analogue creams calcitriol, topical retinoids (Tazorac), moisturizers, topical immunomodulators (tacrolimus and pimecrolimus), coal tar, anthralin, and others.
- Topical corticosteroids (steroids, such as hydrocortisone) are very useful
and often the first-line treatment for limited or small areas of psoriasis. These
come in many preparations, including sprays, liquid, creams, gels, ointments, and
mousses. Steroids come in many different strengths, including stronger ones are
used for elbows, knees, and tougher skin areas and milder ones for areas like
the face, underarms, and groin. These are usually applied once or twice a day to
affected skin areas.
Strong steroid preparations should be limited in use. Overuse or prolonged use may cause problems including potential permanent skin thinning and damage called atrophy. - A vitamin D analogue cream called calcitriol has also been useful in psoriasis. The advantage of calcitriol is that it is not known to overly thin the skin like topical steroids. It is important to note that this drug is not regular vitamin D and is not the same as taking regular vitamin D or rubbing it on the skin.
A similar drug, calcipotriene, may be used in combination with topical steroids for better results. There is a newer two-in-one combination preparation of calcipotriene and a topical steroid called Taclonex. Results with calcipotriene alone may be slower and less than results achieved with typical topical steroids. Not all patients may respond to calcipotriene as well as to topical steroids.
A special precaution with vitamin D analogue creams is that it should not be used on more than 20% of the skin in one person. Overuse may cause absorption of the drug and an abnormal rise in body calcium levels. - Moisturizers, especially with therapeutic concentrations of salicylic acid, lactic acid, urea, and glycolic acid may be helpful in psoriasis. These moisturizers are available as prescription and nonprescription forms. These help moisten and lessen the appearance of thickened psoriasis scales. Some available preparations include Salex (salicylic acid), AmLactin (lactic acid), or Lac-Hydrin (lactic acid) lotions. These may be used one to three times a day on the body and do not generally have a risk of problematic skin thinning (atrophy). Overuse or use on broken, inflamed skin may cause stinging, burning, and more irritation. These stronger preparations should not be used over delicate skin like eyelids, face, or genitals. Other bland moisturizers including Vaseline and Crisco vegetable shortening may also be helpful in at least reducing the dry appearance of psoriasis.
- Immunomodulators (tacrolimus and pimecrolimus) have also been used with some success in limited types of psoriasis. These have the advantage of not causing skin thinning. They may have other potential side effects, including skin infections and possible malignancies (cancers). The exact association of these immunomodulator creams and cancer is controversial.
- Bath salts or bathing in high-salt-concentration waters like the Dead Sea in the Middle East may help some psoriasis patients. Epsom salt soaks (available over the counter) may also be helpful for a number of patients. Overall, these are quite safe with very few possible side effects.
- Coal tar is available in multiple preparations, including shampoos, bath solutions, and creams. Coal tar may help reduce the appearance and decrease the flakes in psoriasis. The odor, staining, and overall messiness with coal tar may make it harder to use and less desirable than other therapies. A major advantage with tar is lack of skin thinning.
- Anthralin is available for topical use as a cream, ointment, or paste. The stinging, possible irritation, and skin discoloration may make this less acceptable to use. Anthralin may be applied for 10-30 minutes to psoriatic skin.
See what others are saying
Comment from: Razz1900, 45-54 Male (Patient)
Published: February 15
When I got Psoriasis, at first it itched like some sort of insect bite. But the problem became worse within a few weeks. It started to spread, so I went to the store and bought different types of anti-itch medicine. I tried almost all of them. After those failed I tried some cream that had coal tar in it. And within a few days it disappeared. Now I keep the coal tar cream in my medicine chest, just in case.
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