Psoriasis treatment: Corticosteroids you apply to the skin

Why dermatologists prescribe corticosteroids to treat psoriasis

If you have mild or moderate psoriasis, a corticosteroid that you apply to your skin may be all the medicine you need. When applied to psoriasis, this medicine can:

• Reduce the redness, swelling, scaling, and itch—and clear the psoriasis

• Slow how quickly your skin cells grow

Even if you have severe psoriasis, a corticosteroid that you apply to your skin may be part of your treatment plan. You would use this medicine along with other psoriasis treatment to help treat thick or stubborn areas of psoriasis. 

Safety and effectiveness

• The US Food and Drug Administration (FDA) has approved several corticosteroids to treat psoriasis

• #1 medicine used to treat psoriasis in adults and children

• Used for decades to treat psoriasis

• Risk of side effects is low when used as directed by your dermatologist

Follow dermatologist's recommendation

For best results, use this medicine only on the areas of your body that your dermatologist recommends.

Using a strong corticosteroid on thin skin, such as on your face, could lead to spider veins, stretchmarks, and other side effects. Dermatologists know which corticosteroids you can safely apply to different areas of the body. Most people quickly see results when they apply a corticosteroid twice a day for a short time. A corticosteroid can reduce the redness, swelling, itch, and scale. It may even get rid of the psoriasis.

How to use

You apply this medicine to the psoriasis (or skin that often has psoriasis).  For best results, use this medicine exactly as prescribed by your dermatologist. This means you should use the medicine:

• As often as instructed 

• Only on the skin that your dermatologist recommends

• Only for as long as your dermatologist prescribes

Different types of corticosteroids work best in different areas. Applying a very strong corticosteroid to your face or groin could cause side effects, such as thinning skin and stretch marks. Following directions will help you get the best results and reduce the risk of developing side effects.

Possible side effects

Side effects are more common when someone uses a corticosteroid improperly. Improper use includes applying the medicine for longer than directed or using it to treat skin that you weren’t told to treat.

Possible side effects include:

• Thinning skin

• Spider veins

• Stretch marks

• Acne-like breakouts

Seeing darker or lighter patches of skin is expected as psoriasis clears. Dermatologists call this “post-inflammatory hyperpigmentation” or PIH. This is expected and not a side effect. The patches will go away. 

What to discuss with your dermatologist

During your next appointment, you should tell your dermatologist if you:

• Experience any side effect

• Feel uncomfortable using the medicine

• See the same amount of psoriasis (or worsening psoriasis) after four to six weeks of using the medicine

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References
Cordoro KM. “Management of childhood psoriasis.” Adv Dermatol. 2008;24:125-69.

Menter A, Korman NJ, et al. “Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies.” J Am Acad Dermatol 2009;60:643-59.