Face

For initial therapy of psoriasis on the face, use a topical corticosteroid rather than a tar; this is for cosmetic reasons and because topical corticosteroids are less irritating. Calcipotriol is irritating and should not be used on the face.

For an adult with psoriasis on the centre of the face, use:

methylprednisolone aceponate 0.1% cream, ointment or fatty ointment topically, once daily until skin is clear (usually 2 to 6 weeks). methylprednisolone aceponate methylprednisolone aceponate methylprednisolone aceponate

For an adult with psoriasis around the ears and along the hairline, use:

mometasone furoate 0.1% cream or ointment topically, once daily until skin is clear (usually 2 to 6 weeks). mometasone furoate mometasone furoate mometasone furoate

For a child with psoriasis on the face, use:

hydrocortisone 1% cream or ointment topically, once daily until the skin is clear (usually 2 to 6 weeks). hydrocortisone hydrocortisone hydrocortisone

Once symptoms are controlled, reduce the potency of the topical corticosteroid gradually, and withdraw if possible. Withdrawal can be facilitated by adding a tar preparation. Use:

LPC 2%+salicylic acid 2% in aqueous cream topically, once daily at night1. coal tar + salicylic acid coal tar+salicylic acid coal tar+salicylic acid

If response to a topical corticosteroid and a tar preparation is inadequate, or prolonged topical corticosteroid treatment is required, refer for dermatologist advice.

For practical information on using topical corticosteroids and tars in psoriasis, see Topical drug treatment for psoriasis in primary care.

1 LPC = liquor picis carbonis = coal tar solutionReturn