Topical corticosteroids

Topical corticosteroids are the mainstay of psoriasis therapy. They are anti-inflammatory and antiproliferative. Topical corticosteroids are often used initially to control the psoriasis, and are also used to treat psoriasis flares.

More potent preparations are used to treat thicker plaques of psoriasis, or areas of the body with thicker skin. Lower potency preparations are used for sensitive areas (eg face).

Rotation and combination of topical treatment options (as opposed to continuous therapy with one treatment option) should be encouraged because this minimises adverse effects and maximises efficacy. More irritant treatments (eg tars, calcipotriol) can be added to or substituted for topical corticosteroids. For example, a topical corticosteroid can be used on weekends, and different topical drugs can be used during the week. When a topical corticosteroid is used in combination with a tar, apply the topical corticosteroid in the morning and the tar at night.

For practical information on topical corticosteroids, see Considerations in the use of topical corticosteroids.