Topical treatments

Medicines applied directly to the skin are often called topical treatments or just 'topicals'. They come in the form of ointments, creams, lotions, gels and shampoos.

Topicals may contain coal tar, vitamin D-derived products, steroids or a combination of different treatments.


What does that mean for me?

For most people a topical treatment is the first medicine that will be used for psoriasis and for many it will be the only one needed.

Topicals can be used alongside all other treatments for psoriasis and you might need to use a topical as a ‘top up’ to control your skin condition.


What does that mean for me?

If you are on one of these treatments you might need to use a topical as a ‘top up’ to control your psoriasis some of the time.

Coal tar products

Coal tar products have been used for many years. They help to slow down the rate at which skin cells are replaced. This may help reduce itchiness and flakiness.

Some people like and respond well to coal tar products, especially the shampoos but can be put off by the smell and messiness of them.

If you don’t like coal tar products discuss other available treatments with your doctor or healthcare provider. A different treatment or combination of treatments may suit you better.

Coal tar can make your skin dry so it's always good to moisturise. It can also make your skin more sensitive to sunlight so remember to use a sunscreen if needed.

Topical steroids

Topical steroids (steroid creams or ointments) are often prescribed for psoriasis. You may be prescribed different strength steroids over a period of time or for different parts of your body.

Please take a look at the topical steroids section to learn more.

Topical calcineurin inhibitors

Topical calcineurin inhibitors, for example tacrolimus or pimecrolimus, act on the immune system by blocking one of the chemicals called calcineurin that causes redness and inflammation of the skin. They are particularly suitable for delicate areas of skin such as the face, skin folds and outer genital skin, where prolonged treatment with topical steroids may not be appropriate.

You may experience a mild burning sensation after the first few applications, but this tends to settle down within a week. They do not contain steroids and can be used with emollients.

Topical vitamin D derivatives

Vitamin D derivatives, for example calcipotriol, are a common and effective topical treatment for psoriasis. They help by slowing down the rate skin cells are replaced.

A fixed combination of vitamin D derivative and a steroid is available as a gel, cream, lotion or foam spray.

They often work better than each product being used alone and may be quicker to apply.

Nurse's top-tip

If you are uncomfortable discussing psoriasis in intimate areas of your body with your doctor, nurse or pharmacist you could try shading the areas that bother you on a body outline and using it to ask what creams you could use.

Doctor's top-tip

You may sometimes feel your treatment is not working so well. Or, you may be wondering if there is a newer treatment available.

If you feel like this, book a double appointment with your doctor or nurse and let them know in advance that you want to discuss how you feel about your current treatment and if there are any other alternatives.

Patient’s top-tip

Remembering which cream or lotion to apply where and when can sometimes seem complicated. Ask the doctor, nurse or pharmacist to go through the instructions again.

If you are unsure or can’t understand some of the instructions ask your doctor, nurse or pharmacist to write them down or draw you a picture of ‘where and when’ to apply each topical.

Make notes

Note down how you feel about your topicals and how you use them.

My psoriasis and topicals

Mark on the diagrams where your psoriasis is

If you have more troublesome areas or areas
that cause concern mark them with a star or
in another colour


What do I want to do next?

Do I need to make an appointment?



For further advice or information please consult your healthcare provider or psoriasis patient association in your region


The University of Manchester
Manchester Academic Health Science Centre
psoriasis association
Salford Royal NHS
Funded by NIHR
Designed by www.spoken-image.com