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Are there any prescription therapies for psoriasis?

Psoriasis is a chronic skin condition in which skin cells are produced and flake off more rapidly than normal, causing dry and red areas of skin that are covered with silvery scaling. These areas are called plaques. Psoriasis can affect people of all ages, but typically first appears in youth to middle age.

A number of prescription therapies are available for psoriasis, and are usually tried when over-the-counter treatments don’t help, or when symptoms are moderate to severe. Steroid creams and ointments such as triamcinolone (brand names Kenalog, Aristocort) and betamethasone (Betatrex) can help reduce psoriasis symptoms. They are effective for flare-ups, but shouldn't be used on a continuous basis unless directed by your doctor.

A prescription ointment or cream containing calcipotriene (>Dovonex) is effective in treating moderate plaques, and has been shown to work better than over-the-counter products.

The topical retinoid, tazarotene (Tazorac) is a type of vitamin A product that is used specifically for psoriasis. Skin irritation can occur similar to other topicals.

Hydroxyurea can be used in combination with light therapy for psoriasis.

Anthralin (Drithocreme) can be used on a shor-term basis to reduce inflammation in psoriasis.

A newer class of medicines called topical immunomodulators (TIMs) are sometimes prescribed for psoriasis that does not respond to other treatment. TIMs work by regulating the activity of the immune system. Medicines in this class include Pimecrolimus (>Elidel) and tacrolimus (>Protopic). Although initial studies have been promising, more medical research needs to be done to determine the effectiveness of these medicines for psoriasis.

Ultraviolet-A light (UVA) in combination with methoxalen (>Oxsoralen) is a very effective treatment, and is often the fastest way to clear the plaques of psoriasis. Ultraviolet-B light has been shown to work as well as ultraviolet-A therapy. UV therapies are administered in the doctor’s office in carefully controlled doses. This form of treatment can cause nausea, itching, and swelling of the treated areas.

Oral medicines are available by prescription for people whose psoriasis is severe. These medicines include cyclosporine (>Neoral), acitretin (>Soriatane), and methotrexate (>Rheumatrex).

Drugs called biologics such as etanercept (Enbrel), infliximab (Remicade), efalizumab (Raptiva), and Alefacept (Amevive) can be used in severe cases of psoriasis when other medicines fail to provide relief. There can be some potentially serious side effects with these drugs because they affect the immune system.

Sources:
Applied Therapeutics: The Clinical Use of Drugs. Applied Therapeutics, 1995.
The Mayo Clinic Family Health Book. William Morrow & Co., 1996.
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
Micromedex® Healthcare Series. Thomson Micromedex, 2007.
Drug Facts and Comparisons. Facts & Comparisons, 2007.
Medline Plus. Medline, 2007.
Diseases and Conditions, “Psoriasis.” http://www.mayoclinic.com. Mayo Clinic Health. Last accessed 1/10/2007.

This answer prepared 4/24/2002.
This information updated 1/10/2007.