Psoriasis is a chronic, inflammatory disease causing skin cells to overgrow. The white, scaly inflamed skin plaques are hallmarks of this disease. The skin, too, may be sensitive, itchy and prone to dryness, cracking and bleeding.
As part of their medication schedules and self-care regimens, people living with psoriasis often use topical treatments that include lotions, creams, and ointments.
Psoriasis affects people differently so no drug fits all. A doctor or pharmacist will help the majority of people find one that fits them.
Understanding what to look for in a prescription for psoriasis will help a person make an informed decision about the right lotion, cream, or ointment.
Why use lotions?
Lotions, creams, and ointments may be useful for the treatment of symptoms of mild psoriasis.
Reasons for using them are:
- They allow a person to apply medication directly to the affected area.
- They can soften the area, allowing other medications to enter the skin’s deeper layers.
- They can ease dryness and cracking, which can reduce discomfort and the risk of infection.
Lotions, creams, and other topical ointments are often the first treatment for people with moderate psoriasis because the swelling, scratching, and pain that may arise may be minimized.
Both over- the-counter lotions and prescription lotions can assist.
Even though some people prefer lotions, creams and ointments may be less irritating and more effective.
Certain ingredients, such as tazarotene and topical calcineurin inhibitors, are present only in creams and onions.
Which is the best lotion?
There are many lotions available, and each individual has a different effect on psoriasis. Finding the most appropriate product or combination of lotions and other therapies to treat psoriasis can take time.
Factors which can influence care choices include:
- the severity of the symptoms
- the type of psoriasis a person has
- what part of the body the symptoms affect
- the active ingredients in the product
- how the body responds to the product
- the strength of the ingredients
A doctor or pharmacist may advise a person to choose a cream instead of a lotion, as some ingredients are not available in the form of lotions.
Types of lotion
Different types of lotions, creams and ointments are available, depending on their active ingredients and whether available over the counter or by prescription.
The following ingredients and products can help treat psoriasis:
- coal tar
- synthetic vitamin D
- salicylic acid
- calcineurin inhibitors
Natural ingredients, such as aloe vera and jojoba, may have a soothing effect, but psoriasis is not confirmed by any study. A doctor can advise a person to choose a thick, fragrance-free lotion that suits sensitive skin.
Copper tar, pine tar, and salicylic acid are also used in psoriasis soaps.
What are retinoids?
Retinoids are a form of vitamin A that can accelerate skin-shedding process in the body and slow skin cell growth. Tazarotene is a retinoid which is prescribed for psoriasis by physicians.
When a person applies them to a plaque with psoriasis, retinoids allow the body to remove the excess skin it has built up. It helps reduce the scaly and inflamed look and soothes the feeling of discomfort.
A health care professional could consider combining tazarotene with a corticosteroid.
Also, the drug can irritate the skin. If this occurs, the American Academy of Dermatology (AAD) suggests first applying petroleum jelly around areas of the skin, then adding the retinoid only to the psoriasis.
The Food and Drug Administration (FDA) issued a warning about the use of retinoids during exposed to sunlight. If they can not prevent exposure to the sun and consider wearing protective clothing, a person should use sunscreen, as too much exposure to the sun can also exacerbate psoriasis symptoms in some people.
What is coal tar?
Coal tar products can be bought over the counter or by prescription.
They will help make the skin affected look healthy and slow the growth of new skin cells. Coal tar also forms an ingredient in lotions.
Coal tar items bear a warning, in some cases, that they can cause cancer. These warnings, however, originate from animal research and industrial exposure.
A product can contain carbon tar of up to 5 per cent. According to the AAD, using a better one doesn’t necessarily mean it’ll be more effective.
Most coal tar remedies require a prescription but there are many on the counter.
What is synthetic vitamin D?
People with psoriasis may use synthetic vitamin D-containing lotions and creams to slow the growth of new skin cells.
These can help:
- reduce the accumulation of skin cells
- flatten thick patches
- remove scales
Some lotions containing vitamin D can irritate the skin of a person but most people, including children, are safe to use.
If people regularly use them on large areas of the body, calcium levels in the blood will rise, increasing the risk of kidney stones and other problems. A person who follows instructions from the doctor, however, is unlikely to experience any adverse effects.
What is anthralin?
Anthralin prevents the growth of new skin cells and helps lessen the swelling that may occur with symptoms of psoriasis. People have been taking anthralin for more than 80 years to combat psoriasis.
It is effective but can have some adverse effects on the skin, such as transient skin and clothing discolouration and itching and burning sensation. A doctor may not prescribe its use, for these reasons.
Current trials are underway to find new ways to prepare anthralin that will not have these disadvantages.
What is salicylic acid?
Salicylic acid helps remove the psoriasis stains that look scaly. It is a keratolytic agent which helps the skin to shed its outer layers.
People with psoriasis often use salicylic acid along with other medicated creams because the salicylic acid helps the other creams to more easily penetrate the skin.
Most products do require a prescription, but there are others on the counter.
What are corticosteroids?
A doctor can prescribe a corticosteroid of appropriate power, depending on:
- individual skin sensitivity
- symptom severity
- the area of the body needing treatment
Corticosteroids can have adverse effects if they are used long by a human. A doctor or pharmacist can give advice on how to apply.
A product which contains steroids can require a prescription.
What are calcineurin inhibitors?
Calcineurin inhibitors are not present in lotions, but are available in form of cream and ointment. We need an ordinance.
Inhibitors of calcineurin include the pimecrolimus and tacrolimus.
People with psoriasis may be using calcineurin inhibitors when other drugs don’t work as well as a doctor hopes. They can help to reduce inflammation, and avoid it. Its main use is for eczema, but psoriasis may be treated by a doctor as “off-label.”
Such medications may be recommended by doctors because they are safe to use on thin areas of skin, such as the groin and neck. These are areas that, due to the risk of adverse effects, are not suitable for long-term topical corticosteroid use.
The ingredients in these medicines may occasionally cause a feeling of burning or itching. Anyone who has questions about symptoms deteriorating or unpleasant side effects should talk to their doctor.
According to 2018 research, herbal ingredients that may help improve psoriasis when a person applies them to the skin include:
- Indigo naturalis
- tea tree oil
- turmeric, which contains curcumin
Not all of these will suit everyone, and there may be adverse effects from some. There is often insufficient research to confirm they are safe and effective for everyone to use.
The National Psoriasis Foundation notes in the case of Mahonia aquifolium (the Oregon grape), that it may be effective in treating mild to moderate symptoms, but a person should use it only under the supervision of a doctor.
What are moisturizers?
Moisturizers provide the psoriasis patches with a boost of moisture. A moisturizer helps with the retention of moisture to reduce dryness.
Better psoriasis moisturizers appear to be greasy, like the petroleum jelly. Creams work fine too.
People with psoriasis should apply moisturizer every day within 5 minutes of finishing a bath or shower. We will test the moisturizer first on a small area before applying to a larger area to check for skin reactions.
Which lotion should I use?
All those lotions can be of use. For more severe symptoms, some may be more successful, and some may have minor risks and potential side effects.
Depending on the individual, how serious their symptoms are and where we appear on the body, the most suitable lotion.
A doctor may recommend trying different lotions to find a combination that works best for a person. Individuals may also apply a soap lotion or some other topical product. We will tell a doctor which ones are safe to mix.
There isn’t always enough evidence to support the use of a specific lotion or cream, but a doctor may advise on which ones are likely to be safe.
A doctor should be consulted by a individual if they:
- are unsure about which lotions to use
- experience severe or worsening symptoms
- are or may be pregnant or breastfeeding
May prescription cream must meet specific quality standards, but there may be further uncertainty over the counter about lotions and creams. This can particularly apply to some herbal products.
Lotions can be a safe and effective method of psoriasis treatment. It’s not possible to say which ones are the best, because this will differ between people. A person may need to try a couple of different lotions before they find the one that works best.
Doctors also equate lotions with other treatment options as well. A person who regularly uses lotions to treat psoriasis will likely notice positive results.