Psoriasis is a chronic skin condition marked by thick, scaly patches that can affect both appearance and quality of life, but with the right treatment approach—ranging from creams and light therapy to cutting-edge medications being studied in clinical trials—many people find relief and regain control over their symptoms.

How Treatment Can Help You Live Better with Psoriasis

Living with psoriasis means dealing with a condition that doesn’t have a cure, but the goal of treatment is clear: to control symptoms, reduce the speed at which skin cells build up, clear scaly patches, and help you feel more comfortable in your own skin. Treatment is not one-size-fits-all. What works depends on how severe your psoriasis is, where it appears on your body, and how you respond to different therapies.^[1][2]

Medical teams today have many tools at their disposal. There are treatments approved by medical societies and recommended in clinical guidelines, which have been used for decades with proven results. At the same time, researchers are constantly testing new therapies in clinical trials, aiming to find even better ways to manage psoriasis and improve the lives of people living with it.^[5]

The journey often begins with the mildest treatment option and moves forward based on how your skin responds. Your doctor will consider the areas of your body affected, how much of your skin is covered, and whether you have related conditions like psoriatic arthritis. Treatment is about finding the right balance—effective relief with manageable side effects—and this might take time and patience.^[8][10]

Standard Treatments: What Doctors Usually Recommend First

For people with mild to moderate psoriasis, the first line of treatment usually involves topical therapies—creams, ointments, lotions, gels, or foams that you apply directly to the affected skin. These work by slowing down the rapid production of skin cells, reducing inflammation, and helping to remove scales. Topical treatments are often the safest option and can be started and managed by your primary care doctor.^[8][10]

Corticosteroids are among the most commonly prescribed topical treatments. These steroid creams or ointments reduce inflammation and calm the immune system’s overactive response. Mild corticosteroids, like hydrocortisone, are recommended for sensitive areas such as the face or skin folds. Stronger corticosteroids, such as triamcinolone or clobetasol, may be prescribed for thicker patches on less sensitive areas like the elbows or knees. Corticosteroids are often applied once a day during flare-ups and then less frequently during remission. However, long-term use of strong corticosteroids can lead to skin thinning, so they must be used carefully.^[8][10]

Vitamin D analogues, such as calcipotriol, calcitriol, and tacalcitol, are another key topical treatment. These work by slowing the production of skin cells and also have anti-inflammatory effects. They are commonly used alongside corticosteroids or as an alternative for people who want to avoid steroids. Vitamin D analogues are generally safe as long as you don’t use more than the recommended amount.^[8][10]

Calcineurin inhibitors, such as tacrolimus and pimecrolimus, are ointments or creams that reduce the activity of the immune system and help reduce inflammation. They are sometimes used to treat psoriasis in sensitive areas, such as the face, genitals, or skin folds, especially if steroid creams are not working or are not suitable. These medications can cause skin irritation or a burning sensation when first used, but this usually improves within a week.^[10]

Coal tar is one of the oldest treatments for psoriasis. It’s a thick, heavy oil that can reduce scales, inflammation, and itchiness. Coal tar is often used when other topical treatments are not effective. It can be combined with light therapy for better results. However, coal tar can stain clothes and bedding and has a strong smell, which some people find unpleasant.^[10]

Dithranol has been used for more than 50 years and is effective in suppressing the production of skin cells. It has few side effects, but it can burn the skin if used in too high a concentration. It’s typically applied for short periods and then washed off.^[10]

Phototherapy: Using Light to Treat Psoriasis

When topical treatments alone don’t work well enough, or if psoriasis covers a larger area of the body, doctors may recommend phototherapy. This involves exposing the skin to certain types of ultraviolet (UV) light under medical supervision. Phototherapy works by slowing down the rapid growth of skin cells and reducing inflammation.^[8][10]

Narrowband ultraviolet B (NB-UVB) radiation is the most common type of phototherapy. It’s effective for many people and is considered safe when administered under medical supervision. Psoralen and ultraviolet A (PUVA) radiation is another option, where a medication called psoralen is taken before UV light exposure to make the skin more sensitive to the light. Phototherapy sessions are typically done several times a week over several weeks or months.^[5][10]

Systemic Treatments: Medications That Work Throughout the Body

For people with moderate to severe psoriasis, or when topical treatments and phototherapy don’t provide enough relief, systemic treatments may be necessary. These are medications taken by mouth or by injection that work throughout the entire body. Because they affect the whole body, they can have more serious side effects, so regular blood tests are often needed to monitor your health.^[8][10]

Methotrexate is a conventional systemic treatment that slows down the immune system and reduces inflammation. It’s taken once a week, usually as a tablet or injection. Methotrexate can affect the liver and blood cells, so regular blood tests are required to check for side effects.^[5]

Ciclosporin (also spelled cyclosporine) is another immunosuppressive drug that reduces the activity of the immune system. It’s usually prescribed for short-term use because long-term use can affect the kidneys and blood pressure. Regular monitoring is essential.^[5]

Acitretin is a retinoid, a medication related to vitamin A. It helps to normalize the growth of skin cells. Acitretin can cause dry skin and lips, and it must not be used during pregnancy because it can cause serious birth defects. Women must use reliable contraception during treatment and for a period after stopping acitretin.^[5]

Biologic Treatments: Targeted Therapies for Severe Psoriasis

Biologic therapies are a newer class of treatments that are genetically engineered to target very specific parts of the immune system. Because they are so targeted, they often have fewer side effects than traditional systemic treatments. Biologics are usually given by injection or intravenous infusion and are reserved for people with moderate to severe psoriasis who have not responded well to other treatments.^[5][8]

Tumor necrosis factor (TNF) inhibitors block a protein called TNF that plays a role in inflammation. Examples of TNF inhibitors used for psoriasis include etanercept, adalimumab, and infliximab. These medications can significantly reduce psoriasis symptoms and are also used to treat psoriatic arthritis.^[5]

Interleukin-17 (IL-17) inhibitors block a protein called IL-17, which is involved in the inflammatory process of psoriasis. Examples include secukinumab, ixekizumab, and brodalumab. These medications have been shown to be highly effective in clearing psoriasis plaques.^[5]

Interleukin-23 (IL-23) inhibitors block a protein called IL-23, which helps drive the inflammatory response in psoriasis. Examples include ustekinumab, guselkumab, tildrakizumab, and risankizumab. These medications are also highly effective and are given less frequently than some other biologics.^[5]

Small Molecule Inhibitors: Oral Medications

Small molecule inhibitors are oral medications that work inside cells to block certain pathways involved in inflammation. Apremilast is a small molecule inhibitor that blocks an enzyme called phosphodiesterase 4 (PDE4), which is involved in inflammation. It’s taken twice a day as a tablet. Dimethyl fumarate is another oral treatment that has anti-inflammatory effects and is used for psoriasis.^[5]

The duration of treatment varies depending on the type of psoriasis, the treatment chosen, and how well you respond. Some treatments, like topical corticosteroids, may be used for short periods during flare-ups. Others, like biologics, may be used long-term to keep psoriasis under control. Your doctor will regularly review your treatment to make sure it’s working and to check for any side effects.^[8]

Treatment in Clinical Trials: New Hope on the Horizon

While there are many effective treatments available for psoriasis, researchers are constantly working to develop new and even better therapies. Clinical trials are research studies where new treatments are tested to see if they are safe and effective. Participating in a clinical trial can give you access to cutting-edge treatments that are not yet available to the general public, and it also helps advance medical knowledge that can benefit others in the future.^[5]

Clinical trials go through several phases. Phase I trials are the first step, where researchers test a new treatment in a small group of people to evaluate its safety, determine a safe dosage range, and identify side effects. Phase II trials involve a larger group of people and focus on whether the treatment works (its efficacy) and further evaluate its safety. Phase III trials involve even larger groups and compare the new treatment to the current standard treatment to see if it’s better, as good, or has fewer side effects.^[5]

Innovative Molecules and Therapies Being Tested

In recent years, advances in understanding the pathophysiology—the biological mechanisms—of psoriasis have led to the development of highly targeted treatments. Psoriasis is now understood as an immune-mediated inflammatory disease, where the immune system mistakenly attacks healthy skin cells, causing them to grow too quickly. Researchers are developing treatments that target specific molecules and pathways involved in this process.^[5]

Many of the newer biologic therapies that are now standard treatments, such as IL-17 and IL-23 inhibitors, were once tested in clinical trials. These trials showed that by blocking specific proteins involved in inflammation, it was possible to achieve significant clearing of psoriasis plaques with a good safety profile. This success has encouraged researchers to explore other targets in the immune system.^[5]

For example, researchers are investigating new biologics that target other interleukins or immune pathways that play a role in psoriasis. They are also exploring combinations of treatments to see if using two therapies together can provide better results than using one alone. Some clinical trials are testing new oral medications that work in different ways than the currently available small molecule inhibitors.^[5]

Another area of research is looking at treatments that can not only clear psoriasis plaques but also address the underlying inflammation that contributes to related health conditions. People with psoriasis have a higher risk of developing cardiovascular disease, diabetes, and depression. Some new treatments being studied aim to reduce systemic inflammation, which could help lower the risk of these comorbidities.^[5]

What to Expect from Clinical Trials

Clinical trials for psoriasis are conducted around the world, including in the United States, Europe, and other regions. Eligibility to participate in a trial depends on many factors, including the type and severity of your psoriasis, your age, your overall health, and whether you have tried other treatments. Some trials are looking for people who have not responded well to standard treatments, while others may be open to people who are just starting treatment.^[5]

If you are considering participating in a clinical trial, it’s important to talk to your doctor and the research team. They will explain what the trial involves, what treatment you will receive, what tests or procedures you will need to undergo, and what the potential risks and benefits are. Participation is always voluntary, and you can choose to leave a trial at any time.

Preliminary results from some clinical trials have been very promising. For example, new biologics targeting specific immune pathways have shown high rates of skin clearance, with many participants achieving clear or almost clear skin. Safety profiles have generally been favorable, with side effects similar to those of existing biologic treatments. These positive results are encouraging and suggest that people with psoriasis will have even more effective treatment options in the future.^[5]

Most common treatment methods

• Topical therapies
  • Corticosteroid creams and ointments that reduce inflammation and slow skin cell production
  • Vitamin D analogues such as calcipotriol, calcitriol, and tacalcitol that slow skin cell growth
  • Calcineurin inhibitors like tacrolimus and pimecrolimus that reduce immune system activity
  • Coal tar preparations that reduce scales, inflammation, and itchiness
  • Dithranol to suppress skin cell production
• Phototherapy
  • Narrowband ultraviolet B (NB-UVB) radiation to slow skin cell growth
  • Psoralen and ultraviolet A (PUVA) radiation combined with psoralen medication
• Conventional systemic treatments
  • Methotrexate to slow the immune system and reduce inflammation
  • Ciclosporin to reduce immune system activity
  • Acitretin to normalize skin cell growth
• Biologic therapies
  • TNF inhibitors such as etanercept, adalimumab, and infliximab that block tumor necrosis factor
  • IL-17 inhibitors such as secukinumab, ixekizumab, and brodalumab that block interleukin-17
  • IL-23 inhibitors such as ustekinumab, guselkumab, tildrakizumab, and risankizumab that block interleukin-23
• Small molecule inhibitors
  • Apremilast that blocks the enzyme phosphodiesterase 4 (PDE4)
  • Dimethyl fumarate with anti-inflammatory effects

Living with Psoriasis: Beyond Medical Treatment

While medical treatments are essential, managing psoriasis also involves lifestyle changes and self-care strategies. Many people find that certain habits can help reduce flare-ups and improve their overall quality of life. Keeping your skin moisturized is very important. Dry skin can make itching and scaling worse. Apply a thick cream or lotion right after bathing to seal in moisture. Some people find that petroleum jelly is helpful during flare-ups.^[17]

Avoiding known triggers can also help. Triggers vary from person to person but can include stress, skin injuries, infections, certain medications, smoking, and heavy alcohol use. Keeping a diary to track your symptoms and potential triggers can help you identify patterns and avoid things that make your psoriasis worse.^[7]

Stress is a common trigger for psoriasis flare-ups, and psoriasis itself can be a source of stress, creating a difficult cycle. Learning to manage stress through techniques like meditation, exercise, or talking to a therapist can be very helpful. Some people find that relaxation techniques or mindfulness practices make a real difference.^[15][17]

Diet and exercise are also important. While there is limited scientific evidence that diet directly impacts psoriasis, some people report that eating an anti-inflammatory diet—rich in fruits, vegetables, fish, whole grains, and low-fat dairy—helps them feel better. Avoiding fatty red meat, refined and processed foods, and high-fat dairy may also be beneficial. Losing weight if you are overweight or obese can reduce the severity of psoriasis. Regular exercise not only helps with weight management but also reduces inflammation and improves mood.^[16][20]

It’s also important to take care of your mental and emotional health. Psoriasis can have a significant impact on self-esteem, body image, and quality of life. Many people with psoriasis experience feelings of embarrassment, frustration, or depression. It’s important to talk to your doctor if you are struggling emotionally. There are resources and support groups available, such as the Psoriasis Association and other organizations, where you can connect with others who understand what you’re going through.^[15][16]