Traditional psoriasis treatments: what works and when

Psoriasis can feel relentless, but many time-tested treatments still help most people. If you want straightforward options that doctors have used for decades, this page breaks them down: how they work, what to expect, and simple safety tips so you get the benefit without surprises.

Topicals and basic skin care

Topical steroids are the go-to first step. They reduce redness and scaling fast. Use the lowest strength that controls your flare, apply to clean skin once or twice daily, and avoid long-term use on the face or thin skin to prevent thinning. Pair steroids with a thick moisturizer—creams or ointments help keep skin flexible and reduce flares.

Vitamin D analogs (like calcipotriol) slow skin cell growth and are safe for long-term use. Many people use a steroid for quick relief and vitamin D to maintain results. Coal tar and anthralin (dithranol) are older but effective for scaling; coal tar soothes and slows growth, while anthralin clears thick plaques. Both can be messy and have an odor, but they still work well for some patients.

Salicylic acid helps remove scales and makes other topicals penetrate better. Try it on thick plaques, but don't use strong salicylic products on large body areas without medical advice—too much can irritate or affect absorption.

Light therapy and systemic drugs

Phototherapy uses controlled ultraviolet light to slow skin cell growth and calm inflammation. Narrowband UVB is widely used and has fewer long-term risks than PUVA (psoralen + UVA). Phototherapy needs multiple clinic visits a week, but many people see big improvement after a few months. Protect unaffected skin and follow the clinic's dosing schedule to reduce risk.

For moderate to severe cases, classic oral or injected drugs still play a key role. Methotrexate reduces immune activity and helps many people, but it requires blood tests and avoiding alcohol because of liver risks. Cyclosporine is fast and powerful but not for long-term use due to blood pressure and kidney concerns. Acitretin, an oral retinoid, helps thick, scaly plaques but causes birth defects—women must use reliable contraception for months after treatment.

Each systemic option needs a conversation with your doctor about monitoring tests and side effects. These drugs are effective, but safety checks are not optional.

Practical tips: keep skin moisturized, avoid harsh soaps, treat infections promptly, and be honest with your clinician about alcohol, pregnancy plans, and other medicines. Traditional treatments often work best in combination—topicals plus light, or short courses of systemic drugs with ongoing skin care. If one approach fails, a different classic option might still help.

If you want, tell me whether you prefer topical, light, or tablet options and I’ll list realistic pros and cons for your situation.