From the Guidelines
Psoriasis cannot be completely cured, but it can be effectively managed with proper treatment, prioritizing morbidity, mortality, and quality of life as the primary outcomes. For mild to moderate psoriasis, start with topical treatments like corticosteroids (such as betamethasone or clobetasol), vitamin D analogs (calcipotriene), or retinoids (tazarotene), applied directly to affected areas once or twice daily as directed 1.
Key Considerations
- The choice of vehicle can significantly alter the use and penetration of the medication, and therefore alter the efficacy, with different vehicles indicated for different body sites 1.
- For more severe cases, phototherapy using UVB light 2-3 times weekly for 2-3 months may help, with narrowband (NB)-UVB therapy showing superior efficacy to broadband (BB)-UVB light 1.
- When these aren't sufficient, oral medications like methotrexate (7.5-25mg weekly), cyclosporine (2.5-5mg/kg daily), or biologics such as adalimumab (Humira), etanercept (Enbrel), or ustekinumab (Stelara) administered by injection every 1-12 weeks depending on the medication may be prescribed by a dermatologist 1.
Lifestyle Changes
- Lifestyle changes are also important:
- Moisturize daily
- Avoid triggers like stress and alcohol
- Maintain a healthy weight
- Consider dietary changes like reducing inflammatory foods
- Psoriasis is an autoimmune condition where your immune system causes skin cells to grow too quickly, resulting in the characteristic plaques, so treatments aim to slow skin cell growth or suppress immune response 1.
Monitoring and Adjustment
- Regular dermatologist visits are essential to monitor treatment effectiveness and adjust as needed, with the goal of minimizing morbidity, mortality, and improving quality of life 1. The most recent and highest quality study 1 prioritizes the use of systemic nonbiologic therapies, such as methotrexate and cyclosporine, for the management of psoriasis, while also considering the role of biologics and phototherapy.
From the FDA Drug Label
Calcipotriene ointment, 0.005%, is indicated for the treatment of plaque psoriasis in adults. The FDA drug label does not answer the question.
From the Research
Treatment Options for Psoriasis
- Psoriasis is an inflammatory skin condition that can be treated with various methods, including topical treatments, systemic treatments, biologic agents, and phototherapy 2
- The choice of treatment depends on the severity of the condition and the affected body surface area
Phototherapy
- Ultraviolet (UV) B phototherapy is a suitable treatment option for patients with more than 10% affected body surface area who have not responded to topical treatments 2
- Narrowband UVB (NB-UVB) and targeted phototherapy, such as excimer laser, are effective treatment options for psoriasis 2
- NB-UVB can be used in combination with adjunctive topical treatments, such as emollients, calcipotriene, corticosteroids, retinoids, and tar 2
Topical Treatments
- Clobetasol propionate 0.05% spray is an effective and safe treatment for plaque psoriasis, producing significant improvement in health-related quality of life (QOL) measures 3
- Clobetasol propionate spray can be used as monotherapy or as an add-on therapy to biologic treatment, resulting in consistent and significant improvement in QOL 4
- Calcipotriene in combination with UVB phototherapy is also an effective treatment option for psoriasis, showing a greater decrease in severity scores compared to UVB plus mineral oil 5
Combination Therapy
- The combination of clobetasol propionate spray with biologic agents or other topical treatments may be effective, but further research is needed to evaluate the safety and efficacy of such combinations 4
- The use of NB-UVB with traditional systemic agents, such as methotrexate, mycophenolate mofetil, and cyclosporine, should be closely monitored due to potential interactions 2