Managing Psoriasis: Top OTC Products That Work

According to the National Psoriasis Foundation, psoriasis affects approximately 3% of adults in the U.S., which is more than 7.5 million Americans.

Psoriasis is a chronic skin condition where the immune system mistakenly attacks healthy skin cells, causing them to multiply much faster than normal. In a healthy individual, skin cells grow and shed over about a month. However, in someone with psoriasis, this cycle speeds up to just a few days. As a result, new skin cells accumulate on the surface before the old ones shed, forming thick, scaly patches known as plaques.

These plaques are often red, inflamed, and covered with silvery-white scales. They can appear anywhere on the body but most commonly affect the scalp, elbows, knees, and lower back. Psoriasis can also cause itching, pain, and discomfort.

Types of Psoriasis

• Plaque Psoriasis: The most common form, affecting about 80-90% of people with psoriasis. It includes raised, inflamed, red lesions covered with silvery white scales, commonly appearing on the elbows, knees, scalp, and lower back.
• Guttate Psoriasis: Small, dot-like lesions often triggered by a bacterial infection.
• Inverse Psoriasis: Red, shiny lesions found in skin folds.
• Pustular Psoriasis: White pus-filled blisters surrounded by red skin.
• Erythrodermic Psoriasis: A rare, severe form that covers large areas of the body and can be life-threatening.

Over-the-Counter (OTC) Products for Psoriasis

Managing psoriasis often involves a combination of prescription medications and over-the-counter (OTC) products. OTC treatments can be particularly effective for mild cases or as an adjunct to prescription therapies. Here’s a look at some of the most common OTC products, how they work, and their effectiveness.

Hydrocortisone

Hydrocortisone is a mild corticosteroid, effective in treating mild flare-ups or sensitive areas of psoriasis. It helps reduce inflammation, redness, swelling, and itching.

How It Works: Hydrocortisone suppresses the local immune response, reducing inflammation. It is available in lower-strength OTC forms like Cortizone 10 Ointment or Cortizone 10 Intensive Healing. Ointments are generally more soothing for cracked or bleeding skin compared to creams.

Recommendation: Ideal for small patches of psoriasis, but larger or more severe areas may require prescription-strength corticosteroids for noticeable results.

Moisturizers (e.g., CeraVe Psoriasis Moisturizing Cream)

Moisturizers are essential in managing psoriasis. Regular use can help reduce redness, flaking, and itching, and prevent the skin from becoming too dry, which can lead to flare-ups.

How It Works: Moisturizers like CeraVe Psoriasis Moisturizing Cream contain urea, a keratolytic agent that helps to soften and loosen thick scales while locking in moisture. This promotes skin healing and alleviates discomfort.

Recommendation: Dermatologists suggest applying moisturizer at least once daily, with more frequent applications when skin is particularly dry.

Salicylic Acid

Salicylic acid is particularly effective for treating scalp psoriasis but can also be used on other body parts. It helps to reduce scaling and smooth the skin by promoting the shedding of the outer layer.

How It Works: As a keratolytic, salicylic acid softens and lifts scales, making them easier to remove. It is commonly found in products like Gold Bond Ultimate Psoriasis Relief Cream and Nizoral Psoriasis Shampoo & Conditioner.

Recommendation: Effective for reducing the appearance of scales and easing discomfort, especially in scalp psoriasis.

Anti-Itch Products (e.g., Calamine, Menthol)

These products provide temporary relief of itching and discomfort. They are especially useful during flare-ups.

How It Works: Calamine reduces itching and irritation, while menthol provides a cooling effect that temporarily soothes the skin. Products like Sarna Calm & Cool Anti-Itch Lotion combine these ingredients for enhanced relief.

Recommendation: Use for quick relief during flare-ups, but they are not intended to treat the underlying causes of psoriasis.

Coal Tar

Coal tar has been used for decades in managing psoriasis. It is particularly effective for scalp psoriasis.

How It Works: Coal tar slows down the rapid growth of skin cells and alleviates symptoms like itching and redness. It is available in various forms, including shampoos, creams, and bath additives.

Safety Considerations: Although there have been concerns about the potential carcinogenicity of coal tar, the FDA has determined that OTC products containing 0.5% to 5% coal tar are safe and effective for treating psoriasis. Users should be aware of potential skin irritation and increased sensitivity to sunlight.

Recommendation: Coal tar is a versatile treatment, particularly effective for scalp psoriasis, but should be used under guidance to monitor for any adverse effects.

Speak with Your Doctor

Over-the-counter products for psoriasis offer a range of options to manage symptoms, from reducing scaling and itching to moisturizing and soothing your skin.

While these products can be very effective, it’s important to use them as part of a broader treatment plan, which may include prescription medications and lifestyle changes. Speaking with your doctor can help you determine the best combination of treatments for you.