Prescription Topical Treatments

Topical treatments such as creams and ointments are often the first therapies recommended to treat psoriasis. Topical treatments primarily work by reducing inflammation and slowing down and regulating skin cell turnover. Topicals exist in many different forms, such as lotions, creams, ointments, foams, or shampoo. Depending on the location of psoriasis plaques on the body, a specific formulation may be better suited for treatment. Many topical medications require a prescription, but some do not. When psoriasis is more severe, topicals are likely to be combined with oral medications, phototherapy, or biologics.

List of Medications (Psoriasis)

Click on a medication for additional information.

Topical Corticosteroids (e.g., betamethasone & mometasone)

How Does It Work?

Corticosteroids applied topically have the ability to decrease inflammation in the skin in many conditions, including psoriasis.

How Is It Used?

Topical corticosteroids are typically prescribed to be applied to psoriatic plaques twice daily. Topical corticosteroids are available in a variety of different potencies (strengths). Your doctor may prescribe a certain strength topical corticosteroid depending on the thickness of psoriasis plaques and their location on your body.

What are the possible side effects?

The most common side effect of topical corticosteroids is an initial mild burning or stinging feeling after application. Long-term use of strong corticosteroids can result in thinning of the skin. This should be monitored by you and your physician. 

Any Other Important Considerations?

Avoid covering the steroids with bandages or plastic wrap unless instructed to do so by your doctor.

What Medications Interact With This Treatment?

N/A

What Provinces and Territories List It On Formulary?

Varies depending on specific corticosteroid.

Product Monograph

N/A

Vitamin D3 Analogues

How Does It Work?

Vitamin D3 analogues work by regulating skin cell production and proliferation (buildup), which is abnormal in psoriasis. Vitamin D3 analogues used to treat psoriasis include calcitriol (Silkis®) and calcipotriol (Dovonex®).

How Is It Used?

Vitamin D3 analogues are available as topical ointments and are applied as to the affected area of skin once or twice daily as directed by physician.

What are the possible side effects?

The most common side effect of vitamin D3 analogues is a temporary burning or stinging sensation when applied to the skin.

Any Other Important Considerations?

N/A

What Medications Interact With This Treatment?

N/A

What Provinces and Territories List It On Formulary?

Calcipotriol (Dovonex®)

British Columbia: Y
Alberta: Y
Saskatchewan: Y
Manitoba: Y
Ontario: Y – S/A for plaque psoriasis
Quebec: Y
New Brunswick: Y
Nova Scotia: Y – S/A for plaque psoriasis
Prince Edward Island: Y
Newfoundland and Labrador: Y
Nunavut: Y
Northwest Territories: Y
Yukon: Y

Calcitriol (Silkis®)

British Columbia: Y
Alberta: N
Saskatchewan: N
Manitoba: N
Ontario: Y – S/A for plaque psoriasis
Quebec: Y
New Brunswick: N
Nova Scotia: N
Prince Edward Island: N
Newfoundland and Labrador: N
Nunavut: N
Northwest Territories: N
Yukon: N

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Combination Vitamin D3 Analogues & Corticosteroids

How Does It Work?

Vitamin D3 analogues work by regulating skin cell production and proliferation (buildup), which is abnormal in psoriasis.

Topical corticosteroids work by decreasing inflammation.

Combination products that contain both a vitamin D3 analogue and a corticosteroid are more effective than either drug used alone.

Combination calcipotrial and betamethasone treatments used for psoriasis include Dovobet® gel, Dovobet® ointment and Enstilar foam.

How Is It Used?

Wash hands before and after use. Rub into affected area gently and completely. Generally applied once or twice daily, as directed by your physician.

What are the possible side effects?

The most common side effect is an initial mild burning or stinging feeling after application. Long-term use of products containing corticosteroids can result in thinning of the skin, but the risk of this is minimal if monitored closely by your physician.

Any Other Important Considerations?

Avoid using bandages or dressings over treated areas unless instructed to do so by your doctor.

What Medications Interact With This Treatment?

N/A

What Provinces and Territories List It On Formulary?

Dovobet® Gel

British Columbia: Y
Alberta: Y
Saskatchewan: Y
Manitoba: Y – S/A for plaque psoriasis
Ontario: Y
Quebec: Y
New Brunswick: Y
Nova Scotia: Y – S/A for plaque psoriasis
Prince Edward Island: Y – S/A for plaque psoriasis
Newfoundland and Labrador: Y – S/A for plaque psoriasis
Nunavut: Y
Northwest Territories: Y
Yukon: Y

Dovobet® Ointment

British Columbia: N
Alberta: Y
Saskatchewan: Y
Manitoba: N
Ontario: Y
Quebec: Y
New Brunswick: N
Nova Scotia: N
Prince Edward Island: N
Newfoundland and Labrador: N
Nunavut: Y
Northwest Territories: Y
Yukon: Y

Enstilar Foam

British Columbia: N
Alberta: Y
Saskatchewan: Y
Manitoba: N
Ontario: Y
Quebec: Y
New Brunswick: Y
Nova Scotia: Y – S/A for plaque psoriasis
Prince Edward Island: N
Newfoundland and Labrador: Y
Nunavut: Y
Northwest Territories: Y
Yukon: Y

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Topical Retinoids (Tazarotene)

How Does It Work?

The exact mechanism of tazarotene is unknown. It is thought to play a role in the differentiation of skin (i.e., it helps to control the multiplication of skin cells), and it may also help to regulate the immune system.

How Is It Used?

Tazarotene comes in both a gel and cream formulation. Typically, it is recommended to be applied to the affected area of skin once a day, usually at night. Improvement is typically noted within two months of treatment.

What are the possible side effects?

The most common side effect of topical retinoids is skin irritation. Redness, a burning sensation, dry skin, and skin shedding are commonly experienced with tazarotene, but these side effects tend to subside after a few weeks of treatment.

Any Other Important Considerations?

Tazarotene cannot be used during pregnancy.

What Medications Interact With This Treatment?

No known significant drug interactions.

What Provinces and Territories List It On Formulary?

British Columbia: Y
Alberta: Y
Saskatchewan: Y
Manitoba: N
Ontario: N
Quebec: N
New Brunswick: Y – S/A for plaque psoriasis
Nova Scotia: Y – S/A for plaque psoriasis
Prince Edward Island: N
Newfoundland and Labrador: Y – S/A for plaque psoriasis
Nunavut: Y
Northwest Territories: Y
Yukon: Y

More information is available on S/A (special access) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Product Monograph

Tazorac 0.05% Gel (tazarotene): https://pdf.hres.ca/dpd_pm/00031077.PDF
Tazorac 0.1% Gel (tazarotene): https://pdf.hres.ca/dpd_pm/00031077.PDF 
Tazorac 0.05% Cream (tazarotene): https://pdf.hres.ca/dpd_pm/00033182.PDF
Tazorac 0.1% Cream (tazarotene): https://pdf.hres.ca/dpd_pm/00033182.PDF

Anthralin & Tars

How Does It Work?

The exact mechanism of anthralin and tars are unknown but they are thought to decrease the skin inflammation that is associated with psoriasis. Coal tar loosens and softens scales and crusts.

How Is It Used?

Anthralin:

Generally applied once daily or as directed by a doctor or pharmacist. When first starting to use anthralin, a short contact time of 5 – 10 minutes of the cream may be advised during the first week of treatment. Contact time can be gradually increased to up to 30 minutes, as tolerated by the skin. Anthralin can be removed by washing or showering.

When applying, gloves may be used to avoid staining of fingers and nails. Apply directly to plaques; rub in gently and avoid application to unaffected skin. Petroleum jelly may be used around the edges of the plaque to prevent irritation of unaffected skin.

Coal tar:

For scalp psoriasis, coal tar may be painted sparingly to the lesions 3-12 hours before shampooing.
For body psoriasis, apply coal tar to the lesions at bedtime.

Wash hands before and after application.

What are the possible side effects?

Anthralin: temporary skin irritation, temporary hair discolouration, temporary nail discolouration, temporary skin discolouration.

Coal tar: temporary skin irritation, increased skin sensitivity to light.

Any Other Important Considerations?

Anthralin is irritating to surrounding normal skin. It also stains skin and fabrics.

Coal tar has an odour and can stain skin and hair.

What Medications Interact With This Treatment?

N/A

What Provinces and Territories List It On Formulary?

N/A

Product Monograph

N/A

Last updated October 28, 2019.

Disclaimer

This Site was designed for educational purposes only and not for the purpose of rendering medical advice. Individual variances in psoriasis cases require the consultation of a physician to make sound medical decisions. The information presented on this website is not intended to replace the counsel of your physician. It is important to see your doctor before altering anything in your treatment plan. The Canadian Psoriasis Network does not endorse any medications, products, equipment or treatments for psoriasis and psoriatic arthritis. Any of the information contained within the Canadian Psoriasis Network’s Site is not presented as a substitute for informed medical advice. Visitors to this site should not engage in self-diagnosis nor act on information contained in the Site without seeking specific advice on the particular matters which are of concern to them from qualified health professionals and advisors. Some of the information contained in the Site has been provided from external sources. While efforts have been made to ensure the accuracy, currency, and reliability of the content, the Canadian Psoriasis Network accepts no responsibility in that regard. Please refer to our Terms of Use for further details.

This resource was made possible through support from:
Abbvie
Pfizer
Janssen
Bausch
 
LEO Pharma
Novartis
Amgen

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