Best topical medications for psoriasis.(Brief article)

Creams or ointments that contain vitamin D and those that contain potent corticosteroids were shown to provide the most benefit to people with psoriasis, a skin condition that occurs most often on the elbows, knees, and scalp. Both products were shown to work better than other topical medications like dithranol (aka anthralin), salicylic acid (topical aspirin), coal tar-based preparations, and vitamin A.

These findings are from a new review of 133 trials published in the Cochrane Library, a subscription-only online publication. The corticosteroid creams had a lower incidence of skin irritation than vitamin D creams, but there is no research to determine the safety of long-term use. This review highlights a common problem in skin research. Psoriasis, like most skin conditions, is chronic, which means that people use medications for the rest of their lives. Yet the 131 studies included in this review typically lasted only six weeks .

This Cochrane review led by A.R. Mason included many trials that had compared vitamin D products with potent and very potent corticosteroids. All three products were comparable in effectiveness no matter where the drugs were applied. However, there was one exception; corticosteroids seemed to work better than vitamin D on scalp psoriasis. The treatments that combined vitamin D with a potent corticosteroid were more effective than either vitamin D alone or a potent corticosteroid alone.

It is common for people with psoriasis to try topical medications before moving on to systemic drugs, and they try to find the one that produces improvement with the fewest adverse effects. "There are very few long-term studies that can help doctors and people with psoriasis decide on the best way to treat this chronic condition," concluded this Cochrane review.

Maryann Napoli, Center for Medical Consumers [C] 2009

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