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Why Your Psoriasis Treatment Is Not Working

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Psoriasis is a skin condition with different classifications. It can differ in type, site, and severity. Your treatment should be tailored to your unique needs and condition.

Here are some current psoriasis treatment options, and some reasons why they may or may not be working for you.

Topical treatments

Topical treatments are best for treating mild to moderate psoriasis. They include corticosteroids and non-steroid treatments.

Topical corticosteroids

When used alone or with vitamin D, topical corticosteroids are effective in treating localized psoriasis. One downside of using corticosteroids, and possibly why they aren't working for you, is that psoriasis symptoms may return if therapy is stopped. There are several types of topical corticosteroids, so talk to your doctor about which one may be right for you.

Non-steroid topical treatment

Non-steroid treatments include retinoids, coal tar, and vitamin D analogues. These treatments may be effective, but are typically less effective than corticosteroids.

Topical retinoids can help reduce inflammation and how often skin cells develop and regrow.

Coal tar is an ancient treatment, and has been used to treat psoriasis for more than 80 years. It's not as appealing as other treatments because of its strong odor and staining properties.

Dithranol

Dithranol is a popular topical treatment for psoriasis. You can apply it as a mixed paste or directly for short contact in higher concentrations.

Read more in Psoriasis Resources
  • Dvorakova, V., & Markham, T. (2013, May). Psoriasis: current treatment options and recent advances. Prescriber, 24(10), 13ñ20. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/psb.1059/abstract
  • Henseler, T. & Schmitt-Rau, K. (2008, October). A comparison between BSA, PASI, PLASI and SAPASI as measures of disease severity and improvement by therapy in patients with psoriasis. International Journal of Dermatology, 47 (10), 1019-1023. Retrieved from http://www.ncbi.nlm
  • Mason, A. R., Mason, J., Cork, M., Dooley, G., & Hancock, H. (2013, March 28). Topical treatments for chronic plaque psoriasis. Cochrane Database of Systematic Reviews. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005028.pub3/abstract
  • Noda, S., Krueger, J. G., & Guttman-Yassky, E. (2014, December 23). The translational revolution and use of biologics in patients with inflammatory skin diseases. Journal of Allergy and Clinical Immunology, 135(2), 324ñ336. Retrieved from http://www.jacionline.org/article/S0091-6749(14)01669-8/abstract
  • Papp, K. A., Menter, M. A., Abe, M., Elewski, B., Feldman, S. R., Gottlieb, A. B., Ö Wolk, R. (2015). Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: results from two randomized, placebo-controlled, phase III trials. British Journal of Dermatology, 173(4), 949ñ961. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/bjd.14018/abstract
  • Phototherapy. (2015). Retrieved from https://www.psoriasis.org/phototherapy
  • Psoriasis area & severity index. (2015). Retrieved from http://www.papaa.org/articles/psoriasis-area-severity-index
  • Robinson, A., Kardos, M, & Kimball, A.B. (2012, March). Physician global assessment (PGA) and psoriasis area and severity index (PASI): why do both? A systematic analysis of randomized controlled trials of biologic agents for moderate to severe plaque psoriasis. Journal of the American Academy of Dermatology, 66(3), 369-375. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22041254
  • Samarasekera, E. J., Sawyer, L., Wonderling, D., Tucker, R., & Smith, C. H. (2013, April 25). Topical therapies for the treatment of plaque psoriasis: systematic review and network meta-analyses. British Journal of Dermatology, 168(5), 954ñ967. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/bjd.12276/abstract
  • Sehgal, V. N., Verma, P., & Khurana, A. (2014, October). Anthralin/dithranol in dermatology. International Journal of Dermatology, 53(10), e449ñe460. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1365-4632.2012.05611.x/abst...
  • Torres, T. & Filipe, P. (2015, August). Small molecules in the treatment of psoriasis. Drug Development Research, 76 (5), 215ñ227. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/ddr.21263/abstract

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What's Your Psoriasis Severity?

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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