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Mild to moderate psoriasis means that the red, scaly patches ("plaques") cover less than 10% of your body. But just because your psoriasis is called "mild" doesn't mean it's easy to live with. If the patches are in visible places like your hands or legs, you may be embarrassed to go out without wearing long sleeves and pants. Also, small areas of psoriasis can turn into big problems if they're itchy or painful.

Your goal is to have clearer skin. To do that, you and your doctor need to find the right psoriasis treatment.

How Your Doctor Chooses Your Psoriasis Treatment

Each person with psoriasis is different. That’s why your doctor will use a few factors to decide which treatment to try:

  • The type of psoriasis you have
  • How much of your skin is covered
  • How big of an impact psoriasis has on your life
  • Your health

Your doctor may use the Koo-Menter Psoriasis Instrument to help decide on a treatment. This one-page tool asks questions to find out how much psoriasis affects your life. The doctor can use your answers to determine whether you need a skin cream, light therapy, or a drug that works throughout your body.

Usually doctors start with the mildest treatments for people with mild-to-moderate psoriasis. Often the first treatment you’ll try is a skin cream or ointment. If a mild treatment doesn’t work, you’ll move up to stronger treatments until your doctor finds one that helps you.

In general, you should not apply topical medications to open and infected areas, so speak with your doctor if your skin plaques become actively inflamed.

Corticosteroids

What it is: Corticosteroids, or steroids, are the most commonly used topical treatment for psoriasis.

How it works: Steroid drugs curb the growth rate of skin cells and reduce inflammation.

Types of corticosteroids: There are a variety of steroid creams, gels, lotions, and shampoos. They range from weak to strong. The stronger the steroid, the more effective it is. However, stronger steroids also cause more side effects.

  • Lower-strength steroids are best for treating sensitive areas for limited periods of time, like the face, groin, and breasts.
  • Higher-strength steroids are best for areas of the skin that don't clear up with milder steroids or areas with thicker plaques.

Side effects include thin skin, changes in skin color, acne, stretch marks, redness, more visible blood vessels, or increased risk for infection. Although uncommon, topical steroids can be absorbed into the circulation and also cause side effects such as cataracts, glaucoma, and Cushing’s syndrome. These uncommon side effects are more likely to occur if you use very high strength topical steroids over a large area for extended period of time.

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