Topical Retinoids for Psoriasis

Medically Reviewed by Debra Jaliman, MD on March 12, 2024
4 min read

You’ve probably heard of – or even use – retinoids as part of an anti-wrinkle, anti-aging skincare routine. These vitamin-A-derived products can play a part in your treatment for moderate to severe psoriasis, too. But what exactly are topical retinoids? And how can they prevent wrinkles but treat psoriasis, too?

Topical retinoids are a group of vitamin A-based medications for various skin diseases and problems. Topical means that you rub them into your skin like lotion. These are not pills that you swallow. You can find them in gel, cream, liquid, and sometimes foam formulas.

There are many types of topical retinoids. Each one has a different purpose. Not all of them treat psoriasis. But generally speaking, they influence how quickly your skin cells replace themselves. Some retinoids speed up this process. Others slow it down. It depends on what condition the retinoid treats. Retinoids in anti-aging skin care treatments, for example, speed up cell division to replace cells more rapidly. But for psoriasis, they do the opposite.

Topical retinoids for psoriasis slow down skin cell growth. This helps prevent the shedding, skin thickening, redness, swelling, scales, and inflammation that are typical signs of the condition.

Your doctor will most likely prescribe a retinoid called tazarotene. It comes as an easy-to-apply cream or gel. For most people living with psoriasis, tazarotene shrinks the affected areas by about 50%. For some people, the treatment brings complete relief from their psoriasis symptoms for up to 3 months.

But if you don’t get the relief you hope for from this medication, or you have unwanted side effects, you have other options available to you. Your doctor might recommend that you pair this daily medication with other treatments or products for better benefits or reduced side effects.

Applying this topical treatment is as simple as rubbing lotion on your skin. Most people apply it to the affected area once a day, sometimes twice. You’ll only need a thin layer of the cream or gel. You can also use it on your nails if they are affected. It’s important to rub the medication into your skin completely, just as you would lotion or sunscreen.

Of course, if any of these instructions differ from the ones your doctor or pharmacist gave you, follow their guidelines.

With most topical retinoids, including tazarotene, skin irritation is always a possibility. This irritation can include moderate to mild:

  • Redness
  • Itching
  • Stinging or burning
  • Peeling
  • Dryness

Less common side effects include blisters and skin discoloration.

You may also have more sensitivity to the sun when you use tazarotene. It’s more important than ever that you remember to wear broad-spectrum sunscreen and protective clothing if you spend time in the sun after you’ve applied your medication.

You shouldn’t try a topical retinoid for your psoriasis if you’re pregnant. It might not be safe when you’re breastfeeding either, but the research on that is less clear. If you're breastfeeding, make sure your doctor knows before you try this topical treatment, and talk about any possible risks.

People who have skin cancer also may not be able to use this medication safely.

If you have eczema in addition to psoriasis topical retinoids could cause a flare-up. It’s rare – it happens to fewer than 1 in 10 people with eczema – but it’s worth discussing with your doctor.

You may not get complete symptom relief from topical retinoids. Or you might have side effects that you can’t tolerate. For these reasons, doctors often pair other medications or over-the-counter products with topical retinoids to get the best possible effects.

When you use other products along with your topical retinoid, you may get the following benefits:

Relief of side effects. Emollient moisturizers or barriers, like petroleum jelly, could help alleviate inflammation and unwanted skin-related side effects. Simply apply and then follow your doctor’s instructions for applying the tazarotene.

Increased overall benefits. Your doctor may prescribe phototherapy along with tazarotene. UVB light therapy that you get in a doctor’s office or at home is a common treatment for people with moderate to severe psoriasis. Pairing it with topical retinoids could give you more symptom relief overall. It also doesn’t seem to add any serious side effects.

Relief of side effects and increased benefits. Your doctor could prescribe another topical medication called a corticosteroid to help relieve irritation. A clinical trial that studied this medication combination included people living with stable plaque psoriasis. It found that applying these topical treatments together increased the overall benefits and provided more symptom relief. Together, these treatments reduced irritation caused by the tazarotene. So this combination may help if you have excessive side effects from retinoids.

If you’re living with psoriasis, vitamin-A-derived topical retinoids may help reduce your symptoms. Don’t worry if you don’t get complete relief from this easy and daily topical medication. Adding other medications or over-the-counter remedies to your topical retinoid can reduce side effects and increase symptom relief.