The best treatment of psoriasis (2025)

The best treatment for psoriasis depends on the type, severity, and location of the disease, as well as patient-specific factors. Here are some commonly recommended treatments:

Topical Therapies:
    Corticosteroids: High-potency steroids (e.g., clobetasol) can be effective but should be used cautiously due to side effects like skin thinning.
    Vitamin D Analogues (e.g., calcipotriene): Often combined with corticosteroids for better efficacy. However, high doses may cause hypercalcemia, so dosing is limited (e.g., max 100 g/week for calcipotriene).
    Retinoids: Topical retinoids like tazarotene can be used but may irritate the skin.

Systemic Therapies:
    Methotrexate, Cyclosporine, Acitretin: Used for moderate to severe psoriasis; require monitoring due to potential side effects (e.g., liver toxicity).
    Biologics (e.g., adalimumab, ustekinumab): Target specific immune pathways and are highly effective but expensive. Often used when other treatments fail.

Phototherapy:
    UVB or PUVA therapy can be very effective for widespread psoriasis.
    Excimer laser is useful for localized plaques.

Supportive Care:
    Moisturizers to reduce scaling and itching.
    Avoiding triggers like stress, infections, or skin injuries that may exacerbate symptoms.

For severe cases with joint involvement (psoriatic arthritis), medications targeting TNF-alpha, IL-17, or IL-23 are often used. Regular monitoring is essential due to potential side effects of systemic therapies.