The Best Over-the-counter Psoriasis Treatments, According to Dermatologists

Topping the list are tar-based products — one of the two ingredients that has beenFDA-approvedas a psoriasis treatment, besides salicylic acid. They’re typically very messy, but they work. “We’ve known they’ve been effective for decades, but only recently have we discovered that tar components bind and activate specific receptors in cells that calm down inflammation (psoriasis is a form of inflammation),” saysSteven Feldman, a dermatologist and psoriasis expert who sits on theNational Psoriasis Foundation Medical Board. One of the most popular tar products for psoriasis (that’sbeen recognizedby the NPF) is this T/Gel shampoo with a small percentage of coal tar in it.

But generally, the higher the concentration of tar, the more potent, says dermatologistMark Lebwohl, a preeminentpsoriasis expertwho is chairman of the National Psoriasis Foundation Medical Board and chair of the Department of Dermatology for the Mount Sinai Health System. This shampoo contains 5 percent coal tar — thehighest amountthat’s FDA approved to be safe for psoriasis.

If you have psoriasis on your body, there are even medicated tar ointments out there that are specifically catered to relieving itching and flaking, like this MG217 product that reviewers call a “miracle product” for psoriasis. If you’re applying it on the body, though, keep in mind that it can stain clothing, linens, and even hair if you’re not careful.

Lebwohl points out that there’s a new range of moisturizers out there that have salicylic acid in them as an active ingredient, anotherFDA-approvedpsoriasis treatment. In fact, almost all of the moisturizers currently recognized by the National Psoriasis Foundation contain a percentage of the exfoliant because they work as keratolytics, or “scale lifters,” to remove the buildup of scales or plaques on the body. “It’s not going to do well for severe disease, but is quite beneficial for mild cases,” Lebwohl says.

Another example is CeraVe’s SA RenewingLotion, which is aderm favoritefor acne-prone skin, too.

Even salicylic-acidshampooscan be helpful for exfoliation if you have a buildup of flakes on your scalp, like this Neutrogena T/Sal shampoo that’s on the NPF’s list of psoriasis products.

Besides tar and salicylic acid, the ingredient that Lebwohl recommends the most is zinc pyrithione (which is found in dandruff shampoos like Head & Shoulders, or concentrated versions like the one below). It has antibacterial properties, and beyond dandruff, it is often used for treating seborrhoeic dermatitis.

And while strong prescription-strength cortisone medications are going to be much more effective at reducing inflammation, milder versions with one percent hydrocortisone can be helpful (“especially for psoriasis on sensitive areas like the face or genitals,” says Feldman). Hydrocortisone ointment, rather than a cream, is preferred by experts because it’s thicker, though some may find it too greasy.

Because keeping skin moisturized can neutralize redness and itching, a thicker cream or ointment with ample ceramides to restore the skin barrier (even a greasier Vaseline) can come in handy, too — the NPFrecommendslooking for fragrance-free products. Something with a ceramide complex like this Curél moisturizer would be a safe option: It’s another product recognized by the NPF that doesn’t contain any fragrance.

Another ingredient that often comes up anecdotally among psoriasis sufferers is tea-tree oil for easing redness and itch. “The National Psoriasis Foundation has a bulletin that goes out to patients and there are countless letters from patients that say it works for them,” says Lebwohl. He adds that the oil has never been shown to work in clinical studies, though “if it works for someone, they should use it.”

Here’s a tea-tree ointment that can be applied topically, too, for the odd scaly patch.

And if your skin is especially itchy, Lebwohl says products that contain menthol are beneficial. A lotion like this medicated one from Gold Bond could lessen the itch: It contains soothers like aloe and menthol, for extra dry and irritated skin.