Non-Steroidal Topical Treatments

Non-steroidal topical treatments are treatments that contain ingredients other than steroids. Some of these prescription treatments contain active or synthetic vitamin D3, a vitamin A derivative, or anthralin. There are a variety of reasons why your health care provider may recommend a non-steroidal topical treatment, including the degree of your psoriasis severity and its location.

Anthralin

Anthralin is a man-made version of a natural substance found in goa powder, which is from the araroba tree. It works by slowing down the growth of skin cells. It is FDA-approved for use in stable, scalp psoriasis in those over the age of 12.

To prevent discoloration of fingernails, apply this medication using plastic gloves. After using this medicine, rinse your hands right away with lukewarm water, then wash with soap and warm water.

Dovonex® (Calcipotriene)

Calcipotriene is a form of synthetic vitamin D3 that is formulated to slow skin cell growth, flatten lesions, and remove scale. It also can be used to treat psoriasis on the scalp and nails.

The most common side effects of calcipotriene are skin irritation, stinging, and burning. Less common side effects include dry skin, peeling, rash, dermatitis, and worsening of psoriasis.

There is another topical treatment, Taclonex, which is a calcipotriene combined with a steroid.

Tazorac® (Tazarotene)

Tazarotene is a vitamin A derivative, topical retinoid used to slow skin cell growth. It is normal for psoriasis plaques to become very red before clearing when using tazarotene. The redness is often intense in color, but it is generally not painful.

The most common side effects are skin irritation, dry skin, and increased susceptibility to sunburn. Use sunscreen and wear sun-protective clothing when using tazarotene. Check with your health care provider if you experience discomfort, burning, itching, or stinging.

Vectical® (Calcitriol)

Calcitriol is a naturally occurring active form of vitamin D3. Studies have shown that it can help control excessive skin cell production. Calcitriol can be applied to most places on the body except for the face, lips, and eyes.

The most common side effects are excessive calcium in urine, itching, and skin discomfort. There is an increased chance of skin tumors due to sensitivity to light. An extremely uncommon side effect is that changes in the limits of calcium metabolism may occur. If this does happen, treatment should be stopped until the levels of calcium return to normal.

VTAMA® (Tapinarof)

Tapinarof is an aryl hydrocarbon receptor antagonist. The aryl hydrocarbon receptor (AHR) is a transcription factor, or protein, involved in the immune system. Over 40% of study patients achieved complete disease clearance at least once during the study period, with some patients remaining clear for several months while not using the medication. Tapinarof can also be used on sensitive locations, such as face, skin folds, and genitals.

The most common side effects were red raised bumps around the hair pores, pain or swelling in the nose and throat, skin rash or irritation, including itching and redness, peeling, burning or stinging, headache, and influenza.

ZORYVE™ (Roflumilast)

Roflumilast is a phosphodiesterase-4 (PDE4) inhibitor. PDE4 is an enzyme that increases the production of pro-inflammatory signals and decreases production of anti-inflammatory signals. Around 50% of individuals were clear or almost clear at week 8 of the study. Roflumilast has been specifically demonstrated in the treatment of intertriginous, or inverse, psoriasis.

The most common side effects are diarrhea, headache, insomnia, nausea, upper respiratory tract infection, and urinary tract infection.

Have more questions about whether a topical treatment is for you? Your health care provider can help make this determination, as well as create a treatment plan.

Last updated 11/22/23 by the National Psoriasis Foundation.