If there's one truth about topical psoriasis medication, it's that the meds live and die by the the Gs: gunky, gloppy, greasy. And, while these creams, ointments, gels, and lotions can be effective ways to reduce redness and flaking, many dermatologists report that patients skip putting them on as directed—just to avoid the unholy mess. But these meds won’t work unless you actually use them, so here are six suggestions to help you apply your topical treatments—stress-free.
#1: Make sure you know how long to use them.
Every topical remedy has a very specific dosage that should be adhered to religiously, says Jeffrey M. Cohen, M.D., a dermatologist at Yale Medicine in New Haven, CT. “The big hiccup is that people don’t understand how to use these creams,” he says. “A ton of patients will tell me that they applied a cream to a spot once and that the topical didn’t work. I always explain to patients that if the instructions are to apply it twice a day for one to two weeks, then you have to follow them for the medication to work.”
#2: Make sure you know how they work.
Your healthcare provider has several medications available to treat your psoriasis. But, unlike injectable biologics and oral medications, topical steroids don’t modify the course of your disease. What they do instead is treat the skin inflammation you already have by reducing swelling and redness. Expect your topical to also include Anthralin, synthetic vitamin D3 and vitamin A. Active ingredients such as salicylic acid and coal tar are also FDA-approved ingredients contained in topicals and your prescription topical may also include aloe vera, jojoba zinc pyrithione and capsaicin to soothe, remove scale or relieve itching, according to the National Psoriasis Foundation. “I think it’s very important to stress that it’s common for you to treat an area of skin inflammation with a topical, see it go away only to come back a month later,” Dr. Cohen says. “A lot of patients have skin inflammation that recurs in the same area, especially on elbows and knees.”
#3: Make sure you know where to apply them.
A topical steroid should always be applied to active plaque, which will be raised, red, scaly and itchy, Dr. Cohen says. You may be given a cream, that has the consistency of a moisturizing cream, an ointment, which has a greasy texture like Vaseline, or a foam solution if you’re treating psoriasis on your scalp. “I’ve noticed that patients will often point to the place where they’ve applied topicals and they’re pointing to active areas as well as areas that aren’t active,” he says. “I always tell patients that they should apply topicals only to the spots that are showing active plaques, not on any other areas that don’t need treatment.”
#4: Make sure you know when to use them.
One way to ease the burden of topical application is to give patients a break on certain days, suggests Jessica Kaffenberger, M.D., an associate professor of dermatology at Ohio State University in Columbus. “I tell my patients to use topical steroids twice a day on Monday through Thursday and then take three days off,” she says. “They’re more likely to apply it this way when they feel like they can take time off from their treatment though you should speak with your healthcare provider to make sure you can take days off during active treatment.”
#5: Make sure you keep to a routine.
To better ensure that you’ll actually apply the topicals, pick a time of the day when you’re going to apply it to your skin and make it a habit to always apply your psoriasis treatments at that time. “For example, if you shower in the morning, apply your topical treatment right afterwards and then apply it again right before you go to sleep at night,” Dr. Cohen says. “I’ve found that the more you keep to a routine about it, the more likely you are to use your topicals and to see them working to help heal your skin.”
#6: Make sure you do what works for you.
“I've heard of people wrapping their specific areas with plastic wrap or an old sock, so the medication doesn't get on their sheets or sofa,” says Health Central Psoriasis Advocate Sabrina Skiles, who currently uses two different psoriasis cream medications. “I tried it once and it was too annoying, so I didn't do it again.” Instead, the mother of two who lives in Denver says she just applies it right after the bath or shower and waits 30 minutes before hitting the sack. Moral of the story: What works for someone else, might not work for you--and that is okay.