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What is the Best Psoriasis Cream?

What is the Best Psoriasis Cream?

Psoriasis is a skin condition that causes red, itchy, scaling plaques. There are many new psoriasis treatments in addition to injectable prescription psoriasis treatment medications that can control moderate to severe psoriasis, but skin can be dry and itchy for weeks until these medications work. A psoriasis cream can be used to moisturize the skin while you are waiting for the prescription medications to begin working.

If you have mild psoriasis, you can try our recommendations first and see if you can control psoriasis naturally. However, we recommend discussing treatment options with your dermatologist because there are many new oral and topical treatments in addition to injectable treatments that are very effective for psoriasis.

How do Psoriasis creams work?

There are four main types of psoriasis creams available, they are:

  1. psoriasis creams that soothe and hydrate the skin
  2. psoriasis creams that remove scales;
  3. medicated psoriasis creams
  4. prescription psoriasis creams

Below, I'll take an in depth look at each of these categories of psoriasis creams, as well as relevant subcategories.

hydrating psoriasis creams

1. Psoriasis Creams That Soothe and Hydrate Skin

The most effective soothing psoriasis creams will contain lipids and oils, which are essential for skin hydration, and work to soothe the skin and decrease itching. If your psoriatic skin is dry and itching, look for a psoriasis cream that has oils such as argan oil, stearic acid (a hydrating fatty acid), and glycerin.

Psoriasis creams that contain MLE Technology are also very effective at soothing dry itching skin. MLE Technology contains a multilamellar emulsion, which mimics the natural skin barrier through layers of lipids. It was originally invented to treat eczema but is also found in psoriasis creams. It is not a psoriasis medication and does not treat psoriasis itself, but helps soothe and hydrate the skin while waiting for prescription psoriasis mediations to work.

Zerafite is one of our favorite barrier repair moisturizers that contains MLE Technology; a sophisticated blend of soothing and hydrating lipids called Myristoyl/palmitoyl oxostearamide/arachamide MEA. Zerafite uses MLE technology in two face creams, eye cream and body cream that are all safe to use if you have psoriasis. The Zerafite Moisturizers are perfect for easing the symptoms of psoriasis, though the best soothing psoriasis cream option for you will depend on the area of the body that has psoriasis patches.

Soothing Psoriasis Creams for the Body

Zerafite Ultra Rich Body Cream is the best body cream for psoriasis. This psoriasis cream is fragrance-free, so is safe to use anywhere on the body without the risk of irritation that scented body lotions can so often cause. Furthermore, it will not stain clothing. Zerafite Ultra Rich Body Cream contains argan oil and stearic acid to provide hydration and protect the skin against water loss. While it is a rich cream, it does not feel greasy on the skin.

Another soothing body cream to use on psoriasis plaques is Skinceuticals Triple Lipid Restore. This lipid-laden cream softens psoriasis plaques, helping decrease skin roughness and itching.

Psoriasis creams for neck and face

Soothing Psoriasis Cream for the Face and Neck

Zerafite Barrier Repair Moisturizer is an ideal face cream for psoriasis if the main issue is dryness and scaling on the face or neck, but there is not much facial redness. This soothing cream uses MLE technology and contains stearic acid, which acts as an emollient, and glycerin, which hydrates the skin and relieves dryness. Both stearic acid and glycerin help protect the skin against additional water loss. 

Zerafite Soothing and Calming Moisturizer, on the other hand, is the best psoriasis cream for the face if the psoriasis plaques are pink or red. Argan oil and niacinamide help reduce inflammation and calm the skin. Argan oil in particular is a good oil to calm and moisturize the skin because it has a large amount of the soothing fatty acid called linoleic acid.

Soothing Psoriasis Creams For The Eyelids

While less common, psoriasis can sometimes affect the eyelids, which can be incredibly uncomfortable since the skin in this area is so thin and sensitive. It is essential to select an eye cream to soothe psoriasis around the eyes that is gentle and protects the eye area from other irritants without irritating the delicate eye area.  

Zerafite Hydrating and Protecting Eye Serum protect the delicate eye area from steroids and other psoriasis medications that are used on the face at night, which can irritate the thin skin around the eyes. This psoriasis cream for the eyes contains niacinamide, which helps to strengthen the skin barrier and seal in moisture. 

Psoriasis creams that remove scales

2. Psoriasis Creams That Remove Scales

To effectively remove the silver scales that are so common in psoriasis, look for a psoriasis cream that contains salicylic acid, glycolic acid, gluconolactone or lactic acid. Salicylic acid is a beta-hydroxy acid that softens and lifts the scales. It is also effective at lifting dead skin cells from the surface of the skin, as well as calming inflammation.  

Lactic acid is an alpha-hydroxy acid (AHA), and milder than salicylic acid. However, lactic acid is equally as effective in psoriasis as it also helps to lift the scales and provides an anti-inflammatory benefit. The only downside to lactic acid is it can have a sour milk smell. 

Given the low pH of both lactic acid and salicylic acid, however, they can cause a stinging sensation on the skin. If skin stinging in areas of psoriasis is a concern, choose a Soothing Psoriasis Cream instead as discussed above. 

CeraVe Psoriasis Moisturizing Cream is a good psoriasis cream that contains both salicylic acid and lactic acid to relieve the scales and smooth the skin while maintaining hydration. 

NeoStrata Problem Dry Skin Cream is a fragrance-free psoriasis cream that is perfect for even the tougher parts of the body, such as the elbows, knees or heels. It contains a high level of AHAs to exfoliate severely dry, rough and thickened skin while providing an emollient and skin conditioning effect. In addition, it may help relieve the itch that psoriasis can cause.

Medicated Psoriasis creams

3. Medicated Psoriasis Creams

Over-the-counter, medicated psoriasis creams may be beneficial for you if you have moderately severe psoriasis. Most over-the-counter psoriasis creams contain hydrocortisone, which is a steroid known to reduce inflammation.

However, over-the-counter hydrocortisone has only a mild mechanism of action, so is often used in combination with other treatments to get the best benefit. For the elbows and knees, in particular, stronger treatments will almost definitely be needed.

Coal tar is another over-the-counter treatment that was popular in the past, but is rarely used these days- it is an old-school psoriasis treatment. Coal tar can help to improve the appearance of the skin and prevent the overgrowth of skin cells that is a symptom of psoriasis. However, it really does not smell good at all and stains clothing, so understandably, the majority of my patients prefer a more subtle treatment option. Coal tar shampoos are still commonly used to treat scalp psoriasis but they can dry out the hair.

Prescription psoriasis creams

4. Prescription Psoriasis Creams

For more severe cases of psoriasis, it is vital to consult with your dermatologist to find a psoriasis cream that will work most effectively for you.

There are a number of prescription-only treatment options for psoriasis available, including higher-strength steroid creams and ointments, retinoids, vitamin D treatments, immunosuppressive treatments and Anthralin.

High-strength steroid creams are often the first-line treatment for psoriasis but should be used only under the direction of your dermatologist as they can cause side effects such as thinning of the skin, bruising and stretch marks.

Retinoids, which are made with vitamin A, can help to speed up skin cell renewal to prevent the formation of plaques but should be avoided in pregnant women.

Vitamin D psoriasis creams are safer than steroid creams if used long-term, but can irritate the skin. They work by making the skin grow more slowly to help prevent the build-up of skin scales.

Immunosuppressive treatments for psoriasis, like Elidel or Protopic, are another treatment option your dermatologist will try if nothing else has worked. They act by easing the inflammation that psoriasis causes.

Finally, Anthralin, which is often used in conjunction with other medications, also eases inflammation and slows the growth of skin cells, but can stain clothing and irritate the skin with long-term use.

Fatty acids in oils

Natural Oils to Treat Psoriasis

Many people want a natural option to treat psoriasis, but moderate ad severe psoriasis requires prescription psoriasis medications. If you have mild psoriasis and want an organic or natural treatment option, oils with linoleic acid are a good choice. Safflower oil, Grapeseed oil, Argan oil, and Borage seed oil are the best oils to soothe psoriasis. One good oil to treat psoriasis is PAORR 100% Organic Argan Oil. Coconut oil is not a good oil to treat psoriasis. Coconut oil only has about 2% linoleic acid and therefore is not a very soothing oil. In addition, coconut oil can make psoriasis worse and can cause acne. Argan oil and safflower oil are the best oils to treat psoriasis- they are easy to find and affordable.

Essential Oils for Psoriasis

Dermatologists are often asked for a good recipe for essential oils to treat psoriasis. There are no essential oils that treat psoriasis. Why don’t essential oils work as a psoriasis treatment? Essential oils do not treat psoriasis because they are not true oils. Essential oils are distillates of the essence or fragrance of the oil and do not contain the soothing fatty acids that are needed to treat psoriasis. Linoleic acid is an example of a soothing fatty acid.

Psoriasis cream, lotion, ointment, or soothing oil?

Should I Use a Psoriasis Cream, Lotion, Ointment or a Soothing Oil?

Creams, ointments and oils are the better choices to treat psoriasis, as lotions just don’t meet the emollient requirements necessary for psoriasis. Always avoid products with alcohol on psoriasis plaques because alcohol can lead to drying and itching.

Psoriasis creams that work to hydrate skin should contain soothing oils like argan oil. Psoriasis ointments are greasy, but medications penetrate better in ointments, so psoriasis treatments often come as an ointment.

Do I Use a Psoriasis Cream Before or After a Psoriasis Medication?

Always put your prescription medications closest to the skin and apply the moisturizer after the medication. You can layer a barrier repair moisturizer, a hyaluronic acid-containing moisturizer or an occlusive oil over your psoriasis medication to help the psoriasis medication get in the skin better. Never put the moisturizer on first and follow with prescription medication.

Why do i need a psoriasis moisturizer?

Why Do I Need A Psoriasis Moisturizer?

A psoriasis cream that moisturizes the skin is an essential step in your daily skincare routine as it soothes and hydrates the skin, as well as helping to reduce scales and itching. It can also help hold the medication on the skin so it does not rub off onto your clothing.

The Final Word on Psoriasis Creams

Psoriasis can be a tough skin condition to manage and live with, but new treatments are very effective. There are many psoriasis treatment options available to ease the symptoms and keep the skin soothed and hydrated.  

Regardless of whether you require a medicated treatment or prescription medication for your psoriasis, using a moisturizer for psoriasis can help soothe skin while you are waiting for treatment. See if there is an STS-approved dermatologist near you to discuss the best psoriasis treatment options for you.

Level up your skin care knowledge with medical advice from dermatologists

References

  1. Baumann, L. (2006). The skin type solution: a revolutionary guide to your best skin ever. Bantam.
  2. Baumann, L. Cosmeceuticals and Cosmetic Ingredients (McGraw Hill 2015)
  3. Baumann's Cosmetic Dermatology (McGraw Hill 2022)

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