Over the Counter Psoriasis Treatments
Understanding OTC Psoriasis Treatments
Over-the-counter products can help manage mild to moderate psoriasis symptoms like scaling, itching, and redness. They can complement prescription medications and help manage symptoms. While OTC options typically can't replace medical treatment for severe psoriasis, they can provide relief and can help maintain your skin health between flare-ups. Many people with psoriasis find that using OTC products reduces their dependence on stronger medications and helps them manage day-to-day symptoms more effectively.
Salicylic Acid for Scaling
Salicylic acid helps remove scales by softening keratin, a protein that makes up a significant portion of the skin's structure. Available in concentrations ranging from 0.5% to 5% in shampoos, soaps, ointments, and medicated pads, it's particularly effective for managing scalp psoriasis and thick plaques. It helps to lift and remove the buildup of dead skin cells that form psoriasis plaques. For best results, start with lower concentrations (1-2%) and gradually increase if needed. Don't apply it to open wounds or inflamed areas, as it may cause stinging or irritation. Consistent use is key—apply as directed for several weeks for the best results.
Coal Tar Benefits
Coal tar works by slowing rapid skin cell growth and reducing inflammation, scaling, and itching. This time-tested treatment has been used for over a century and remains one of the most effective OTC options, particularly for scalp and plaque psoriasis. Available in various strengths (0.5-5%) in shampoos, creams, oils, and bath solutions, coal tar products should be introduced gradually into your routine. Start with lower concentrations and shorter application times to see how your skin tolerates it. Be aware that coal tar products may cause irritation, have a strong odor, and can stain clothing, bedding, and light-colored hair. They also significantly increase sun sensitivity, so wear sunscreen and limit your sun exposure for up to 24 hours after application.
Daily Moisturizing
Moisturizers are a cornerstone of psoriasis management, working to trap water in the skin and reduce dryness, scaling, and itching. Apply right after bathing when skin is still damp (within 3-5 minutes) for the best results. Thick creams and ointments provide better moisture retention than lighter lotions, making them ideal for psoriasis-affected skin. Look for products with ingredients like ceramides, hyaluronic acid, glycerin, shea butter, and jojoba oil, which help repair the skin barrier and keep your skin hydrated. Fragrance-free options are best, as fragrances can irritate sensitive skin. Daily moisturizing is important even when psoriasis is not flaring, as it can help prevent future flare-ups by keeping your skin healthy.
Petroleum Jelly for Protection
Petroleum jelly creates a protective barrier that locks in moisture and helps heal dry, cracked skin associated with psoriasis. This inexpensive option is particularly useful for tough areas like elbows, knees, and the lower back where psoriasis plaques are often thicker and more stubborn. For daily maintenance, apply to trouble spots after showering while skin is still slightly damp to seal in moisture and reduce flaking and irritation. For intensive overnight treatment, apply a thick layer to affected areas before bed and cover with cotton gloves, socks, or plastic wrap to enhance penetration. While petroleum jelly won't treat the underlying causes of psoriasis, it can significantly improve skin comfort, reduce the appearance of plaques, and prevent further drying that can trigger flare-ups.
Scale Lifters
Products like salicylic acid, lactic acid, urea, or glycolic acid help remove scales by breaking down tough skin proteins and speeding up the shedding of dead skin cells. These ingredients can help other treatments penetrate through thick psoriasis plaques. For best results, use them before applying medicated creams. Products containing urea (10-40%) are particularly effective for thick, stubborn plaques, while lactic acid (5-12%) provides both exfoliation and hydration. Start with lower concentrations and apply every other day, gradually increasing the frequency. Be patient—it may take 1-2 weeks of consistent use to see noticeable scale reduction, but these products can dramatically improve the appearance of plaques.
Aloe Vera for Soothing Relief
Pure aloe vera gel offers natural relief for psoriasis symptoms, helping to reduce redness, scaling, and inflammation. Look for products with high aloe content (ideally 99% or higher) and minimal additives, preservatives, or fragrances, or use gel directly from the plant for the purest application. Aloe contains compounds with anti-inflammatory, antimicrobial, and wound-healing properties that can help calm irritated skin. For best results, apply several times daily to clean skin and allow it to fully absorb getting dressed. Many people find aloe helpful for facial psoriasis, where stronger treatments may be too harsh. While research shows moderate benefits for psoriasis, aloe vera works best as part of a comprehensive treatment approach rather than a standalone solution.
Epsom Salt Baths
Adding Epsom salt (magnesium sulfate) to warm—not hot—baths can help soften and remove scales while easing the itching and irritation associated with psoriasis. The magnesium in Epsom salt is thought to reduce inflammation by improving cellular function and decreasing stress hormones that can trigger flares. Dissolve 2 cups of Epsom salt in a standard-sized bathtub filled with comfortably warm water (94-98°F). Soak for 15-20 minutes, gently rubbing affected areas with a soft washcloth to help remove loosened scales. After bathing, gently pat skin dry and apply a heavy moisturizer. Limit these baths to 2-3 times weekly to prevent drying out your skin, and always follow with moisturizer. For sensitive skin, start with just 1 cup of salt and shorter soaking times.
Anti-Itch Products
Managing the persistent itch of psoriasis is important to prevent the scratch-itch cycle that can worsen plaques. Calamine lotion provides a cooling sensation and mild astringent properties that temporarily relieve itching. Over-the-counter hydrocortisone creams (0.5-1%) reduce inflammation and itching but should only be used for short periods (1-2 weeks maximum) as directed, as long-term use can thin the skin and potentially worsen psoriasis over time. Products containing menthol (0.5-1%), camphor, or pramoxine provide cooling sensations that interrupt itch signals. For nighttime relief, antihistamines like diphenhydramine may help reduce itching and improve sleep. Apply anti-itch products to clean, dry skin, avoiding broken or infected areas, and don't cover your skin with a non-breathable bandage.
Oatmeal Treatments
Colloidal oatmeal has been recognized for centuries for its skin-soothing properties and is now backed by research showing its effectiveness for inflammatory skin conditions. Oatmeal baths can significantly reduce the itching, redness, and inflammation associated with psoriasis. Look for commercial bath products containing colloidal oatmeal or make your own by grinding plain, unflavored rolled oats into a fine powder using a food processor or coffee grinder. The resulting powder should be fine enough to stay suspended in water. Add one cup to warm (not hot) bathwater while the tub is filling. Soak for 15-20 minutes, gently patting—not rubbing—affected areas. After bathing, pat skin dry and apply moisturizer while skin is still damp. Oatmeal can also be made into a paste with a little water for spot treatment of particularly itchy or inflamed areas.
Dead Sea Salts
Bath soaks with authentic Dead Sea salts have long been used to manage psoriasis symptoms, mimicking the beneficial effects reported by people who visit the Dead Sea for treatment. These salts contain a unique mineral composition—rich in magnesium, potassium, calcium, bromide, and sulfates—that is different from regular table salt or Epsom salt. The high mineral content helps improve skin hydration, reduce inflammation and roughness, and help to slough off scales. For a soothing bath, dissolve 1-2 cups of genuine Dead Sea salt in warm water and soak for 15-20 minutes. Be sure to buy from reputable sources, as not all products labeled "Dead Sea salt" contain authentic minerals. Use 2-3 times weekly for best results, and always follow with moisturizer. Some people experience mild stinging at first, but that usually goes away.
When to See a Doctor
Talk to a dermatologist if OTC treatments aren't helping after 2-3 weeks of consistent use, or if your psoriasis worsens, spreads to new areas, or causes significant discomfort despite treatment. Get immediate medical care if you develop signs of infection in psoriasis plaques, such as increased redness, warmth, swelling, pus, or fever. Joint pain, especially with swelling, stiffness, or limited range of motion, could indicate psoriatic arthritis and requires prompt evaluation. Severe psoriasis (covering more than 10% of the body) typically requires prescription treatments that may include topical steroids, vitamin D analogs, systemic medications, or biologics.