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Topical
Steroids
Topical steroids are very helpful
and are frequently prescribed. Low- to mid-potency steroids
may be used for short periods on the trunk, scalp and
extremities, as instructed by your doctor. Medium- or
high-potency steroids can also be used for short periods
on the arms and body, as instructed by your doctor.
Non-steroidal
Creams and Ointments
Calcipotriol
Calcipotriol decreases redness
and scaliness but can cause burning in some children,
particularly on sensitive areas, such as the face.
Anthralin
Anthralin can be applied and left,
or applied for a short period, then washed off. This
is known as Short Contact Anthralin Therapy (SCAT).
Application time is generally increased with subsequent
applications until the psoriasis lesions have improved.
Coal Tar
There are different types of coal
tar used to treat psoriasis-affected skin (shale, wood,
coal and crude coal tar). Crude coal tar is one of the
oldest psoriasis treatment options available although
many children and parents dislike using tar because
it may be messy, smelly and irritating. However, coal
tar can provide significant benefit for patients and
is available in a topical form, and a shampoo form for
the treatment of scalp psoriasis.
Topical coal tar is available
as a gel, cream, ointment, liquid, bath solution or
shampoo. Coal tar can stain white or blond hair, clothing,
towels and bedding. If you apply treatment before going
to bed, use old pajamas and bedding. Coal tar can make
the skin more sensitive to sunlight (photosensitizer),
so be careful when exposing your skin to sunlight when
you have it on and carefully follow your doctor's instructions.
Calcineurin Inhibitors
These are currently under investigation
for psoriasis and may be helpful for face, groin and
genital areas. They are available in ointment (tacrolimus
0.1% and 0.03%) or cream (pime-crolimus 1%) forms.
Calcineurin inhibitors can cause
slight burning with initial application. This burning
is mild and tends to last only a few minutes. The burning
generally resolves completely after one to two weeks
of repeated use.
Tazarotene
Tazarotene has been used to treat
psoriasis but can cause irritation. It is often necessary
to use topical steroids in conjunction with tazarotene
to reduce irritation.
Phototherapy
Phototherapy can be considered
for older children who fail to respond to topical treatments.
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