Topical psoriasis treatments: What about side effects?

The side effects of a topical medication depend on which medication you're using, the length of time it is used, your general health and underlying medical conditions, and whether you are using the medication appropriately.

Some side effects can occur with most topical medications. The most common of these is skin irritation. It's also possible to have an allergic reaction to the medication or its ingredients.

Other side effects are more specific to the medication itself. Some occur when the medication is used improperly or the dose is too high. Others can occur even when the medication is being used properly at the recommended doses.

Here are some of the most common side effects:

Common side effects of topical psoriasis treatments
Normal use Skin irritation, allergic reactions
High doses / inappropriate use With high doses: increased calcium in the blood (the doctor will keep an eye on this using blood tests)
Normal use Skin irritation (but less than with calcipotriol alone)
Corticosteroid side effects (see below)
High doses / inappropriate use With high doses: increased calcium in the blood (the doctor will keep an eye on this using blood tests)
Corticosteroid side effects (see below)
Corticosteroids (stronger corticosteroids are more likely to have side effects than weaker corticosteroids)
Normal use Thinning of the skin, stretch marks, redness, and easy bruising
If used on the face: pimples, redness, or visible blood vessels
High doses / inappropriate use If absorbed through the skin (more likely with high doses, strong corticosteroids, using an airtight dressing, long treatment times, and treating large body areas): moon face (a rounding out of the face), increased blood pressure, muscle cramps, weight changes, loss of blood sugar control, or unusual hair growth
Salicylic acid
Normal use Skin irritation or stinging
High doses / inappropriate use If absorbed into the body (more likely with long treatment times, large body areas, or airtight dressings): ringing in the ears, confusion, nausea, or vomiting
Normal use Skin itching, redness, burning, and irritation; increased sun sensitivity
High doses / inappropriate use With higher doses: skin pain, skin peeling, rash, dry skin, stinging, and high triglyceride levels (a type of fat found in the blood)
Coal tar
Normal use Irritation of skin and hair follicles; staining of clothing and hair; increased sun sensitivity
High doses / inappropriate use With very high doses (much higher than normally used): increased risk of skin cancer
Normal use Skin irritation or redness; staining of skin, clothing, or hair
High doses / inappropriate use No known long-term side effects

Some medications, such as corticosteroids and salicylic acid, can only be used over a small body area or for a limited period of time to protect from the side effects they would cause if absorbed into the blood. The maximum time period depends on many factors, including the size of the area to be treated, whether airtight dressings are used, and the person's age and general health. Check with your doctor or pharmacist to see how long you should be using your topical medication.

This is not a complete list of all side effects caused by topical psoriasis medications. Some people may experience side effects not listed above. Consult your doctor or pharmacist if you notice any symptoms that worry you.

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