Severe psoriasis causes multiple symptoms and side effects. Treatment results can differ from person to person. For these reasons, most doctors prefer to treat psoriasis with a combination of treatments.

Read on to learn about the benefits of a combination treatment plan and what kinds of treatments are typically used to treat psoriasis.

Below is a list of treatments available for psoriasis.

Topical medications

Topical medications include:

  • creams
  • ointments
  • shampoos
  • other forms of medication that are applied to the skin’s surface

The most commonly used topical treatments for psoriasis contain steroids. These treatments are used to decrease inflammation, relieve itching, and block skin cell production.

Besides steroids, topical medications used as part of combination treatment may include:

  • moisturizers
  • vitamin D3
  • coal tar and anthralin
  • salicylic acid
  • retinoids
  • calcineurin inhibitors

Topical treatments are often used in combination with other, more potent treatments, because they aren’t enough to treat the symptoms of severe psoriasis.

Systemic medications

These medications affect the entire body as opposed to just the skin. They can be taken orally or by injection. The most commonly used systemic medications include:

  • cyclosporine
  • methotrexate
  • apremilast
  • oral retinoids

Systemic medications are often effective even when used on their own. However, they’re associated with side effects that range from mild to severe.

Using them in combination with other treatments allows for a lower dose and potency, which makes side effects less likely.


Also known as “biological response modifiers,” biologics are protein-based drugs. They’re derived from living cells cultured in a laboratory and are given by injection or IV infusion.

Biologics target specific parts of your immune system. They block specific immune cells or proteins that are part of the development of psoriatic disease.


This type of light therapy involves consistent use of ultraviolet light on the skin. It’s performed either under medical supervision or at home using a light unit designed for home use that a certified dermatologist recommends.

Phototherapy is sometimes used as a secondary treatment in combination with another therapy, such as a topical. It can clear up the skin completely or at least improve it.

Phototherapy is usually given in small doses that are gradually increased to avoid burning the skin.

Though there’s some evidence that commercial tanning beds can aid in treating psoriasis, it’s a risky and suboptimal treatment. The U.S. Department of Health and Human Services considers use of an indoor tanning bed to be carcinogenic (cancer-causing).

Talk with your healthcare team before the using a tanning bed.

Combination treatments are given in different stages or steps. The first step aims to clear skin lesions during an outbreak. This is often done using a strong topical steroid or an oral immunosuppressant for cases of severe psoriasis.

If the psoriasis is well managed after the first stage, topical corticosteroids can be tapered off and only reintroduced when flare-ups occur.

If symptoms still occur or get worse, corticosteroid injections and other treatments may be introduced.

Special patient populations, such as children, the elderly, and pregnant people, may need more specialized treatments.

Some psoriasis treatments work well on their own. But using a combination of treatments may have added benefit.

A 2012 research review examined the use of combination therapy for psoriasis. Although it indicated that more research is needed, they suggested that combination treatments are more effective and better tolerated than single-therapy treatment.

This result may be due to several benefits of combination treatment. To start, using a combination of treatments allows for smaller doses of each drug. This can decrease the risk of side effects experienced and may end up being less expensive for you.

Also, combining therapies has been shown to relieve symptoms more quickly and efficiently. Some combination therapies may even lower the risk of skin cancers, which can be elevated in people with psoriasis.

Another important benefit of combining treatments is that it offers numerous possible combinations.

Having a potentially large supply of treatment combinations is valuable because there’s no known cure for psoriasis. People depend on treatment to help them keep their symptoms under control.

Each person’s experience with psoriasis is different, and if you have severe psoriasis, combination treatment could be a good option for you. It allows your doctor to have flexibility in addressing your specific symptoms and preferences.

If your doctor suggests a combination of treatments, know that it could be the best way for you and your doctor to build the treatment plan that’s right for you.