Psoriasis has a profound impact with patients reporting feelings of low self-esteem, depression, social isolation and stigmatisation. The relapsing and remitting pattern of the disease means that many patients live in constant fear that the disease will flare up. 

Visible plaques (e.g. on the hands and scalp) have a greater psychosocial impact than plaques that can be covered more easily. Psoriasis can be at least as damaging to quality of life as cancer, arthritis, hypertension, heart disease, diabetes or depression.

Treatment of psoriasis

Most patients with chronic plaque psoriasis have mild to moderate disease that can be managed in a primary care setting using topical treatments – a combination of a potent corticosteroid and a vitamin D analogue. Second-line treatment, including phototherapy or photochemotherapy (PUVA), or third-line treatment with systemic drugs is usually reserved for patients with more severe disease. Evidence-based recommendations for treatment are set out in NICE clinical guideline 153. 

Successful topical treatment depends on good adherence and the correct application of the products.

Responding to OTC requests

• OTC products that can be helpful to patients with psoriasis are limited to emollients, products containing coal tar and those containing salicylic acid. These can be useful to patients with mild psoriasis
• Eumovate Eczema and Dermatitis Cream (clobetasone butyrate 0.05%) may not be supplied for the treatment of psoriasis
• Calcipotriol ointment (50microgram/g) was approved as a pharmacy (P) medicine in August 2017 but the manufacturer has now decided not to market the product in the UK.