In general, topical treatments are the first line for mild to moderate psoriasis, but they may also be used alone or in combination with more powerful treatments for more severe cases. Brands differ in potency, and the more powerful a drug the higher the risk for more severe side effects, which include burning, irritation, dryness, acne, thinning of the skin, dilated blood vessels, and loss of skin color. Less potent drugs should be used for mild to moderate psoriasis and high potency for more severe conditions. The very potent drugs carry a small risk for adrenal insufficiency, in which the body loses its ability to produce natural steroid hormones for a period of time after the drug has been withdrawn. Low levels of these natural stress hormones can cause severe side effects.
Children are at higher risk for adrenal insufficiency in such cases than older people are.
Corticosteroids should not be used during pregnancy or when nursing. Eventually in most cases, resistance to these drugs develops or the disease recurs after treatment is stopped. The drug can cause sun sensitivity and increases the risk for sunburn for up to 24 hours after use. Preparations have a strong smell and can stain clothing and irritate the skin. If the medication is ingested, poison control should be called immediately.