Ointments for psoriasis on the skin: hormonal and non-hormonal, home ointments

A dermatologist should prescribe the necessary ointment for psoriasis, but for patients who have been trying for years to alleviate their condition and reduce the manifestations of this chronic disease, it is useful to be familiar with the names of the products. It would not be superfluous to have an idea of the pharmacological characteristics of dermatotropic drugs, including their contraindications and side effects.

Names of ointments for psoriasis

Even specialists find it difficult to rank the best ointments for psoriasis, since each patient's reaction to a particular drug depends on many factors, and a remedy that helps some may not have a therapeutic effect on others. Dermatologists admit that patients are often forced to change dozens of medications before a truly effective ointment for psoriasis is determined for a particular patient.

There are two main classes of external antipsoriatic agents - non-hormonal ointments for psoriasis and hormonal ones. Among the first, experts include:

• ointments with salicylic acid and zinc oxide;
• ointments for psoriasis based on solid oil;
• ointments based on naphthalene oil;
• ointments based on bitumen derivative of anthracene;
• tar-based ointments for psoriasis;
• ointments with calcipotriol (a derivative of vitamin D3);
• homeopathic ointments and combined herbal ointments (based on medicinal plants).

The main names of ointments for psoriasis that do not contain hormones: Antipsor, Psorilam, Kartalin, Daivonex (Psorkutan), naphthalan ointment Naftaderm, Akrustal, Anthralin, Sophora ointment, Psoriaten, Psorilom.

Any hormonal ointment for psoriasis contains a synthetic substance similar to the steroid hormones of the adrenal cortex - glucocorticoids, the main function of which is to regulate metabolism and coordinate all parts of the body's immune system.

Ointments with salicylic acid and zinc oxide

Salicylic ointment (2%), an effective keratolytic, still helps to soften areas of skin that have become rough from excess keratinized cells. In addition, it is part of many combination drugs. The main indications for the use of ointments for psoriasis with this acid include progressive stages of the disease.

Zinc ointment is an antiseptic and adsorbent, it dries up oozing and relieves inflammation, like Yam ointment (a combination of salicylic acid and zinc oxide). How these products affect psoriatic rashes, read in the article - Non-hormonal ointments for psoriasis

An ointment with antimicrobial and fungicidal zinc pyrithione, Zinokap (Skin-cap), is used for psoriasis (as well as eczema, atopic dermatitis and neurodermatitis) - twice a day, treating skin rashes (daily for 4-6 weeks). This fairly effective ointment for psoriasis is good because it has no contraindications (except for early childhood) and side effects (except for possible minor skin irritation).

Psoriasis ointments based on solidol

Medical grease solidol is the basis of such products as Akrustal ointment, Antipsor cosmetic balm or Ivanov's ointment for psoriasis, Tsitopsor, Psorium, Psorilam. And also homemade ointments, in particular, Golyuk's ointment for psoriasis (read more about it in the Homemade ointment for psoriasis section), Markin's ointment for psoriasis, Rybakov's ointment (solidol, petroleum jelly, boric acid and menthol).

The pharmacodynamics of solidol, that is, the biochemical mechanism of its ability to reduce the intensity of keratinocyte proliferation at the progressive stage of the disease, is not described in any of the instructions for the listed drugs.

Akrustal ointment, positioned as a phytocream, works due to the presence of oils (eucalyptus, cedar, wheat germ, yarrow), oil extracts (calendula, chamomile, rose hips), extracts (licorice root, aloe, juniper berries). This product also contains honey and wax. During the first week, Akrustal ointment is applied to rashes only on the extremities - every other day (once a day, without washing off for 6-7 hours); after that, during the subsequent treatment, the product should be used daily.

Contraindications of Akrustal – individual hypersensitivity; side effects may manifest as skin allergies with redness and itching.

Storage conditions for this product require a temperature of no lower than +5-7°C, and the shelf life is 2 years.

The composition of the drug Antipsor, in addition to solidol, includes birch tar, fir oil, chitin (crushed shells of Kamchatka crabs), red seaweed, and extracts of medicinal plants: succession, celandine, toadflax, felt burdock and Manchurian aralia. The pharmacodynamics of these components is not explained, although it is emphasized that it is thanks to solidol that essential oils, organic acids, flavonoids and plant alkaloids, which Ivanov's ointment for psoriasis contains, penetrate well into the epidermis and promote exfoliation of dead keratinocytes and reduce itching.

In addition, the indications for the use of Antipsor ointment include various dermatoses, trophic ulcers, external hemorrhoids, varicose veins, alopecia and other diseases, including gynecological and cancerous ones.

Kartalin ointment, or more precisely, Kartalin ointment, has in its list of components solid oil, eucalyptus and lavender oils, retinol (vitamin A), natural honey, salicylic acid, the antiseptic enzyme lysozyme, extracts of chamomile and three-part celandine.

According to the instructions, this product has anti-inflammatory, antipruritic and keratolytic properties. It is recommended to apply it to rashes for two months - at least twice a day. After clearing the plaques from scales - once a day for 30 days. Contraindications and side effects of Kartalin are the same as those of Antipsor ointment.

Ointment for psoriasis based on naphthalene oil and bitumen anthracene

Naphthalan ointment in the form of the drug Naftaderm has pronounced antiseptic and keratoplastic properties, it also stimulates blood circulation in the skin vessels, activates metabolic processes, promotes moisturizing and softening of the epidermis. The pharmacodynamics of this product is provided by biologically active cycloalkanes - isomers of hydrocarbon compounds purified from resins of higher fractions of naphthalan oil - naphthalan. Naphthalan contains carboxylic acids, sulfur-containing compounds, salts of manganese, copper, zinc, cobalt. Their combined effect is manifested not only in the exfoliation of excess keratinization in psoriasis and other hyperkeratoses, but also in the activation of growth zones of the epithelium. Experts believe that this is an effective ointment for psoriasis.

Contraindications to its use are functional insufficiency of the liver and kidneys, anemic conditions, thrombocytopenia, oncology of any localization, dysfunction of the adrenal cortex and pheochromocytoma of their medulla, childhood.

Only the attending physician, taking into account the patient's condition, can allow the use of naphthalan ointment for psoriasis during pregnancy. Among the side effects of Naftaderm are skin reactions (rashes, hyperemia, swelling) and inflammation of the hair follicles (folliculitis). This product should be applied to dry skin in a very thin layer (without rubbing) - twice a day for a month.

But the ointment for psoriasis Anthralin (other trade names - Antraderm, Psoriaten, Dithranol, Tsignoderm) contains anthracene - a derivative of naphthide (bitumen) 1,8-dihydroxy-9 (10H) -anthracenone, which belongs to polycyclic aromatic hydrocarbons. Under its influence, the rate of mitosis of keratinocytes decreases, which helps to slow down the growth of plaques. Anthralin is applied to the affected areas for half an hour, maximum for an hour, after which the ointment should be washed off by taking a warm shower with soap. The course of treatment is 1.5-3 months.

Contraindications for this product include allergies to its components, renal failure, pregnancy, and active psoriatic rashes. Anthralin tends to irritate the skin and can cause redness and soreness. The drug also temporarily stains the skin brown. It can be stored at room temperature, but away from heat, moisture, and light.

Tar-based ointment for psoriasis

It is important to keep in mind that tar-based ointment for psoriasis should be used during the stationary stage of the disease (that is, when new spots do not appear, and existing ones become larger in size and peel heavily).

Among the components of tar, obtained by dry distillation of the upper layer of birch bark, are salicylic acid, methyl ester of salicylic acid (methyl salicylate), betulin and betulenol, which disinfect and tone the skin, stimulate its blood supply and restoration, normalize cellular immunity, remove toxins and help free plaques from keratin particles.

The well-known sulfur-tar ointment (5%) or 10% tar ointment is used once a day, if there are no contraindications: kidney failure, pustular inflammation or weeping rashes on the skin (with exudative psoriasis). Also, these products cannot be used during pregnancy. Side effects include increased sensitivity of the skin to ultraviolet rays, irritation in the form of dermatitis and folliculitis.

Contains tar Monastic ointment for psoriasis - a medicinal cream of the "Monastic" series. This product also contains solid oil, vitamins (A and D3), oils (chamomile, lavender, soy), extracts (succession and oats) and beeswax. The cream is applied to the affected areas of the skin once or twice a day. Contraindications and side effects are similar.

Ointment for psoriasis with calcipotriol

Ointment for psoriasis with calcipotriol (1, 25-hydroxyvitamin D3) - Daivonex (other trade names Psorkutan, Silkis) is intended for the treatment of mild and moderate stages of the disease in the inpatient stage.

The pharmacodynamics of Daivonex is based on the ability of the active substance to bind to vitamin D receptors of T cells and inhibit the proliferation of keratinocytes by normalizing the synthesis of certain proteins.

Pharmacokinetics: no more than 1% of calcipotriol is absorbed into the blood, the drug is broken down in the liver, metabolites are excreted in the urine and feces.

Contraindications to the use of Daivonex ointment: renal failure, liver disease, hypercalcemia, age under 12 years. This drug should not be used on the skin of the facial part of the skull. The use of ointments with calcipotriol during pregnancy is contraindicated.

Daivonex may be accompanied by such side effects as dermatitis; hyperemia, swelling, dryness, hyperpigmentation and increased photosensitivity of the skin; Quincke's edema; increased calcium levels in the blood and urine.

Method of administration and dosage: the ointment is applied to plaques no more than twice a day, the maximum daily dose is 15 g, the maximum duration of use is two months.

Overdose is possible with more frequent application of the ointment and is manifested by constipation, increased thirst, general and muscular weakness.

Interaction with other drugs: Daivonex is incompatible with ointments containing salicylic acid and diuretics that remove sodium from the body (hypothiazolid, furosemide, etc.).

Storage conditions: at a temperature not exceeding +25°C. Shelf life – 24 months.

By the way, Radevit ointment, containing vitamins A, E and D3 (cholecalciferol), relieves inflammation, reduces pruritus and moisturizes the skin. It is recommended to apply it twice a day. It should not be used during pregnancy.

Treatment of psoriasis with hormonal ointments

Hormonal ointments containing corticosteroids (GCS) - synthetic analogues of endogenous glucocorticoids, are used in dermatology as topical treatments for many pathologies, including psoriasis. Of course, these are effective ointments for psoriasis.

Their anti-inflammatory action, as well as the ability to relieve itching and swelling of the skin, are associated with immunosuppression, which is provided by the binding of pharmacologically active substances to glucocorticoid receptors on cell membranes. This is followed by an increase in the production of lipocortin, due to the increase in the level of which in the tissues of the dermis, the enzymatic activity of cytosolic phospholipase A2 decreases. In turn, this sharply reduces the synthesis of inflammation mediators and inhibits the release of the mediator of allergic reactions histamine from mast cells.

Here are some names of ointments for psoriasis with GCS:

• Hydrocortisone ointment, Hydrocort, Acortin, Lokoid, Laticort, Oxycort are synonyms and contain the same active substance – hydrocortisone-17-butyrate.
• Beloderm ointment (other trade names: Betamethasone, Akriderm, Betacorten, Celestoderm-B) contains the fluorinated GCS betamethasone dipropionate, which is many times more effective than hydrocortisone.
• Dermovate (Clobetasol, PsoriDerm, Clovate) with the active ingredient clobetasol propionate.
• Sinaflan ointment (Flucinar, Flukort, Sinoderm, Ultralan) contains fluocinolone acetonide; it penetrates well into the epidermis and accumulates in the dermal layer, providing a prolonged pharmacotherapeutic effect.
• Elokom ointment (or cream) contains the steroid substance mometasone furoate; other ointments with the same GCS are Uniderm, Avecort, Momat, Gistan.

There are also many hormonal ointments with a combined composition. Belosalik ointment - synonyms: Betasalik, Betaderm A, Diprosalik, Rederm ointment, etc. - is a combination of betamethasone dipropionate and salicylic acid (which is almost 98% in the ointment).

The components of Daivobet ointment are betamethasone and calcipotriol (in a ratio of 99:1).

Chinese cream King of Skin (Compound ketoconazole cream KL) is a combination of the GCS clobetasol propionate with the antifungal agent nizoral (ketoconazole).

Contraindications for the use of all ointments with corticosteroids are identical and do not depend on a specific GCS. These are viral and fungal diseases, acne (common and pink), damage to the integrity of the skin, malignant dermatological neoplasms, childhood (up to two years).

The use of hormonal ointments for psoriasis during pregnancy is permitted only in the most extreme cases and strictly as prescribed by a doctor.

The side effects of ointments for psoriasis containing GCS are absolutely no different. And here we come to the answer to the question: what is the danger of hormonal ointments for psoriasis?

Their main danger lies in the side effects that can manifest themselves:

• in allergic reactions, Quincke's edema and the risk of developing anaphylactic shock;
• in exacerbations of existing internal infections and secondary infections;
• in the occurrence of acne, dermatoses, purpura;
• in a decrease in collagen synthesis and the development of atrophic processes in the skin with the involvement of underlying tissues (the appearance of striae is possible);
• in the reduction of muscle mass and myopathies;
• in the loss of bone tissue strength (osteoporosis);
• in persistent increase in blood pressure;
• in glucose metabolism disorders (development of so-called steroid diabetes);
• in suppression of the functions of the hypothalamic-pituitary-adrenal system and adrenal insufficiency with the risk of developing Itsenko-Cushing syndrome.

Homeopathic ointments for psoriasis and phyto-ointments

Psoriaten is a homeopathic ointment for psoriasis based on the bark of the evergreen shrub Mahonia aquifolium in the form of a homeopathically diluted matrix tincture; the ointment base is lanolin. The pharmacodynamics of the drug is associated with the effect of the alkaloids of this plant (berberine, berbamine, tetrahydroberberine, canadine, oxyacanthine, hydrastine, columbamine) and tannins on skin cells. According to the instructions, Psoriaten ointment helps reduce itching and desquamation of the skin in minor manifestations of psoriasis.

And the homeopathic external remedy PsoriLom contains oil from the seeds of milk thistle, essential oils (eucalyptus, lavender and rosemary), extracts of ten medicinal plants (St. John's wort, calendula, sage, violet, sweet clover, etc.). The therapeutic effect is similar to Psoriaten.

The method of application and dosage are also the same: ointments are applied to plaques (without rubbing) three times a day. Side effects include urticaria and increased itching. These products are not used by children or pregnant women.

The main component of the herbal remedy Sophora ointment is an oil extract of the buds and fruits of the Japanese pagoda tree (Styphnolobium japonicum), containing the flavonoid sophorin or rutin, which is an antioxidant, strengthens the walls of capillaries and promotes normal metabolism in the dermis. This ointment can be used twice a day for 30-45 days. It is contraindicated to use the ointment during pregnancy.

The Indian ointment Psoroderm (Chetan Medicare) contains ostrich fat (with a high percentage of omega fatty acids); oil from the seeds of hydnocarpus (Chaulmoorga), which has antimycotic activity; karanja oil (from the seeds of the East Asian tree Pongamia Pinnata); extracts of ginger roots and Indian madder (Rubia cordifolia).

Another Ayurvedic herbal ointment for psoriasis is Regsor; its active ingredients are Wrightia tinctoria extract and coconut oil, which, as the instructions say, relieve itching of the skin and reduce its flaking.

Homemade ointment for psoriasis

With all the variety of antipsoriatic remedies, perhaps someone can benefit from homemade psoriasis ointment made by hand...

So, Golyuk's ointment for psoriasis (the recipe was protected by a copyright certificate in the 1980s) - with raw egg white, honey, dried celandine powder, baby cream and solidol - is intended for treating the disease at the stage of its stabilization. It is recommended to lubricate the rash twice a day, daily for two to three months.

Tar-honey homemade ointment for psoriasis can be prepared by thoroughly mixing birch tar, buckwheat honey and castor oil. Another ingredient can enhance the effect of this ointment - powdered turmeric or extremely finely ground comfrey root, which contains allantoin.

The solidol-honey ointment contains solidol (2 parts), honey (1 part) and the raw protein of two eggs (the use of the protein is justified by the fact that it contains the enzyme mucopolysaccharidase (lysozyme), which has pronounced antibacterial properties.

To make an ointment based on vinegar and egg, you should pour a raw egg from a village chicken in a glass container of the appropriate volume (for example, in a 0.5-liter jar) not with vinegar, but with an 80% solution of acetic acid, i.e. essence. The egg should be in the liquid entirely. The tightly closed jar is put away in a dark place for a day - so that the shell becomes soft. The egg prepared in this way should be taken out of the jar, crushed until smooth and combined with a fat base - lard, butter or melted butter (the ointment should have the consistency of thick sour cream).

This homemade ointment for psoriasis is applied to the surface of the keratinized spots in minimal quantities (and only once a day), and the procedure itself requires caution, since the mixture can cause a burn if it gets on healthy skin. After an hour, the product must be washed off, and the plaques must be lubricated with olive (linseed or sea buckthorn) oil.

If you mix raw egg white with a small amount of 6-9% table vinegar, and for a thicker consistency add homemade butter and a few drops of fish oil, you will get an ointment based on vinegar and oil.

How to prepare and use egg ointment see – Treatment of psoriasis with folk methods

To prepare an ointment with celandine, you should combine a tablespoon of powder from the dried plant with three tablespoons of lard, petroleum jelly or baby cream.

And the recipe for homemade ointment with propolis is as follows: 20 g of propolis is heated in a water bath with 130-140 g of pharmacy lanolin, mixed well and 10 g of beeswax is added. Also read - Treatment of psoriasis at home

What other psoriasis ointments are patients interested in?

Stop Psoriasis Ointment or Psoriasis (the package says: Stop Psoriasis) – contains the skin-blistering poison mustard gas mixed with Vaseline. The ointment is used at the stationary stage of the disease – once a day for a week with a one-day break before the next application. The main side effects of this ointment are: blisters on the skin, total hyperemia and exacerbation of the disease.

Chinese ointment 999 (China Resources Sanjiu Medical & Pharmaceutical Co Ltd) contains the corticosteroid dexamethasone, camphor, menthol, essential oils, alcohol, sodium carbonate (soda), glycerin. The ointment should relieve itching due to the presence of GCS, as well as the activation of cold receptors of the skin by camphor and menthol.

Thai Neuropson ointment is a set of two ointments. Ointment NSC-001 (blue) contains hydrocortisone (GCS), which potentiates the action of other components (they are not named in the instructions). The second Thai ointment from this "duet" is yellow; its composition is a commercial secret.

Vietnamese ointments: Kedermfa with snake fat, antifungal agent (nizoral) and antibiotic neomycin sulfate.

Zorka ointment is a veterinary medicine used to prevent cracking of the nipples and udder skin of dairy cows. And Ornit ointment is intended for the treatment of anal fissures.

Locobase Ripea (Astellas Pharma Europe, Netherlands) is a moisturizing cosmetic product for dry skin; it contains ceramides, fatty acids (oleic and palmitic) and cholesterol.

Nano ointment is the Anti Psori NANO gel offered for purchase online, and, at the same time, the ointment for psoriasis from Elena Malysheva (that is, which she advertised in her TV show). As the advertisement claims, this is a universal remedy with silver ions, produced in Switzerland. However, the Anti Psori nano ointment is not listed in the Guide to the treatment of psoriasis (Guide systemic treatment for psoriasis), agreed upon by European experts in the field of dermatology, working under the auspices of the European Academy of Dermatology and Venereology.