Psoriasis treatments

Adcortyl contains triamcinolone acetonide, a potent topical corticosteroid, together with the antibiotics gramicidin and neomycin sulphate, and the antifungal nystatin. It is used for inflammatory skin conditions where bacterial and/or fungal infection is present or likely to occur, and where treatment with a potent topical corticosteroid is appropriate. It may be used for psoriasis only when this is considered appropriate by a specialist because potent topical corticosteroids can worsen some forms of psoriasis.

How does it work?

When triamcinolone is applied to the skin it works by acting inside the skin cells to decrease the release of these inflammatory substances. This reduces swelling, redness and itch.

Neomycin sulphate is a type of antibiotic called an aminoglycoside. It works by entering bacterial cells and interfering with the production of proteins that the bacteria need to divide and multiply. It doesn’t directly kill the bacteria, but leaves them unable to increase in numbers. The existing bacteria eventually die or are destroyed by the immune system.

Gramicidin is a different type of antibiotic, and the combination of these two antibiotics provides treatment against a wide variety of bacteria that may infect the skin.

Nystatin is an antifungal medicine. It kills fungi and yeasts by interfering with their cell membranes. Nystatin works by binding to a substance called ergosterol, which is a component of fungal cell membranes. Binding to ergosterol disrupts the cell membrane and causes holes to appear. The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. As nystatin causes holes to appear in the cell membranes, essential constituents of the fungal cells can leak out. This kills the fungi.

Who can get it?

Suitable for adults and children over 1 year of age. It is available on prescription as a cream or an ointment.

How is it used?

Apply a thin layer to the affected area twice daily, or as directed by your healthcare professional. Treatment should be used for the shortest time necessary. If the condition does not improve within 7 days, treatment should be reviewed by the prescriber.

What are the side effects?

Triamcinolone Acetonide:

The following side effects have been reported. Usually with prolonged usage: skin effects - impaired wound healing, thinning of the skin, petechiae and ecchymoses, facial erythema and telangiectasia, increased sweating, purpura, striae, hirsutism, acneiform eruptions, lupus erythematosus-like lesions and suppressed reactions to skin tests. These effects may be enhanced with occlusive dressings.

The possibility of the systemic effects which are associated with all steroid therapy should be considered. These include reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, signs of Cushing’s syndrome, hyperglycaemia and glucosuria in some patients. Following discontinuation, recovery of HPA axis function is generally prompt and complete.

Neomycin:

Sensitivity reactions may occur especially with prolonged use. Ototoxicity and nephrotoxicity have been reported. The product should be used with caution and in small amounts in the treatment of skin infections following extensive burns, trophic ulceration and other conditions where absorption of neomycin is possible. The product should be used with care in patients with established hearing loss. Prolonged use may increase the risk of allergic contact dermatitis.

Gramicidin:

Sensitivity has occasionally been reported.

Nystatin:

Allergic reactions to topical nystatin are uncommon but can occur.

Other warnings

• Do not use under airtight dressings unless advised.
• Avoid prolonged use.
• Avoid use on the face unless specifically advised.
• Avoid contact with the eyes.
• Do not use on untreated viral infections such as cold sores or chickenpox.
• Potent steroids should be used cautiously in psoriasis because of the risk of rebound flares and pustular psoriasis.

Marketed by

Adcortyl is marketed in the UK by Bristol Myers Squibb Pharmaceuticals Ltd (formerly Bristol-Myers Squibb Pharmaceutical.

Reviewed: August 2026

Version ID: 2/ADC/PST/08/26

Canesten HC Cream contains clotrimazole, an antifungal medicine, together with hydrocortisone 1%, a mild topical corticosteroid. It is used to treat fungal skin infections where there is also inflammation, redness and itching.

How does it work?

Hydrocortisone reduces inflammation, redness and itching while it is being used. It helps relieve symptoms but does not treat the underlying fungal infection, which is why it is combined with clotrimazole. Topical corticosteroids are often prescribed as first-line treatment because they are effective.

Clotrimazole treats fungal skin infections by damaging the fungal cell membrane, helping to eliminate the infection.

Who can get it?

Canesten HC Cream can be bought from pharmacies without a prescription or prescribed by a healthcare professional. It is suitable only for certain fungal skin infections and should not be used for longer than seven days without medical advice. If you or your child has had an allergic reaction to any similar medicine you should not use it.

How is it used?

Canesten HC Cream should be thinly and evenly applied to the affected area twice daily and rubbed in gently. Treatment should be for a maximum of 7 days. There is no separate dosage schedule for the elderly or the young. However, long-term therapy to extensive areas of skin should be avoided particularly in infants and children. Wash your hands before and after applying the cream unless the hands are being treated.

What are the side effects?

• burning or stinging
• irritation
• itching
• redness
• dry skin
• allergic skin reactions

Rare with prolonged use:

• skin thinning
• stretch marks
• acne-like rash
• visible blood vessels
• changes in skin colour
• adrenal suppression (very rare)

Important precautions

• Do not use for more than seven days unless advised by your healthcare professional.
• Avoid applying to large areas of skin.
• Do not cover with airtight dressings unless advised.
• Avoid contact with the eyes.
• Take extra care when using in infants, as nappies can act like occlusive dressings and increase absorption of hydrocortisone.

Canesten HC should not be used for:

• acne
• rosacea
• perioral dermatitis
• untreated bacterial infections
• untreated viral infections such as cold sores or chickenpox
• tuberculosis affecting the skin

Marketed by

Canesten HC is available as a cream and it is marketed in the UK by Bayer plc

Reviewed: August 2026

Version ID: 2/CAN/PST/08/26

Daktacort Hydrocortisone cream is a mild topical corticosteroid broad-spectrum antifungal and anti-bacterial cream containing the active ingredients hydrocortisone and Miconazole. It belongs to the group of medicines for application to the skin called topical corticosteroids combinations which should not be confused with anabolic steroid tablets or injections which can be misused by some athletes. Topical corticosteroids have been shown to reduce the itching, redness and inflammation of certain skin problems

How does it work?

Topical Corticosteroids suppress the inflammatory reaction during use; they are not curative and on discontinuation a rebound exacerbation of the condition may occur. They are generally used alongside topical corticosteroids to relieve symptoms and suppress signs of the disorder when other measures such as emollients are ineffective.

Topical corticosteroids are often prescribed as first-line treatment. Daktacort reduces inflammation while miconazole treats the fungal infection.

Miconazole works by damaging the fungal cell membrane, causing the fungi to die. It also has activity against some Gram-positive bacteria that may be present in infected skin.

Who can get it?

Daktacort HC is available on prescription. It should not be used in the following conditions:

• On open wounds
• On large areas of skin
• Used for longer than 7 days
• To treat cold sores and acne
• Use on the face, eyes and mucous membranes
• On the ano-genital region unless prescribed by a doctor
• To treat secondary infected conditions unless prescribed by a doctor
• Hypersensitivity to any of the excipients
• Untreated viral skin infections (for example, cold sores, chickenpox or shingles)
• Tuberculosis affecting the skin
• Skin reactions following vaccination
• Rosacea Perioral dermatitis

How is it used?

Apply a thin layer to the affected area two or three times a day for up to seven days, or as directed by your healthcare professional. Wash your hands after applying the cream unless your hands are being treated.

What are the side effects?

Side effects

• burning or stinging
• itching
• irritation
• allergic skin reactions
• skin thinning with prolonged use
• acne-like rash
• changes in skin colour

Warnings

• avoid prolonged use
• avoid large areas
• avoid occlusive dressings
• avoid contact with eyes

How do I get Daktacort?

Daktacort Cream is available on prescription from a healthcare professional.

Marketed by

It is marketed in the UK by Janssen-Cilag Ltd.

Reviewed: August 2026

Version ID: 2/DAH/PST/08/26

Timodine Cream contains hydrocortisone, a mild topical corticosteroid, together with nystatin, an antifungal medicine, benzalkonium chloride, an antiseptic, and dimeticone, which helps protect the skin. It is used to treat inflamed skin conditions where Candida infection is present or likely, such as infected eczema, intertrigo and infected nappy rash. It belongs to the group of medicines for application to the skin called topical corticosteroids combinations which should not be confused with anabolic steroid tablets or injections which can be misused by some athletes. Topical corticosteroids have been shown to reduce the itching, redness and inflammation of certain skin problems.

How does it work?

Topical Corticosteroids suppress the inflammatory reaction during use;. They are generally used to relieve symptoms and suppress signs of the disorder. Timodine Cream contains hydrocortisone, a mild topical corticosteroid, together with nystatin, an antifungal medicine, benzalkonium chloride, an antiseptic, and dimeticone, which helps protect the skin. It is used to treat inflamed skin conditions where Candida infection is present or likely, such as infected eczema, intertrigo and infected nappy rash.

Nystatin

Nystatin works by damaging the cell membrane of fungi and yeasts, helping to clear Candida infections. Dimeticone

Dimeticone forms a protective barrier over the skin, helping to reduce irritation from moisture and other irritants. Hydrocortisone

Hydrocortisone is a mild, but effective anti-inflammatory agent.

Benzalkonium chloride

Benzalkonium chloride is an antiseptic that helps reduce bacteria on the skin.

Who can get it?

Timodine is available on prescription for adults and children.

Timodine should not be used in:

• viral skin infections (for example, cold sores or chickenpox)
• tuberculosis affecting the skin
• acne vulgaris
• rosacea
• perioral dermatitis

How is it used?

For topical application to the skin.

Adults (including the elderly) and children

Dermatoses: Sufficient Timodine should be applied to cover the lesion in a thin layer. It should then be massaged into the skin until the cream disappears. The treatment should be repeated three times a day until the lesion has healed. There is no indication that dosage need be modified for the elderly. Your doctor may tell you to cover this with a special "occlusive" dressing, but this is not usually necessary.  Wash your hands after applying the cream unless your hands are the area being treated.

What are the side effects?

• skin thinning
• irritation
• infection worsening
• pigment changes
• acne
• burning
• itching
• rash
• allergic contact dermatitis
• redness
• swelling
• hypersensitivity reactions
• adrenal suppression (rare after prolonged or extensive use)
• blurred vision (rare corticosteroid effect)

Warnings

• avoid prolonged use unless advised
• avoid contact with the eyes
• avoid applying to large areas unless directed
• seek medical advice if the condition worsens or does not improve

Marketed by

Timodine is marketed in the UK by Alliance Pharmaceuticals Ltd

Reviewed: August 2026

Version ID: 2/TIM/PST/08/26

Antihistamines may sometimes be used to help relieve troublesome itching in people with psoriasis, particularly if itching is affecting sleep.  Antihistamines work by blocking the action of histamine at H1 receptors, reducing the effects of histamine in the body.

In psoriasis:

• itch is caused by a complex interaction of inflammatory cytokines, nerve fibres and immune cells
• histamine does not appear to be the main driver
• this is why antihistamines often have limited benefit for psoriasis itch

In allergic conditions, blocking the action of histamine can reduce itching. In psoriasis, however, itching is caused by several different mechanisms, so antihistamines may not relieve itching for everyone. Sedating antihistamines may help some people sleep better if itching is disturbing their rest. Scratching can damage the skin and may trigger new psoriasis plaques to develop in susceptible areas (known as the Koebner phenomenon). It can also increase the risk of secondary skin infection. Persistent itching can affect sleep, concentration, mood and quality of life.

They are not a treatment for psoriasis itself.

Non-sedating antihistamines are less likely to cause drowsiness.

Sedating antihistamines may affect driving or operating machinery.

They should be used according to the advice of a healthcare professional or the patient information leaflet.

Reviewed: August 2026

Version ID: 2/ANT/PST/08/26

Adalimumab is a biological medicine used to treat moderate to severe plaque psoriasis and several inflammatory forms of arthritis. It belongs to a group of medicines known as tumour necrosis factor (TNF) inhibitors.

How does it work?

Adalimumab blocks tumour necrosis factor-alpha (TNF-α), a chemical "messenger" in the immune system that signals other cells to cause inflammation. People with psoriasis have increased levels of TNF-α in affected skin and the joints of people with certain types of arthritis.

TNF-α helps activate immune cells, including T cells, leading to inflammation and the rapid growth of skin cells seen in psoriasis. T cells are a type of white blood cell in the body; in psoriasis, once T cells are mistakenly activated, they can trigger inflammation and other immune responses and fuel the development of psoriasis lesions.

Adalimumab helps lower the amount of TNF-α, thus interrupting the inflammatory cycle of psoriasis and leading to improvement in symptoms for many people who take it.

Who can get it?

Biologics are recommended for adults with severe plaque psoriasis when:

• PASI ≥10
• DLQI >10

and conventional systemic treatments have failed, are contraindicated or are not tolerated.

How is it used?

Patients take adalimumab at home every fortnight by giving themselves an injection under the skin (subcutaneously), similar to diabetes patients who give themselves insulin injections. The initial dose is 80mg followed by 40mg given every two weeks after the initial dose. The first dose is 80 mg, followed one week later by 40 mg. Thereafter, 40 mg is given every other week by subcutaneous injection.

What are the side effects?

Adalimumab should not be administered in patients with active TB, opportunistic or other severe infections, moderate to severe heart failure (NYHA lll/lV) or known hypersensitivity to adalimumab.

Before initiation of therapy with adalimumab, all patients must be evaluated for infection, including active and latent TB. Patients must be actively and regularly monitored for infections during and for 5 months after treatment. Patients should also be evaluated for non-melanoma skin cancer prior to and during treatment.

Other serious side effects have been reported including:

• Infections/sepsis
• Opportunistic infections
• TB
• Demyelinating disease
• Malignancies including lymphoma and skin cancers

• Reactivation of hepatitis B

• Cytopenia
• Worsening heart failure
• Anaphylaxis

Safety advice

• TB screening before treatment
• hepatitis B screening
• avoiding live vaccines
• recognising signs of infection
• regular monitoring throughout treatment

How do I get adalimumab?

Today it is usually initiated by a consultant dermatologist or rheumatologist, with prescribing often continuing through hospital or homecare services.

Available Gudiance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health,(Northern Ireland)

Adalimumab is known commercially as:

Amgevita, Humira, Hyrimoz, Idacio, Imraldi and Yuflyma

Reviewed: August 2026

Version ID: 2/BIO/PST/08/26

Bimekizumab is a biologic medicine used to treat adults with moderate to severe plaque psoriasis who are suitable for systemic treatment (medicines that work throughout the body).

How does it work?

Bimekizumab selectively binds to IL-17A, IL-17F and IL-17AF. By blocking IL-17A and IL-17F, bimekizumab reduces inflammation in the skin and helps slow the overproduction of skin cells that causes psoriasis plaques.

Who can get it?

Before treatment patients are usually screened for:

• tuberculosis
• hepatitis B (and sometimes hepatitis C)
• other infections

Bimekizumab is for adults with severe plaque psoriasis when:

• the disease has not responded to other systemic treatments,
• or those treatments are unsuitable or not tolerated.

How is it used?

The recommended dose for adult patients with plaque psoriasis is 320 mg (given as 2 subcutaneous injections of 160 mg each) at week 0, 4, 8, 12, 16 and every 8 weeks thereafter.

Consideration should be given to discontinuing treatment in patients who have shown no improvement by 16 weeks of treatment.

What are the side effects?

Serious side effects

• fever, flu-like symptoms, night sweats
• feeling tired or short of breath, cough which will not go away
• warm, red and painful skin, or a painful skin rash with blisters

Very common (may affect more than 1 in 10 people)

• upper respiratory infections with symptoms such as sore throat and stuffy nose Common (may affect up to 1 in 10 people)
• blocking IL-17 increases susceptibility to Candida (thrush), which is the characteristic adverse effect of this class of medicinesfungal infection of the skin, such as athlete’s foot between the toes
• ear infections
• cold sores (herpes simplex infections)
• stomach flu (gastroenteritis)
• inflamed hair follicles which may look like pimples
• headache
• itchy, dry skin or an eczema-like rash sometimes with swollen and reddened skin (dermatitis)
• acne
• redness, pain or swelling at the site of injection
• feeling tired Uncommon (may affect up to 1 in 100 people)
• lowered levels of white blood cells (neutropenia)
• fungal infections of the skin and mucous membranes (including oesophageal candidiasis)
• discharge from the eye with itching, redness and swelling (conjunctivitis)
• blood in the stool, abdominal cramps and pain, diarrhoea or weight loss (signs of bowel problems)
• inflammatory bowel disease (can develop or worsen)
• liver monitoring is not routine
• hypersensitivity reactions

You should seek medical advice if you develop persistent diarrhoea, abdominal pain or blood in your stools, as these may be signs of inflammatory bowel disease.

How do I get bimekizumab

Bimekizumab is prescribed by a specialist and is usually self-administered at home after appropriate training.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health (Northern Ireland)

Marketed by

Bimekizumab is known commercially as Bimzelx and is marketed in the UK by UCB Pharma Ltd

Reviewed: August 2026

Version ID: 2/BIM/PST/08/26

Brodalumab is a monoclonal antibody (a type of biologic medicine) used to treat adults with moderate to severe plaque psoriasis.

How does it work?
Brodalumab works by binding to the interleukin-17 receptor A (IL-17RA). This blocks the activity of several inflammatory proteins, including IL-17A, IL-17F and IL-25, reducing inflammation and slowing the rapid growth of skin cells seen in psoriasis.

Who can get it?
Brodalumab is recommended for adults with severe plaque psoriasis when:

• the disease has not responded to conventional systemic therapies,
• those treatments are unsuitable,
• or they are not tolerated.

How is it used?
The recommended dose is 210 mg given as a subcutaneous injection at weeks 0, 1 and 2, followed by 210 mg every two weeks. After appropriate training, most people give the injections themselves at home.

What are the side effects?

Crohns Disease
Brodalumab should not be used in patients with active Crohn's disease.  Patients with a history of Crohn's disease require careful monitoring. If patients develop active Crohn's disease, treatment should be discontinued permanently.

Suicidal ideation and behaviour
Suicidal ideation and behaviour, including completed suicide, have been reported in patients treated with Brodalumab. The majority of patients with suicidal behaviour had a history of depression and/or suicidal ideation or behaviour. A causal association between treatment with Brodalumab and increased risk of suicidal ideation and behaviour has not been established.

The risk and benefit of treatment with Brodalumab should be carefully weighed for patients with a history of depression and/or suicidal ideation or behaviour, or for patients who develop such symptoms. Patients, caregivers, and families should be advised of the need to be alert for the emergence or worsening of depression, suicidal ideation, anxiety, or other mood changes, and they should contact their healthcare provider if such events occur. If a patient suffers from new or worsening symptoms of depression and/or suicidal ideation or behaviour is identified, it is recommended to discontinue treatment with Brodalumab.

Infections
Brodalumab may increase the risk of infections. Caution should be exercised when considering the use of Brodalumab in patients with a chronic infection or a history of recurrent infection. Patients should be instructed to seek medical advice if signs or symptoms suggestive of an infection occur. If a patient develops a serious infection, the patient should be closely monitored and Brodalumab should not be administered until the infection resolves.

No cases of active tuberculosis were reported from clinical trials. However, Brodalumab should not be given to patients with active tuberculosis. Anti-tuberculosis therapy should be considered prior to initiation of Brodalumab in patients with latent tuberculosis.

Other serious side effects have been reported including:

Common

• Influenza
• Tinea infections (including tinea pedis, tinea versicolor, tinea cruris)
• Neutropenia
• Headache
• Eye disorders
• Oropharyngeal pain
• Diarrhoea
• Nausea
• Arthralgia
• Myalgia
• Fatigue
• Injection site reactions (including injection site erythema, pain, pruritus, bruising, haemorrhage)
• upper respiratory tract infections (common)
• oral candidiasis (common within the broader Candida category)

Uncommon

• Candida infections (including oral, genital, and oesophageal infections)
• Conjunctivitis

Before treatment patients will usually be assessed for:

• tuberculosis
• hepatitis B (where appropriate)
• other infections
• vaccination status

During treatment advise patients to seek medical advice if they develop:

• persistent fever
• signs of infection
• severe diarrhoea or symptoms of Crohn's disease
• changes in mood or suicidal thoughts

 How do I get brodalumab?

Brodalumab is prescribed by a specialist dermatologist and is usually supplied through hospital or homecare services. Most people administer the injections themselves after appropriate training.

Available Gudiance

National Institute for Health and Care Excellence (NICE) guidance

Scottish Medicine Consortium guidance

All Wales Medicines Strategy Group

Department of Health (Northern Ireland)

Marketed by

Brodalumab is known commercially in the UK (and Europe) as Kyntheum (210 mg solution for injection in pre-filled syringe) and is marketed in the UK by LEO Pharma.

In the United States of America the product is commercially known as Siliq.

Reviewed: August 2026

Version ID: 2/BRO/PST/08/26

Certolizumab pegol is a biologic medicine used to treat adults with moderate to severe plaque psoriasis who are suitable for systemic treatment (medicines that work throughout the body).

How does it work?

Certolizumab pegol blocks tumour necrosis factor-alpha (TNF-α), a chemical ‘messenger’ in the immune system that signals other cells to cause inflammation. People with psoriasis have increased levels of TNF-α in affected skin, contributing to inflammation and the rapid growth of skin cells. TNF-α can also lead to increased immune system activity through the activation of immune cells, including T-cells. T-cells are a type of white blood cell in the body. In psoriasis, once T-cells are mistakenly activated, they can trigger inflammation and other immune responses and fuel the development of psoriasis lesions.

Certolizumab pegol helps lower the amount of TNF-α, thus interrupting the inflammatory cycle of psoriasis and leading to improvement in symptoms for many people who receive it.

Who can get it?

NICE recommends certolizumab pegol for adults with severe plaque psoriasis when:

• conventional systemic treatments have failed,
• are contraindicated,
• or are not tolerated.

How is it used?

Treatment starts with 400 mg (given as two injections of 200 mg) at weeks 0, 2 and 4. After this, the usual maintenance dose is 200 mg every two weeks. Some people may receive a different dosing schedule based on their response to treatment.

What are the side effects?

Serious side effects (seek urgent medical advice)

• signs of severe infection
• allergic reactions
• unexplained bruising or bleeding
• worsening heart failure
• severe skin reactions
• symptoms suggestive of tuberculosis

Common side effects

• upper respiratory infections
• headache
• rash
• injection-site reactions
• nausea
• fatigue

Before treatment patients are usually screened for:

• tuberculosis
• hepatitis B (where appropriate)
• other infections

Vaccination

Live vaccines should generally be avoided during treatment.

How do I get certolizumab pegol

Certolizumab pegol is prescribed by a specialist and is usually self-injected at home after appropriate training.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health (Northern Ireland)

Marketed by

Certolizumab pegol is known commercially as Cimzia and is marketed in the UK by UCB Pharma Ltd

Reviewed: August 2026

Version ID: 2/CEP/PST/08/26

Etanercept is a biologic medicine used to treat moderate to severe plaque psoriasis, psoriatic arthritis and several other inflammatory conditions. It belongs to a group of medicines called tumour necrosis factor (TNF) inhibitors.

How does it work?

Etanercept blocks tumour necrosis factor-alpha (TNF-alpha), a chemical "messenger" in the immune system that signals other cells to cause inflammation. People with psoriasis have increased levels of TNF-α in affected skin, contributing to inflammation and the rapid turnover of skin cells.
TNF-α can also lead to increased immune system activity through the activation of T-cells. T-cells are a type of white blood cell in the body; in psoriasis, once T-cells are mistakenly activated, they can trigger inflammation and other immune responses and fuel the development of psoriasis lesions.
Etanercept helps lower the amount of TNF-α, thus interrupting the inflammatory cycle of psoriasis and psoriatic arthritis and leading to improvement in symptoms for many people who take it.

Who can get it?

NICE recommends etanercept for adults with severe chronic plaque psoriasis when:

• conventional systemic therapies have failed,
• are contraindicated,
• or are not tolerated.

How is it used?

The usual starting dose for adults with plaque psoriasis is 50 mg given by subcutaneous injection twice weekly for the first 12 weeks. If treatment is continued, the usual maintenance dose is 50 mg once weekly. Your specialist will regularly review your response to treatment and decide whether it should continue.

What are the side effects?

Common side effects are:

• dizziness
• sore throat
• cough
• stomach pain
• injection site reactions (redness, itching, pain, swelling)
• upper respiratory infections
• headache
• rhinitis (irritation of the nose)

These side effects were generally mild and did not cause most patients to stop taking etanercept. These events happened most often after the first dose of etanercept and may decrease after additional doses.

Less common side effects

• serious infections (including tuberculosis)
• allergic reactions
• injection-site reactions (already included)
• worsening heart failure
• blood disorders
• demyelinating disorders
• lupus-like syndrome
• non-melanoma skin cancer (rare)

Patients should also be advised to seek urgent medical advice if they develop signs of infection.

Before treatment

Patients are usually screened for:

• tuberculosis
• hepatitis B (where appropriate)
• other infections

Vaccinations

Live vaccines should generally be avoided while receiving etanercept.

How do I get etanercept?

Etanercept is available by prescription, primarily from rheumatologists and dermatologists.

Available Gudiance

National Institute for Health and Care Excellence (NICE) guidance

Scottish Medicine Consortium guidance

All Wales Medicines Strategy Group

Department of Health (Northern Ireland)

Etanercept is known commercially as:
Benepali, Enbrel and Erelzi

Reviewed: August 2026

Version ID: 2/ETA/PST/08/26

Guselkumab is a biologic medicine used to treat adults with moderate to severe plaque psoriasis who are suitable for systemic treatment (medicines that work throughout the body).

How does it work?

Guselkumab is a monoclonal antibody that selectively targets interleukin-23 (IL-23), an important protein involved in the inflammation that causes psoriasis. By blocking IL-23, it reduces inflammation and slows the overproduction of skin cells, helping to clear psoriasis plaques.

Who can get it?

It is for use in adults with moderate to severe plaque psoriasis when:

• conventional systemic treatments have failed,
• are contraindicated,
• or are not tolerated.

It can improve the condition of the skin and appearance of nails and reduce symptoms, such as scaling, shedding, flaking, itching, pain and burning.

How is it used?

Guselkumab is given as a subcutaneous injection. The usual dose is 100 mg at week 0, another 100 mg at week 4, followed by 100 mg every 8 weeks thereafter.

What are the side effects?

Serious side effects:

Possible serious allergic reaction (may affect up to 1 in 100 people) - the signs may include: -

• difficulty breathing or swallowing
• swelling of the face, lips, tongue or throat
• severe itching of the skin, with a red rash or raised bumps

Mild to moderate side effects

Some side effects are very common (may affect more than 1 in 10 people):

• respiratory tract infections
• headache
• joint pain (arthralgia)
• diarrhoea
• redness, irritation or pain at the injection site
• increased level of liver enzymes in the blood

Some side effects are uncommon (may affect up to 1 in 100 people):

• allergic reaction
• skin rash
• decreased number of a type of white blood cell called neutrophils
• herpes simplex infections - fungal infection of the skin, for instance between the toes (e.g., athlete’s foot)
• stomach flu (gastroenteritis)
• hives

Seek medical advice if symptoms of infection develop.

Before treatment

Patients are usually assessed for:

• tuberculosis
• infections
• vaccination status

During treatment

Patients should seek medical advice if they develop:

• persistent fever
• signs of infection
• symptoms of an allergic reaction

Vaccinations

Live vaccines should generally be avoided during treatment.

How do I get Guselkumab

Guselkumab is prescribed by a specialist dermatologist. After appropriate training, most people administer the injections themselves at home.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health (Northern Ireland)

Marketed by

Guselkumab is known commercially as Tremfya and is marketed in the UK by Janssen-Cilag Ltd

Reviewed: August 2026

Version ID: 2/GUS/PST/08/26

Infliximab is a biologic medicine used to treat adults with moderate to severe plaque psoriasis when conventional systemic treatments have not worked, are not suitable or are not tolerated.

How does it work?

Infliximab blocks tumour necrosis factor-alpha (TNF-α), a chemical "messenger" in the immune system that signals other cells? to cause inflammation. People with psoriasis have increased levels of TNF-α in affected skin, contributing to inflammation and the rapid growth of skin cells.

TNF-α can also lead to increased immune system activity through the activation of immune cells, including T-cells. T-cells are a type of white blood cell in the body; in psoriasis, once T-cells are mistakenly activated, they can trigger inflammation and other immune responses and fuel the development of psoriasis lesions.

Infliximab helps lower the amount of TNF-α, thus interrupting the inflammatory cycle of psoriasis and leading to improvement in symptoms for many people who take it.

Who can get it?

Infliximab is for use in adults with severe plaque psoriasis when:

• conventional systemic therapies have failed,
• are contraindicated,
• or are not tolerated.

How is it used?

Infliximab is given by intravenous infusion in hospital. The usual dose is 5 mg/kg at weeks 0, 2 and 6, followed by an infusion every 8 weeks. Each infusion usually takes around 2 hours, although some patients who tolerate treatment well may be able to receive shorter infusions in accordance with local practice.

What are the side effects?

The most common side effects of infliximab are:

Viral infections, fever, headache, vertigo, dizziness, flushing, upper or lower respiratory tract infection, dyspnoea, sinusitis, GI upset, skin reactions, fatigue, chest pain, increased transaminases, infusion-related reactions. Delayed hypersensitivity reactions may occur if patient retreated after a drug free interval. Signs and symptoms include: myalgia and or/arthralgia with fever and/or rash, with some patients experiencing pruritus, facial, hand and lip oedema, dysphagia, urticaria, sore throat and headache. Rare, usually fatal, hepatosplenic T-cell lymphoma (this has been reported very rarely, mainly in younger patients receiving infliximab with other immunosuppressive medicines for inflammatory bowel disease).

Safety information

• serious bacterial infections
• tuberculosis
• opportunistic infections
• hepatitis B reactivation
• worsening heart failure
• demyelinating disorders
• lupus-like syndrome
• severe allergic reactions

Before treatment patients are usually screened for:

• tuberculosis
• hepatitis B (and sometimes hepatitis C)
• infections
• heart failure where appropriate

 Vaccinations

Live vaccines should generally be avoided during treatment.

How do I get infliximab?

Infliximab is prescribed by a specialist and is administered in hospital or an infusion unit under medical supervision.

Further guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance All Wales Medicines Strategy Group
Department of Health (Northern Ireland)

Infliximab is known commercially as: Flixabi, Inflectra, Remicade, Remsima and Zessly

Reviewed: August 2026

Version ID: 2/INF/PST/08/26

Ixekizumab is a biologic medicine used to treat adults with moderate to severe plaque psoriasis who require systemic treatment (medicines that work throughout the body).How does it work?

By blocking IL-17A, ixekizumab reduces inflammation and helps improve psoriasis symptoms such as scaling, redness, itching and pain. It is used to treat “plaque psoriasis” in adults with moderate to severe disease. It reduces the signs and symptoms of scaling, itching and pain.

Who can get it?

It is for use in adults with severe plaque psoriasis when:

• conventional systemic treatments have failed,
• are not tolerated,
• or are unsuitable.
  
  

How is it used?

Ixekizumab is given by injection under the skin (subcutaneous injection).

The recommended starting dose is 160 mg (two 80 mg injections) at week 0, followed by 80 mg every two weeks until week 12. After this, the usual maintenance dose is 80 mg every four weeks.If there is no response after 16 – 20 weeks the treatment should be reassessed.

What are the side effects?

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Serious side effects

Possible serious infection (may affect up to 1 in 100 people) - the signs may include:

• fever, flu-like symptoms, night sweats
  •   feeling tired or short of breath, cough which will not go away
  •   warm, red and painful skin, or a painful skin rash with blisters

Serious allergic reaction - the signs may include:

• difficulty breathing or swallowing
• swelling of the face, lips, tongue or throat
• severe itching of the skin, with a red rash or raised bumps

Other side effects that have been reported

Some side effects are very common (may affect more than 1 in 10 people):

• upper respiratory tract infections with symptoms such as sore throat and stuffy nose (nasopharyngitis).
• injection site reactions (e.g. red skin, pain).

Some side effects are common (may affect up to 1 in 10 people):

• nausea (feeling sick).
• tinea (fungal) infections such as athlete’s foot.
• pain in the back of the throat.

Some side effects are uncommon (may affect up to 1 in 100 people):

• oral thrush (oral candidiasis).
• runny nose.
• bacterial skin infection.
• discharge from the eye with itching, redness and swelling (conjunctivitis).
• signs of low levels of white blood cells, such as fever, sore throat or mouth ulcers due to infections (neutropenia).
• low blood platelet count (thrombocytopenia).

Patients should seek medical advice if they develop:

• persistent diarrhoea
• abdominal pain
• blood in the stool

Before treatment patients are usually screened for:

• tuberculosis
• infections
• vaccination status

How do I get Ixekizumab?

Ixekizumab is prescribed by a specialist dermatologist. After appropriate training, most people administer the injections themselves at home.

Available Gudiance
National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health (Northern Ireland)

Marketed by

Ixekizumab is known commercially as Taltz and is marketed in the UK by Eli Lilly and Company Limited.

Reviewed: August 2026

Version ID: 2/ETA/PST/08/26

Risankizumab is a biologic medicine used to treat adults with moderate to severe plaque psoriasis who are suitable for systemic treatment (medicines that work throughout the body).

How does it work?

Risankizumab works by selectively blocking interleukin-23 (IL-23), a protein involved in the inflammation that causes psoriasis. By reducing IL-23 activity, it helps decrease inflammation and slows the overproduction of skin cells.

Who can get it?

It is for for adults with severe plaque psoriasis when conventional systemic treatments have failed, are unsuitable or are not tolerated.

How is it used?

Risankizumab is given as a subcutaneous injection. The usual dose is 150 mg at week 0, another 150 mg at week 4, followed by 150 mg every 12 weeks. Most people administer the injection themselves after appropriate training.

What are the side effects?

Serious side effects

• fever, flu-like symptoms, night sweats
• feeling tired or short of breath, cough which will not go away
• warm, red and painful skin, or a painful skin rash with blisters

Very common: may affect more than 1 in 10 people

• upper respiratory infections with symptoms such as sore throat and stuffy nose

Common: may affect up to 1 in 10 people

• feeling tired
• fungal skin infection
• injection site reactions (such as redness or pain)
• itching
• headache

Uncommon: may affect up to 1 in 100 people

• small raised red bumps on the skin

Before treatment

Patients are usually assessed for:

• tuberculosis
• infections
• vaccination status

During treatment

Patients should seek medical advice if they develop:

• persistent fever
• signs of infection
• symptoms of an allergic reaction

 How do I get risankizumab?

Risankizumab is prescribed by a specialist dermatologist. After appropriate training, most people administer the injections themselves at home.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health (Northern Ireland)

Marketed by

Risankizumab is known commercially as Skyrizi and is marketed in the UK by AbbVie Ltd.

Reviewed: August 2026

Version ID: 2/RIS/PST/08/26

Secukinumab is a biologic medicine used to treat adults with moderate to severe plaque psoriasis who require systemic treatment.

How does it work?
Secukinumab is a monoclonal antibody that selectively binds to and neutralises interleukin-17A (IL-17A), a protein involved in the development of psoriasis and found in significantly higher concentrations in psoriasis-affected skin. This inhibits the release of proinflammatory cytokines, chemokines and mediators of tissue damage and reduces IL-17A-mediated contributions to autoimmune and inflammatory diseases.

Who can get it?
For psoriasis, secukinumab is licensed for adults with moderate to severe plaque psoriasis who are candidates for systemic therapy.

Do not use if:

• you are allergic to secukinumab or any of the other ingredients of this medicine
• you have an active infection which your doctor thinks is important.

Warnings and precautions .  Tell your doctor or pharmacist before using secukinumab if:

• you currently have an infection or if you have long-term or repeated infections.
• you have tuberculosis.
• you have ever had an allergic reaction to latex.
• you have Crohn’s disease.
• you have recently had a vaccination or if you are due to have a vaccination during treatment with secukinumab
• you are receiving any other treatment for psoriasis, such as another immunosuppressant or phototherapy with ultraviolet (UV) light.

How is it used?
Secukinumab is given as an injection. You and your health care provider should decide if you should inject secukinumab yourself of whether it should be done in a hospital setting. It is important not to try to inject yourself until you have been trained by your doctor, nurse or pharmacist. A caregiver may also give you your injection after proper training.

The recommended dose is 300 mg by subcutaneous injection at weeks 0, 1, 2, 3 and 4, followed by 300 mg every four weeks. Depending on the device supplied, the dose may be given as one 300 mg injection or two 150 mg injections.

What are the side effects?

• Serious side effects

Stop using secukinumab and tell your doctor or seek medical help immediately if you get any of the following side effects.

• fever, flu-like symptoms, night sweats
• feeling tired or short of breath, cough which will not go away
• warm, red and painful skin, or a painful skin rash with blisters
• burning sensation when passing urine.
  
  

Serious allergic reaction - the signs may include: 

• difficulty breathing or swallowing
• low blood pressure, which can cause dizziness or light-headedness
• swelling of the face, lips, tongue or throat
• severe itching of the skin, with a red rash or raised bumps.
  
  

Some side effects are very common (may affect more than 1 in 10 people): 

• upper respiratory tract infections with symptoms such as sore throat and stuffy nose (nasopharyngitis, rhinitis)
• cold sores (oral herpes)
• diarrhoea
• itchy rash (urticaria) 4
• runny nose (rhinorrhoea)

Some side effects are uncommon (may affect up to 1 in 100 people): 

• oral thrush (oral candidiasis)
• signs of low levels of white blood cells, such as fever, sore throat or mouth ulcers due to infections (neutropenia)
• athlete’s foot (tinea pedis)
• infection of the external ear (otitis externa)
• discharge from the eye with itching, redness and swelling (conjunctivitis).

• Inflammatory bowel disease
• New onset or worsening Crohn's disease and ulcerative colitis have been reported.

Patients should seek medical advice if they develop:

• persistent diarrhoea
• abdominal pain
• blood in the stool

Before treatment

Patients are usually assessed for:

• tuberculosis
• infection
• vaccination status

Further guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health (Northern Ireland)

Marketed by
Secukinumab is known commercially as Cosentyx and is marketed by Novartis.

Reviewed: August 2026

Version ID: 2/RIS/PST/08/26

Tildrakizumab is a biologic medicine used to treat adults with moderate to severe plaque psoriasis who require systemic treatment (medicines that work throughout the body).

How does it work?

Tildrakizumab selectively blocks interleukin-23 (IL-23), a protein that plays an important role in the inflammation associated with psoriasis. By reducing IL-23 activity, it helps decrease inflammation and improves psoriasis symptoms.

Who can get it?

It is for use in adults with moderate to severe plaque psoriasis when conventional systemic treatments have failed, are not tolerated or are unsuitable. Using tildrakizumab can help with skin clearance and reducing psoriasis symptoms.

How is it used?

The usual dose is 100 mg at week 0, week 4 and then every 12 weeks. In some patients, such as those weighing 90 kg or more, a 200 mg dose may be recommended by the specialist.

What are the side effects?

Serious side effects

• swelling of the face, lips or throat
• breathing difficulties

Very common side effects (may affect more than 1 in 10 people):

• upper respiratory infections

Common side effects (may affect up to 1 in 10 people):

• gastroenteritis
• nausea
• diarrhoea
• injection site pain
• back pain
• headache

Seek medical advice if they develop signs of infection, such as:

• fever
• persistent cough
• flu-like symptoms

 Before treatment patients are usually assessed for:

• tuberculosis
• active infections
• vaccination status

How do I get tildrakizumab?

Tildrakizumab is prescribed by a specialist dermatologist. After appropriate training, most people administer the injections themselves at home.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health (Northern Ireland)

Marketed by

Tildrakizumab is known commercially as Ilumetri and is marketed in the UK by Almirall Ltd.

Reviewed: August 2026

Version ID: 2/TIL/PST/08/26

Ustekinumab is a biologic medicine used to treat adults and children aged 6 years and over with moderate to severe plaque psoriasis who require systemic treatment.

How does it work?

Ustekinumab is a monoclonal antibody that blocks the activity of two proteins involved in inflammation, interleukin-12 (IL-12) and interleukin-23 (IL-23). These proteins play an important role in the immune processes that cause psoriasis. By blocking them, ustekinumab reduces inflammation and helps improve psoriasis symptoms.

Who can get it?

Ustekinumab is for use in adults and children aged 6 years and older with moderate to severe plaque psoriasis when other therapies, including ciclosporin, methotrexate and PUVA, are ineffective, not tolerated or contraindicated. 

How is it used?

Starting dose: For body weight under 100kg, initially take 45mg by subcutaneous injection and for body weight over 100kg, initially take 90mg by subcutaneous injection. Repeat the dose after 4 weeks then every 12 weeks thereafter. Consider stopping therapy if no response after 28 weeks.

What are the side effects?

Common side effects include (but are not limited to): Upper respiratory tract infection, nasopharyngitis, cellulitis, depression, dizziness, headache, pharyngolaryngeal pain, nasal congestion, diarrhoea, pruritus, back pain, myalgia, fatigue, injection site reactions

Precautions
Screen for TB prior to therapy; initiate treatment of latent TB before starting therapy. Do not start if active TB found; monitor for active TB during and after treatment. Consider anti-TB therapy prior to treatment for patients with a history of latent or active disease in whom an adequate course of TB treatment cannot be confirmed. Instruct patients to report any signs or symptoms of infection; if serious infection develops, monitor closely and do not administer until resolved. Increased risk of malignancy; caution in patients with a history of malignancy or who develop malignancy during treatment. Discontinue immediately in case of anaphylactic or other serious allergic reaction. Upper respiratory tract infection, nasopharyngitis, cellulitis, depression, dizziness, headache, pharyngolaryngeal pain, nasal congestion, diarrhoea, pruritus, back pain, myalgia, fatigue, injection site reactions.

In patients with psoriasis, exfoliative dermatitis has been reported following ustekinumab treatment. Patients with plaque psoriasis may develop erythrodermic psoriasis, with symptoms that may be clinically indistinguishable from exfoliative dermatitis, as part of the natural course of their disease. As part of the monitoring of the patient’s psoriasis, physicians should be alert for symptoms of erythrodermic psoriasis or exfoliative dermatitis. If these symptoms occur, appropriate therapy should be instituted. STELARA should be discontinued if a drug reaction is suspected.

Patients should seek medical advice if they develop:

• fever
• persistent cough
• unexplained infections

How do I get ustekinumab?

Ustekinumab is prescribed by a specialist dermatologist. After appropriate training, most people administer the injections themselves at home.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance

Scottish Medicine Consortium guidance

All Wales Medicines Strategy Group

Department of Health (Northern Ireland)

Ustekinumab is known commercially as:  

Reviewed: August 2026

Version ID: 2/UST/PST/08/26

This page is for reference only as this product is now discontinued

Alphosyl® 2 in 1 Medicated Shampoo is used to treat scalp conditions such as psoriasis, seborrhoeic dermatitis, eczema and dandruff, helping to reduce itching, scaling and flaking.

How does it work?

The active ingredient is alcoholic extract of coal tar. Coal tar helps slow the rapid production of skin cells, reduces scaling, softens thickened skin and relieves itching and inflammation associated with scalp psoriasis and other scalp conditions.

Who can get it?

Alphosyl 2 in 1 is available over the counter from pharmacies. If using it in young children, seek advice from a pharmacist or doctor. It should not be used in the following circumstances:

• If you have ever had an allergic reaction to coal tar
• To treat infected, open or damaged skin
• To treat sore or acute pustular psoriasis

How is it used?

Use Alphosyl 2 in 1 Shampoo once or twice a week for four weeks.

• Wet hair thoroughly
• Use enough shampoo so that the lather is sufficient to cover your scalp, hair and adjacent areas, if also affected
• Massage the scalp and adjacent areas, if needed, well using your fingertips
• Rinse your hair thoroughly
• Repeat steps 2 to 4
• Alphosyl 2 in 1 Shampoo should be in contact with your scalp for a total time of three to five minutes over the two applications.

Patients are advised to:

• avoid contact with the eyes
• rinse thoroughly if accidental eye contact occurs
• avoid excessive sunlight if increased sensitivity develops

What are the side effects?

Like all medicines, Alphosyl 2 in 1 Shampoo can have side effects, but not everyone gets them.
Stop the treatment and contact your doctor immediately if you experience:
Allergic reactions which may be severe such as raised and itchy skin rash (hives), swelling of the face or mouth or difficulty breathing.
Some of the below effects can also be symptoms of the condition you are treating. However, if you experience any of these effects for the first time after starting use, or if these effects worsen, stop  using Alphosyl 2 in 1 Shampoo and speak to your doctor or pharmacist:

• eye irritation
• unusual hair loss or thinning
• eczema (itchy skin rash)
• hair colour changes
• abnormal hair texture
• sensitivity to sunlight
• skin irritation, skin may be dry, red or itchy, you
• feel a burning sensation of the skin
• skin pain, rash or swelling at the application site.

Manufactured by

Alphosyl 2 in 1  is manufactured in the UK by Omega Pharma.

Reviewed: August 2026

Version ID: 2/ALP/PST/08/26

Capasal® Therapeutic Shampoo is a medicated shampoo used to treat scalp psoriasis, seborrhoeic dermatitis and other scaling scalp conditions. It contains ingredients with emollient, keratolytic and antipsoriatic properties.

Coal tar has a characteristic smell and may stain light-coloured fabrics, but it remains an effective treatment for many people with scalp psoriasis.

How does it work?

Capasal contains coal tar, salicylic acid and coconut oil. Coal tar helps slow the excessive production of skin cells and relieves itching. Salicylic acid softens and removes scales, while coconut oil moisturises the scalp and helps loosen thickened skin.

Who can get it?

Capasal is available on NHS prescription for adults and children and can be bought over the counter from your local pharmacy.

How is it used?

For adults, children and the elderly: Use as a shampoo, daily if necessary. Wet the hair thoroughly. Massage a small amount of the shampoo into the scalp, leaving on for a few minutes before washing out.

Repeat, producing a rich lather. Rinse hair well and dry.

What are the side effects?

• skin irritation
• redness
• burning
• itching
• rash
• allergic contact dermatitis
• photosensitivity (rare)
• avoid using on broken or infected skin unless advised by a healthcare professional
• seek medical advice if symptoms worsen or fail to improve
• avoid contact with the eyes
• rinse immediately if accidental eye contact occurs
• Discontinue use if sensitivity occurs.

Manufactured by

Capasal is manufactured in the UK by Dermal Laboratories Ltd.

Reviewed: August 2026

Version ID: 2/CAP/PST/08/26

Cocois® Scalp Ointment is a medicated scalp treatment used to treat psoriasis, seborrhoeic dermatitis, dandruff and other scaling disorders of the scalp.

How does it work?

Cocois® Scalp Ointment is a medicated scalp treatment used to treat psoriasis, seborrhoeic dermatitis, dandruff and other scaling disorders of the scalp.

Who can get it?

Cocois is available over the counter from your local pharmacy.

It should not be used in the following circumstances.
• Sensitivity to any of the ingredients
• Ask your doctor before use during pregnancy
• Children under 6 years of age
• Pustular psoriasis
• Acute infection of the skin.

How is it used?

Apply to scalp, shampoo after 1 hour. Use daily for 3—7 days then intermittently

What are the side effects?

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Abnormal reaction of the skin to light, usually a rash (photosensitivity)
• Skin irritation
• Inflammation of the hair follicles
• Cocois can stain clothing and jewellery
• allergic skin reactions
• redness
• burning
• itching

Manufactured by

Cocois is manufactured in the UK by Focus Pharmaceuticals Ltd

Reviewed: August 2026

Version ID: 2/COC/PST/08/26

Exorex® is a coal tar preparation used to help relieve the symptoms of psoriasis affecting the skin and scalp.  Exorex contains prepared coal tar in a moisturising lotion base.

How Does it Work?

Coal tar is mildly antiseptic and relieves itching. It also acts as a keratolytic, which works to break down a protein which forms part of the skin structure called keratin. Skin thickening occurs due to the deposition of keratin. Coal tar helps slow the excessive production of skin cells, reducing scaling and thickening of the skin. It also relieves itching and has mild anti-inflammatory and antiseptic properties.

Who Can Get It?

Exorex is available over the counter from your local chemist. For children and the elderly, it should usually be used only on the advice of a doctor or pharmacist.

How is it Used?

Body

Before each treatment cleanse the affected areas gently using non-irritant cleaners. Pat dry.

Apply to the affected areas of your body. Don’t worry if the lotion gets onto good skin – no harm will be done. Apply sufficient lotion so that it dries in approximately two minutes.

Once the lotion has dried it is a good idea to apply a moisturiser to the affected areas and massage it in gently until it dries.

Repeat the regime at midday and in the evening.

Scalp

Shampoo hair with a non irritant shampoo. Apply lotion to the affected areas of the scalp and massage in lightly for a minute.

General Use

Do not rinse off.

For external use only, avoid contact with the eyes.

Discontinue use if sensitivity occurs.

• avoid use on broken or infected skin unless advised by a healthcare professional
• coal tar may stain clothing and bedding
• increased sensitivity to sunlight may occur
• avoid excessive UV exposure during treatment

Side effects

• skin irritation
• redness
• itching
• burning
• allergic skin reactions
• folliculitis
• photosensitivity
• staining of clothing and light-coloured hair

Manufactured by

Exorex is available as a lotion, moisturising cream and hair and body shampoo and is manufactured in the UK byTeva UK Limited .

Reviewed: August 2026

Version ID: 2/EXO/PST/08/26

Pentrax Shampoo is used to treat scalp psoriasis and help relieve itching, irritation, redness, flaking and scaling. It belongs to the group of treatments known as antipsoriatics.

How does it work?

Coal tar is mildly antiseptic and relieves itching. It also acts as a keratolytic, which works to break down a protein which forms part of the skin structure called keratin. Skin thickening occurs due to the deposition of keratin. Coal tar helps slow the excessive production of skin cells, reducing scaling and thickening of the skin. It also relieves itching and has mild anti-inflammatory and antiseptic properties.

Who can get it?

Pentrax is available for adults and children and can be bought over the counter from most local chemists.

How is it used?

Shampoo should be massaged into wet hair and scalp to produce a lather. The hair should be rinsed and the procedure repeated applying a liberal amount of shampoo and allowing the lather to remain on the hair for up to 10 minutes. Hair should be rinsed thoroughly.

Avoid contact with the eyes. If shampoo gets into the eyes rinse thoroughly with water.

What are the side effects?

• skin irritation
• redness (erythema)
• itching
• allergic skin reactions (hypersensitivity)
• folliculitis (rare)
• increased sensitivity to sunlight (photosensitivity)
• staining of fabrics or light-coloured hair (where applicable)

Pentrax Shampoo may cause irritation to the skin. Erythema and hypersensitivity to coal tar has been reported.

Precautions

• discontinue treatment if severe irritation develops
• seek medical advice if symptoms worsen or fail to improve
• avoid excessive exposure to sunlight or UV treatment if photosensitivity occurs

Manufactured by

Pentrax is manufactured in the UK by Alliance Pharmaceuticals Ltd

Reviewed: August 2026

Version ID: 2/PEN/PST/08/26

Psoriderm is a coal tar-based topical treatment used for sub-acute and chronic psoriasis, including psoriasis affecting the skin, scalp and skin folds (flexures). It belongs to the group of treatments known as antipsoriatics.

How does it work?

Psoriderm contains distilled coal tar. Coal tar helps reduce the excessive production of skin cells that occurs in psoriasis, helping to reduce thickening and scaling. It can also help relieve itching. The precise way coal tar works is not fully understood. It also acts as a keratolytic which works to break down a protein which forms part of the skin structure called keratin.
Skin cells are thickened due to the deposition of keratin. Coal tar therefore helps to reduce the excessive hardening, thickening and scaling of the skin.

The cream is used for sub-acute or chronic plaque psoriasis affecting the skin and scalp.

The scalp lotion however is specifically designed to only treat psoriasis affecting the scalp.

Who can get it?

Psoriderm is available on prescription.

How is it used?

Cream

Apply a thin layer to the affected areas once or twice daily, or as directed by your doctor.

Scalp lotion

Use as a shampoo, daily if necessary, reducing to once or twice a week as the condition improves and then occasionally if required. It should be massaged gently into the scalp to produce a rich lather and retained for a few minutes before rinsing.

What are the side effects?

Psoriderm may cause skin irritation in some people. If you develop significant irritation, redness, burning, itching or an allergic reaction, stop using the product and speak to your doctor or pharmacist.

Manufactured by

Psoriderm is manufactured in the UK by Diomed Developments Limited, trading as Dermal Laboratories.

Reviewed: August 2026

Version ID: 2/PSO/PST/08/26

Polytar is a range of topical tar preparations that has been used to help manage conditions such as psoriasis, eczema, dandruff and itchy or inflamed skin conditions. Tar preparations can help reduce itching and scaling and may be used as part of a treatment plan for psoriasis.

How does it work?

Tar preparations have antipruritic (anti-itching), keratoplastic and mild antiseptic properties. They can help reduce itching and the excessive scaling and thickening of the skin associated with conditions such as psoriasis.

The exact way in which coal tar works is not fully understood. Different tar preparations may contain different combinations of ingredients, so their effects and directions for use can vary between products.

Who can get it?

The suitability of a Polytar product depends on the particular preparation and the individual person's age and skin condition.

Because some older Polytar products may no longer be routinely marketed in the UK, patients should check with a pharmacist or healthcare professional about current availability and whether a particular product is appropriate.

How is it used?

Directions vary according to the individual Polytar preparation. Always follow the instructions supplied with the product or those given by your doctor or pharmacist.

Tar preparations may be used on the scalp or added to bath water, depending on the product.

Do not use more frequently or in larger amounts than recommended.

What are the side effects?

Possible side effects of topical tar preparations include:

• Skin irritation
• Redness or rash
• Increased sensitivity to sunlight (photosensitivity)

If significant irritation or a new rash develops, stop using the product and speak to your doctor or pharmacist.

Tar preparations may also stain clothing, bedding or other materials and can have a strong smell.

Important information

Coal tar preparations can increase sensitivity to sunlight. Avoid excessive exposure to direct sunlight and follow the product instructions regarding sun exposure.

The exact ingredients, uses, age restrictions and directions differ between products, so always check the individual product information before use.

Manufactured by

The Polytar range is manufactured in the Republic of Ireland by Stiefel Laboratories (Ireland) Ltd and marketed in the UK by Stiefel Laboratories (UK) Ltd.

Reviewed August 2026

Version ID: 2/POL/PST/08/26

Polytar Scalp Shampoo is a coal tar treatment used for scalp conditions such as psoriasis, seborrhoeic dermatitis, eczema, dandruff, itching and scaling. It contains coal tar solution 4%. It is available without a prescription in the UK.

How does it work?
Coal tar helps to reduce inflammation, itching and scaling of the skin. It also slows down excessive skin-cell growth, which can help reduce the thickening and scaling associated with conditions such as scalp psoriasis.

Coal tar also has mild antiseptic properties and can help soothe an itchy, inflamed scalp.

Who can get it?
Polytar Scalp Shampoo is suitable for adults and children over 12 years of age. It is available from pharmacies without a prescription.

If you are unsure whether Polytar Scalp Shampoo is suitable for you or your child, speak to a pharmacist or doctor.

How is it used?

Always read the product instructions before use.

1. Wet the hair and scalp thoroughly.
2. Apply enough shampoo to produce a rich lather.
3. Gently massage the shampoo into the scalp and surrounding areas.
4. Leave the shampoo in contact with the scalp for a total of 3–5 minutes.
5. Rinse thoroughly.
6. Repeat the application and rinse again.

For scalp psoriasis, the shampoo is generally used once or twice a week.

Avoid contact with the eyes. If the shampoo gets into the eyes, rinse thoroughly with water.

What are the side effects?
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any

Like all medicines, Polytar Scalp Shampoo can cause side effects, although not everyone will experience them.

Possible side effects include:

• Skin irritation
• Skin rash
• Increased sensitivity of the skin to sunlight (photosensitivity)

Stop using the shampoo and speak to a doctor or pharmacist if you develop significant irritation or another reaction that concerns you.

 Polytar Scalp Shampoo is marketed in the UK by GSK group of companies. 

Reviewed: August 2026

Version ID: 2/PSS/PST/08/26

Sebco is a coal tar preparation used to help treat scalp conditions such as psoriasis. Coal tar preparations can help reduce itching, inflammation, thickening and scaling of the scalp.

How does it work?

Coal tar has antipruritic (anti-itching), anti-inflammatory and mild antiseptic properties. It can help slow excessive skin-cell growth and reduce the thickening and scaling associated with psoriasis.

Who can get it?

Sebco is available over the counter from your local pharmacy for adults and children over the age of 6.

How is it used?

Always follow the instructions supplied with the product.

Apply to scalp, shampoo after 1 hour.

Use daily for 3—7 days then intermittently

What are the side effects?

Like other coal tar preparations, Sebco may cause skin irritation in some people.

Possible effects may include:

• Skin irritation or redness
• Skin rash
• Increased sensitivity to sunlight (photosensitivity)

Stop using the product and speak to a pharmacist or doctor if significant irritation or another reaction develops.

Important

Coal tar preparations can increase the skin's sensitivity to sunlight. Avoid excessive exposure to sunlight or ultraviolet (UV) light while using coal tar preparations and follow the advice supplied with the product.

Manufactured by

Sebco is manufactured in the UK by Derma UK

Reviewed: August 2026

Version ID: 2/SEB/PST/08/26

This page is for reference only as this product is now discontinued

Neutrogena T/Gel Therapeutic Shampoo is a medicated shampoo containing Neutar™ solubilised coal tar extract. It is used to treat itchy, flaky scalp conditions including scalp psoriasis, seborrhoeic dermatitis and dandruff.

The shampoo is designed to help reduce itching, flaking and redness of the scalp.

How does it work?

The active ingredient is Neutar™ solubilised coal tar extract. Coal tar helps to slow excessive growth of skin cells and can reduce the thickening and scaling associated with scalp psoriasis.

It also has anti-itching, anti-inflammatory and mild antiseptic properties, which can help relieve symptoms such as itching and redness.

Who can get it?

Neutrogena T/Gel Therapeutic Shampoo is intended for adults and children aged 12 years and over.

It should not be used in children under 12 years of age.

Do not use it if you are allergic to coal tar or any of the other ingredients.

It should not be used on acutely inflamed or broken skin, erythrodermic psoriasis or generalised pustular psoriasis.

How is it used?

Always read the instructions supplied with the product before use.

1. Wet the hair and scalp thoroughly.
2. Apply a liberal amount of shampoo and massage it into the scalp to produce a rich lather.
3. Leave the lather on the scalp for several minutes.
4. Rinse thoroughly and repeat the application.
5. Rinse the scalp thoroughly again, taking care to avoid contact with the eyes.

For scalp psoriasis, dandruff and seborrhoeic dermatitis, the shampoo is used two or three times a week.

Treatment usually lasts for about six weeks. If there is no improvement after six weeks, speak to your doctor or pharmacist. Longer treatment should only be undertaken under medical supervision.

If irritation develops, stop using the shampoo and speak to your doctor or pharmacist.

Coal tar can increase sensitivity to sunlight, so take care with exposure to sunlight while using the product.

What are the side effects?

Like all medicines, Neutrogena T/Gel Therapeutic Shampoo can cause side effects, although not everyone will experience them.

Possible side effects include:

• Skin irritation
• Skin rash
• Increased sensitivity to sunlight (photosensitivity)
• Temporary discolouration of grey, blonde, bleached or tinted hair

Stop using the shampoo if significant irritation develops and speak to your doctor or pharmacist if necessary.

Manufactured by

Neutrogena Tgel is manufactured in the UK by Johnson and Johnson Ltd

Reviewed: August 2026

Version ID: 2/NTG/PST/08/26

Ceanel Concentrate® is a topical liquid used for the management of psoriasis of the scalp, seborrhoeic dermatitis, dandruff and psoriasis affecting other areas of the body, including the trunk and limbs.

It contains three active ingredients: cetrimide, undecenoic acid and phenylethyl alcohol. Cetrimide is an antiseptic and cleansing agent, undecenoic acid has antifungal properties, and phenylethyl alcohol has antiseptic and antimicrobial properties.

How does it work?

Ceanel Concentrate® contains:

• Cetrimide, an antiseptic and cleansing agent that helps remove scales, debris and microorganisms from the skin.
• Undecenoic acid, which has antifungal properties and helps control fungal organisms on the skin.
• Phenylethyl alcohol, which has antiseptic and antimicrobial properties.

Together, these ingredients help cleanse the skin and scalp and control microorganisms that can contribute to conditions such as dandruff and seborrhoeic dermatitis.

Who can get it?

Ceanel concentrate is for topical use only for adults, young children and the elderly.

How is it used?

Scalp conditions

Wet the scalp and hair with warm water. Protect the eyes with a towel or keep the eyes closed to avoid discomfort.

Apply ½–1 teaspoonful of Ceanel Concentrate® to the scalp. Add a small amount of water and work into a lather. Rinse and repeat. Finally, rinse the hair and scalp thoroughly.

Use three times during the first week and then twice weekly.

Other areas of the body

Wet the area to be treated with warm water. Apply sufficient Ceanel Concentrate® by gentle massage to cover the affected area.

Leave in contact with the skin for two minutes, then rinse thoroughly with warm water.

Use as required.

Ceanel Concentrate® is for external use only. Take care to avoid contact with the eyes. If the product is accidentally swallowed, seek medical advice promptly.

What are the side effects?

Like all medicines, Ceanel Concentrate® can cause side effects, although not everybody gets them.

An allergic reaction may occur. If you develop an allergic reaction, if your symptoms persist, or if your condition becomes worse, stop using Ceanel Concentrate® and consult your doctor.

If you experience any side effects, speak to your doctor or pharmacist. This includes any possible side effects not listed in the product information.

Marketed by

Ceanel Concentrate is available over the counter from your local pharmacy. It is marketed in the UK by Alliance Pharmaceuticals Ltd.

Reviewed: August 2026

Version ID: 2/CEC/PST/08/26

This page is for reference only as this product is now discontinued

Aureocort is a potent topical corticosteroid combined with an antibacterial agent. It contains two active ingredients: triamcinolone acetonide, a potent corticosteroid, and chlortetracycline hydrochloride, an antibiotic. It is used for certain secondarily infected inflammatory skin conditions, including eczema and dermatitis. It should not be used to treat widespread plaque psoriasis.

Aureocort belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Chlortetracycline is an antibiotic belonging to the tetracycline group. It works against susceptible bacteria by interfering with their growth.

Triamcinolone acetonide is a corticosteroid that reduces inflammation, itching and other symptoms associated with inflammatory skin conditions. Corticosteroids control symptoms and signs while they are being used but do not cure the underlying condition. Treatment should therefore be used for the period recommended by your doctor.

Who can get it?

Aureocort can be used in adults, older people and children over 8 years of age. It is a prescription-only medicine.

How is it used?

Aureocort ointment should be applied sparingly to the affected area two or three times a day, as directed by your doctor. Apply a thin layer directly to the affected skin or, where advised, to sterile gauze.

Avoid contact with the eyes. If the ointment gets into your eyes, rinse them thoroughly with water.

Aureocort treatment should normally be limited to seven days. Do not use it for longer than advised by your doctor.

What are the side effects?

Some people may develop irritation or an allergic reaction to Aureocort. If you develop worsening irritation, a rash or other signs of sensitivity, stop using the treatment and speak to your doctor or pharmacist.

Using topical corticosteroids over large areas, for prolonged periods, on broken skin or under an occlusive dressing can increase absorption of the corticosteroid and the risk of side effects.

Prolonged or repeated use may also increase the risk of skin thinning and other local corticosteroid effects.

The antibiotic component may occasionally cause sensitisation or contribute to the growth of organisms that are not sensitive to the antibiotic. If your skin condition becomes worse or a new infection develops, contact your doctor.

If you experience any other side effects while using Aureocort, speak to your doctor or pharmacist.

Marketed by

Aureocort is marketed in the UK by Goldshield Pharmaceuticals Ltd.

Reviewed August 2026

Version ID: 2/AUR/PST/08/26

Betnovate is a potent topical corticosteroid containing betamethasone valerate. It is used to treat the itching and inflammation associated with a number of steroid-responsive skin conditions, including eczema, dermatitis and psoriasis (excluding widespread plaque psoriasis). Betnovate Scalp Application is used for steroid-responsive scalp conditions, including scalp psoriasis.

Betnovate belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Topical corticosteroids reduce inflammation and itching by acting on the body's inflammatory response in the skin. They control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition.

Betnovate is a potent corticosteroid and is generally prescribed when a less potent corticosteroid is not sufficiently effective. Because more potent corticosteroids have a greater risk of side effects, they should be used in the smallest amount necessary and for the shortest time needed to control the condition.

Who can get it?

Betnovate is available on prescription for adults, older people and children over 1 year of age. It should not be used in children under 1 year.

Children are more susceptible to the side effects of topical corticosteroids and may need shorter courses and less potent treatments.

How is it used?

Betnovate cream or ointment is usually applied as a thin layer to the affected areas once or twice a day, as directed by your doctor or pharmacist. Gently rub it into the skin until it has been absorbed.

Creams are generally more suitable for moist or weeping areas, while ointments are particularly suitable for dry, scaly or thickened areas.

The amount needed can be measured using fingertip units. As a general guide, one fingertip unit of cream or ointment is enough to cover an area approximately twice the size of an adult's palm.

Do not use more than you have been advised to use. Using too much, applying it too frequently or using it for too long can increase the risk of side effects.

Betnovate Scalp Application is applied to the scalp morning and night until improvement is noticeable. Once the condition has improved, it may be possible to reduce treatment to once a day or less frequently, as advised by your doctor.

What are the side effects?

Using potent topical corticosteroids for too long, too frequently or over large areas can increase the risk of side effects.

Local side effects can include itching, burning or pain, skin thinning, stretch marks, changes in skin colour, increased hair growth and visible small blood vessels. In some cases, the underlying condition may become worse or another skin infection may develop.

Although uncommon, enough betamethasone can be absorbed through the skin to cause effects throughout the body, particularly when used over large areas, for prolonged periods or under dressings that prevent the skin from breathing. These effects can include suppression of the body's natural steroid production and features associated with excessive corticosteroid exposure.

Avoid using Betnovate on the face unless your doctor has specifically advised you to do so, as the skin on the face is particularly susceptible to steroid-related side effects.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, speak to your doctor before using Betnovate. During pregnancy, betamethasone valerate should only be used when the expected benefit to the mother outweighs any potential risk, and the smallest amount should be used for the shortest possible time.

If used while breastfeeding, Betnovate should not be applied to the breasts to avoid accidental ingestion by the baby.

Manufactured by

Betnovate is available as a cream or an ointment and is manufactured in the UK by GlaxoSmithKline.

Reviewed: August 2026

Version ID: 2/BET/PST/08/26

Dovobet® gel is a prescription-only treatment containing two active ingredients: calcipotriol and betamethasone dipropionate. It is used for the topical treatment of scalp psoriasis in adults and mild to moderate plaque psoriasis affecting areas other than the scalp.

It belongs to a group of medicines known as vitamin D analogue/corticosteroid combinations. Calcipotriol is a vitamin D analogue that helps to slow the excessive growth and development of skin cells associated with psoriasis. Betamethasone dipropionate is a potent corticosteroid that reduces inflammation, redness and itching.

How does it work?

Calcipotriol helps to normalise the growth and development of skin cells, while betamethasone dipropionate reduces inflammation and itching. The combination therefore tackles two important features of psoriasis.

Who can get it?

Dovobet® gel is available on prescription and is intended for use in adults. Its safety and effectiveness in children and adolescents under 18 years have not been established, and no recommended dosage can be given for this age group.

How is it used?

Dovobet® gel should be applied to the affected areas once daily.

The usual treatment period is:

• 4 weeks for scalp psoriasis
• 8 weeks for mild to moderate plaque psoriasis affecting areas other than the scalp

If treatment needs to be continued or restarted after this period, this should be following medical review and under regular medical supervision.

The maximum amount of Dovobet® gel that should be used is 15 g per day, and the area treated should not exceed 30% of the body's surface area. For scalp psoriasis, usually 1–4 g per day is sufficient.

Dovobet® gel should not be applied to the face or eyes. It should also not normally be used on the genitals or in skin folds, such as the groin or armpits, because these areas are more sensitive to corticosteroids. Hands should be washed after application.

Avoid using Dovobet® under airtight or occlusive dressings, as this can increase absorption of the corticosteroid.

What are the side effects?

he most frequently reported side effect is itching (pruritus).

Other side effects that may occur include:

Common:

• Itching

Uncommon:

• Worsening of psoriasis
• Dermatitis
• Redness of the skin (erythema)
• Rash
• Acne
• Burning sensation
• Skin irritation
• Dry skin
• Skin infection
• Folliculitis
• Pain at the application site
• Eye irritation

Rare:

• Skin stretch marks (striae)
• Skin peeling (exfoliation)
• Hypersensitivity reactions
• Rebound effects after stopping treatment

Various types of rash, including pustular rash, have been reported. When topical corticosteroids are used to treat psoriasis, there is also a risk of generalised pustular psoriasis or rebound effects, particularly when treatment is stopped.

Calcipotriol may very rarely cause changes in calcium levels in the blood or urine, particularly if more than the recommended amount is used.

Because Dovobet® contains a potent corticosteroid, prolonged use can cause local effects such as thinning of the skin, visible small blood vessels (telangiectasia), stretch marks, increased hair growth, inflammation around the mouth, allergic contact dermatitis and changes in skin pigmentation.

Rarely, topical corticosteroids can cause effects elsewhere in the body, such as suppression of the adrenal glands, increased pressure inside the eye, cataracts, infections or effects on blood glucose. These effects are more likely when corticosteroids are used for long periods, over large areas, or under occlusion.

If blurred vision or other visual disturbances occur, medical advice should be sought.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are planning a pregnancy, speak to your doctor before using Dovobet®. During pregnancy, Dovobet® should only be used when the potential benefit justifies the potential risk.

If you are breastfeeding, speak to your doctor before using Dovobet®. Dovobet® should not be applied to the breast while breastfeeding.

Marketed by

Dovobet® Gel is available on prescription and is marketed in the UK by Leo Pharma

Reviewed: August 2026

Version ID: 2/DOV/PST/08/26

Enstilar® is a cutaneous foam containing calcipotriol and betamethasone dipropionate. It is used for the topical treatment of plaque psoriasis in adults, including psoriasis affecting the scalp and body.

Calcipotriol is a synthetic vitamin D analogue that helps regulate the growth and development of skin cells. Betamethasone dipropionate is a potent corticosteroid that reduces inflammation associated with psoriasis.

Topical corticosteroids are medicines related to hormones produced naturally by the adrenal glands. They should not be confused with anabolic steroids, which are sometimes misused by athletes.

How does it work?

Calcipotriol helps to slow down the excessive growth and development of skin cells seen in psoriasis and also has anti-inflammatory effects.

Betamethasone dipropionate is a potent corticosteroid that reduces inflammation, redness and itching.

The two ingredients work together and have greater anti-inflammatory and anti-proliferative effects than either ingredient used alone.

Who can get it?

Enstilar® is available on prescription for adults with plaque psoriasis.

The safety and effectiveness of Enstilar® in children and adolescents under 18 years have not been established, and there is currently no recommended dosage for this age group.

How is it used?

Shake the can for a few seconds before use.

Apply Enstilar® to the affected areas once daily.

Hold the can at least 3 cm from the skin and spray directly onto each affected area. The foam can be sprayed while holding the can in any orientation except horizontally.

The maximum amount should not exceed 15 g of foam per day, and no more than 30% of the body's surface area should be treated.

The usual treatment period is 4 weeks. If treatment needs to be continued or restarted after four weeks, this should be following medical review and under regular medical supervision.

For people who respond well to the initial four-week treatment, Enstilar® may also be prescribed as long-term maintenance treatment twice a week on two non-consecutive days, with two or three days without treatment between applications.

Enstilar® should not be applied to the face or genitals. Avoid applying it to skin folds, such as the groin, armpits or underneath the breasts, unless specifically instructed by a healthcare professional.

Wash your hands after applying the foam to avoid accidentally transferring it to the face, mouth or eyes.

What are the side effects?

Like all medicines, Enstilar® can cause side effects, although not everybody gets them.

Common side effects (may affect up to 1 in 10 people):

• Itching

Uncommon side effects (may affect up to 1 in 100 people):

• Eye irritation
• Burning sensation of the skin
• Skin pain or irritation
• Inflammation or swelling around the hair roots (folliculitis)
• Dermatitis
• Redness of the skin (erythema)
• Acne
• Dry skin
• Rash
• Pustular rash
• Skin infection
• Changes in skin colour (hypopigmentation)
• Increased calcium levels in the blood (hypercalcaemia)
• Application-site irritation or pain

Rare side effects (may affect up to 1 in 1,000 people):

• Allergic reactions
• Stretch marks (striae)
• Skin peeling (exfoliation)
• Rebound effect, where psoriasis becomes worse after treatment has ended

Other side effects with an unknown frequency include temporary yellowish discolouration of white or grey hair where the foam has been applied to the scalp and blurred vision or other visual disturbances.

Because Enstilar® contains a potent corticosteroid, prolonged or excessive use can cause additional corticosteroid-related side effects. These can include:

• Thinning of the skin
• Stretch marks
• Small blood vessels becoming more visible
• Changes in hair growth
• Inflammation around the mouth (perioral dermatitis)
• Increased sensitivity to light
• Cataracts
• Increased pressure inside the eye (glaucoma)
• Infections
• Suppression of the adrenal glands

• Changes in blood sugar levels

Using the medicine over large areas, for prolonged periods, under dressings or in skin folds can increase the risk of these effects.

Calcipotriol can affect calcium metabolism. Using more than the recommended amount can increase calcium levels in the blood. These levels normally return to normal when treatment is stopped.

If you develop swelling of the face, mouth or throat, difficulty breathing, severe allergic symptoms or other serious reactions, seek urgent medical attention.

If you develop blurred vision or other visual disturbances, speak to your doctor so that the cause can be investigated.

Enstilar^®and is marketed in the UK by LEO Pharma.

Reviewed: August 2026

Version ID: 2/ENS/PST/08/26

Diprosalic® is a potent topical corticosteroid preparation containing betamethasone dipropionate and salicylic acid. It is used for dry, thickened and scaly skin conditions that respond to corticosteroids, including psoriasis of the scalp.

Diprosalic® belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes.

Topical corticosteroids reduce inflammation and can help relieve symptoms such as itching, redness and irritation. Diprosalic® also contains salicylic acid, which helps soften and remove scales from the skin.

How does it work?

Betamethasone dipropionate is a potent corticosteroid that reduces the inflammation associated with psoriasis and other corticosteroid-responsive skin conditions.

Salicylic acid acts as a keratolytic, helping to soften and loosen the outer layer of thickened, scaly skin. This descaling action can also help the corticosteroid penetrate the skin more effectively.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions but do not cure the underlying condition. When treating psoriasis, prolonged continuous use should be avoided because psoriasis can flare again after treatment is stopped, and there is a risk of local or systemic steroid-related side effects.

Who can get it?

Diprosalic® is available on prescription for adults and children.

It is available as an ointment for use on the skin and as a scalp application for conditions affecting the scalp.

Diprosalic® should not be used for certain conditions, including rosacea, acne, perioral dermatitis, some infections and certain viral skin conditions. It should not be used on fungal or bacterial skin infections unless appropriate anti-infective treatment is also being used.

How is it used?

Ointment.

Adults :
Once to twice daily. In most cases a thin film should be applied to cover the affected area twice daily.
For some patients adequate maintenance therapy may be achieved with less frequent application.
It is recommended that Diprosalic preparations are prescribed for two weeks, and that treatment is reviewed at that time. The maximum weekly dose should not exceed 60g.
Children :
Dosage in children should be limited to 5 days.

Scalp Solution.

Adults :
Once to twice daily. In most cases a thin film should be applied to the affected areas twice daily and massaged gently and thoroughly into the skin.
For some patients adequate maintenance therapy may be achieved with less frequent application.
It is recommended that Diprosalic preparations are prescribed for two weeks, and that treatment is reviewed at that time. The maximum weekly dose should not exceed 60g.
Children :
Dosage in children should be limited to 5 days.

What are the side effects?

Diprosalic® skin preparations are generally well tolerated and side effects are uncommon or rare.

Possible local side effects include:

• Burning or stinging
• Itching
• Irritation
• Dryness
• Rash
• Folliculitis
• Acne-like eruptions
• Increased hair growth
• Changes in skin pigmentation
• Inflammation around the mouth (perioral dermatitis)
• Allergic contact dermatitis

Continuous or prolonged use can cause thinning of the skin (skin atrophy), stretch marks (striae) and enlargement of small blood vessels (superficial vascular dilation), particularly when used on the face.

Prolonged use of salicylic acid preparations can also cause skin irritation or dermatitis.

Because Diprosalic® contains a potent corticosteroid, using large amounts, treating large areas, using it for prolonged periods or using it on damaged skin can increase the amount absorbed into the body. Rarely, this can cause effects such as suppression of the adrenal glands or other systemic corticosteroid effects. Children are particularly susceptible.

When topical corticosteroids are used to treat psoriasis, there is a risk of rebound flare-ups and generalised pustular psoriasis, so careful medical supervision is important.

If irritation or sensitisation develops, treatment should be stopped and medical advice sought.

If you develop blurred vision or other visual disturbances, speak to your doctor, as topical corticosteroids have been associated with eye problems including cataracts, glaucoma and, rarely, central serous chorioretinopathy.

Important safety information for the scalp application

Diprosalic® Scalp Application is flammable. Do not smoke or go near naked flames while applying it or immediately afterwards. Clothing, bedding or dressings that have come into contact with the product can burn more easily. Washing these items can reduce, but does not completely remove, the product build-up.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor or pharmacist before using Diprosalic®.

Topical corticosteroids should only be used during pregnancy when the potential benefit justifies the potential risk, and large amounts or prolonged treatment should be avoided.

Manufactured by

Diprosalic is available on prescription and is manufactured in the UK by Merck Sharp and Dohme Ltd (MSD).

Reviewed: August 2026

Version ID: 2/DIP/PST/08/26

Meted® Shampoo contains salicylic acid and colloidal sulphur. It is a medicated shampoo used for the relief of itching, irritation, redness, flaking and scaling associated with dandruff, seborrhoeic dermatitis and psoriasis of the scalp.

It contains 3% salicylic acid and 6.25% colloidal sulphur (equivalent to 5% sulphur).

Meted® belongs to the group of treatments known as keratolytic and antiseptic preparations.

How does it work?

Sulphur is a keratolytic and mild antiseptic.
Salicylic acid has keratolytic and fungicidal properties.

Keratolytic agents encourage the removal of dead skin cells as seen in psoriasis. Salicylic acid works by breaking down keratin, a protein which forms part of the skin structure. This results in the shedding of skin cells from the affected area, and removes a layer of scale more effectively than an ordinary shampoo.

The sulphur component is a mild antiseptic and has antifungal properties. It is thought that dandruff may be partly due to an overgrowth of a fungus on the scalp, and that by killing this fungus the dandruff symptoms will be relieved.

Together, the ingredients help to loosen and remove excess scale and cleanse the scalp.

Who can get it?

Meted® Shampoo can be used by adults and children with dandruff, seborrhoeic dermatitis or scalp psoriasis.

If you are considering using it on a young child, ask your doctor or pharmacist for advice.

How is it used?

Thoroughly wet the hair and scalp.

Apply sufficient Meted® Shampoo to produce an abundant lather. Rinse the hair thoroughly and then repeat the procedure.

Use as directed by your doctor, pharmacist or the product instructions.

Avoid contact with the eyes. If the shampoo gets into the eyes, rinse thoroughly with clean water.

If the condition becomes worse or does not improve with regular use as directed, consult your doctor.

What are the side effects?

Like all medicines and topical preparations, Meted® Shampoo can cause side effects, although not everybody gets them.

Salicylic acid can cause skin irritation or dermatitis, particularly in people with sensitive skin or if the product is used excessively.

Stop using the shampoo and seek medical advice if you develop a significant skin reaction, severe irritation or signs of an allergic reaction.

If you experience any side effects, speak to your doctor or pharmacist.

Marketed by

Salicylic acid / Sulphur is known commercially as Meted and is available over the counter from your local pharmacy. It is marketed in the UK by Alliance Pharmaceuticals Ltd

Reviewed: August 2026

Version ID: 2/MET/PST/08/26

The drug tariff describes specials as:

“Specials are unlicensed medicinal products manufactured in the UK for human use which have been specially prepared to meet a prescription ordered for individual patients without the need for the manufacturer to hold a marketing authorisation for the medicinal product concerned.”

Find out more from the British Association of Dermatologists Access to Medicines 

This page is for reference only as this product is now discontinued

Dithrocream® contained the active ingredient dithranol, a topical treatment used for subacute and chronic psoriasis. Dithranol belongs to a group of treatments known as antipsoriatics.

Dithrocream® has been discontinued in the UK and is no longer available from UK pharmacies. All strengths of the product were discontinued by the manufacturer in 2022. If you previously used Dithrocream® and need an alternative treatment, speak to your GP, pharmacist or dermatology team.

How does it work?

Dithranol works mainly by reducing the excessive production of skin cells associated with psoriasis. This helps to reduce the thickening and scaling of psoriatic plaques.

Dithranol was normally introduced at a low strength and increased gradually according to the person's response and tolerance. The aim was to find the lowest strength that provided an effective response without causing excessive irritation.

The strength required depended on factors including the thickness and location of the psoriasis and how the person's skin responded to treatment.

Who can get it?

No longer available

How is it used?

Dithranol was applied to the affected areas of psoriasis according to the strength prescribed and the instructions provided by the doctor or pharmacist.

Treatment could be given as short-contact therapy, where the cream was applied and washed off after a prescribed period, or as longer-contact treatment under medical guidance.

Dithranol needed to be applied carefully to psoriasis plaques because it could irritate normal skin. It could also stain the skin, hair, clothing, towels and bedding.

What are the side effects?

Skin irritation, redness, burning or a feeling of warmth at the site of application were common features of dithranol treatment.

Applying too strong a preparation or leaving it on the skin for too long could cause significant burning and irritation.

Dithranol could also cause temporary brown or reddish-brown staining of the skin and hair. It could stain clothing and other fabrics.

If severe burning or irritation occurred, the treatment should be washed off and medical advice sought.

Reviewed: August 2026

Version ID: 2/DIT/PST/08/26

This page is for reference only as this product is now discontinued

Micanol® Cream contained the active ingredient dithranol, a topical treatment for psoriasis. Dithranol belongs to a group of treatments known as antipsoriatics.

Micanol® Cream has been discontinued in the UK and is no longer available from UK pharmacies. Both the 1% and 3% strengths were discontinued by the manufacturer in 2017.

How does it work?

Dithranol works mainly by slowing the excessive production of skin cells associated with psoriasis. This helps to reduce the thickening and scaling of psoriatic plaques.

Dithranol treatment was normally started at a lower strength or with a short contact time and gradually adjusted according to the person's response and tolerance. The aim was to achieve an effective response without causing excessive irritation.

Who can get it?

Micanol cream is no longer available.

How is it used?

Micanol® Cream was applied sparingly to the affected areas of psoriasis once daily, following the prescribed strength and contact time.

The treatment was normally washed off after the recommended contact period using lukewarm water.

Dithranol needed to be applied carefully to psoriasis plaques because it could irritate normal skin.

Dithranol can also stain the skin, hair, clothing, towels and bedding. Hot water, soap and detergents can increase staining and irritation.

What are the side effects?

Skin irritation and a burning sensation could occur, particularly if too much cream was applied, if the preparation was too strong or if it was left on the skin for too long.

Dithranol could cause temporary brown staining of the skin and hair. It could also stain clothing and other fabrics.

If severe burning or irritation occurred, the preparation should be washed off and medical advice sought.

Reviewed: August 2026

Version ID: 2/MIC/PST/08/26

This page is for reference only as this product is now discontinued

Psorin® was a topical treatment for psoriasis containing dithranol, coal tar, salicylic acid and zinc oxide. It belonged to a group of treatments known as antipsoriatics.

Psorin® has been discontinued in the UK and is no longer available as a licensed product from UK pharmacies.

How does it work?

Psorin® contained several ingredients that worked in different ways.

Dithranol helped to slow the excessive production of skin cells associated with psoriasis. This helped reduce the thickening and scaling of psoriatic plaques.

Salicylic acid is a keratolytic. It helps to soften and loosen the outer layer of thickened, scaly skin, making it easier to remove.

Coal tar has anti-inflammatory and antiproliferative properties and can help reduce the scaling and inflammation associated with psoriasis.

Zinc oxide provided a protective and soothing component to the preparation.

Who can get it?

Psorin is no longer available.

How is it used?

Psorin® was applied topically to affected areas of psoriasis according to the product instructions.

Dithranol preparations need to be used carefully because they can cause irritation, particularly if too much is applied or if the preparation is left on the skin for too long.

Dithranol should not normally be used on the face and should not be used on acute, pustular or significantly inflamed psoriasis.

What are the side effects?

Psorin® could cause:

• Burning or warmth at the site of application
• Skin irritation
• Temporary brown or reddish-brown staining of the skin
• Staining of hair, clothing and fabrics

Using too much dithranol or leaving it in contact with the skin for too long could increase irritation and burning.

Reviewed: August 2026

Version ID: 2/PSO/PST/08/26

Ciclosporin is an approved treatment for severe psoriasis where conventional therapy is inappropriate or ineffective. It belongs to a group of medicines known as immunosuppressants that inhibit T-cell activation and reduce the production of inflammatory cytokines, particularly interleukin-2.

How does it work?

Ciclosporin works by suppressing parts of the immune system that are overactive in psoriasis. It inhibits the activation of T cells and reduces the production of inflammatory substances. This reduces inflammation and helps slow the excessive growth of skin cells associated with psoriasis, improving redness, scaling and thickening.

Who can get it?

Ciclosporin is prescribed by a dermatologist and it is important that the medicine is taken exactly as the dermatologist has advised. It is usually prescribed for adults with severe psoriasis when conventional treatments are inappropriate or have not worked.

As ciclosporin can interact with other medicines it is important that everyone involved in the care (nurses, GPs, pharmacists and dermatologists) are aware that the patient is taking ciclosporin and what other medications are also being taken.
Women who are pregnant, planning a pregnancy or think they may be pregnant should tell their doctor. Ciclosporin should only be used during pregnancy if the potential benefits outweigh the potential risks.

How is it used?

Before treatment, the dermatologist will assess the patient's general health, including blood pressure and kidney function. Blood tests are used to assess kidney function, including measurements used to calculate estimated glomerular filtration rate (eGFR). Regular monitoring is then carried out during treatment because ciclosporin can affect kidney function and blood pressure.

Ciclosporin should be taken consistently at the same time each day and in relation to meals. Do not eat grapefruit or drink grapefruit juice while taking ciclosporin because this can increase the amount of ciclosporin in your blood.

What are the side effects?

Ciclosporin can cause side effects in some people and any side effects should be reported to the dermatologist. Sometimes ciclosporin can cause stomach upsets in which case the dermatologist may recommend that ciclosporin is taken with food. Some people develop swollen or overgrown gums. Good oral hygiene and regular dental care can help reduce the risk of gum problems. Some patients report and increase in hair growth or tingling or burning sensations in the arms or legs, these usually disappear with time.

Regular blood tests and blood-pressure checks are needed during treatment. These monitor kidney and liver function and other important blood measurements. The dose may need to be changed depending on the results. Even if a patient feels well it is important that all appointments with the dermatologist are kept to enable them to closely monitor the patient and to be updated on any problems. Sometimes the dermatologist may decide to adjust the dose of ciclosporin according to the blood pressure and blood sample tests. It is important that the patient DOES NOT adjust the dose themselves no matter how well they are feeling.

Available Guidance
National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health,(Northern Ireland)

Marketed by

Ciclosporin is known commercially as Neoral® and is marketed in the UK by Novartis Pharmaceuticals Ltd.

Reviewed: August 2026

Version ID: 2/CIC/PST/08/26

Dimethyl fumarate is an immunomodulatory medicine that changes the activity of the immune system and reduces inflammation associated with psoriasis.

How does it work?

Dimethyl fumarate works by  changing the activities of the  immune system and reducing the  production of substances involved in causing psoriasis.  It is thought to act on T cells (a type of white blood cell that forms part of the immune system) to prevent the cells from producing substances that cause inflammation.

Improvement may take several weeks and treatment is continued according to how well the psoriasis responds and how well the medicine is tolerated.

Who can get it?

Dimethyl fumarate is available on prescription and is used in adults with moderate to severe plaque psoriasis who need systemic treatment. It should be prescribed under the supervision of a doctor experienced in diagnosing and treating psoriasis.

How is it used?

In the first week, dimethyl fumarate  30 mg tablet is taken once daily (1 tablet in the evening)
In the second week, dimethyl fumarate 30 mg is taken twice daily ( 1 tablet in the  morning  and 1 in the  evening).
In the third week, dimethyl fumarate 30 mg is taken three times daily (1 tablet in the morning,  1 at midday,  and 1 in the evening ).
 From the fourth week, treatment is switched to  only 1 tablet of  dimethyl fumarate  120  mg in the evening. This dose is then increased by 1 dimethyl fumarate 120  mg tablet per week  at different times of day for the subsequent 5 weeks.
The maximum daily dose allowed is 720 mg (6 x 120 mg tablets )
The tablets should be taken during or immediately after a meal and swallowed whole. They should not be crushed, divided, dissolved or chewed

Monitoring

Before treatment starts, blood tests will be carried out to check your blood-cell counts. These tests will be repeated regularly during treatment. Your doctor may alter the dose or stop treatment if your blood counts become too low.

What are the side effects?

 The most common side effects with dimethyl fumarate (which may affect more than 1 in 10 people) are:

• effects on the digestive system (diarrhoea, bloating, stomach ache and nausea)
• headache, abdominal discomfort, flatulence and vomiting
• flushing (reddening of the skin)
• A reduction in the number of lymphocytes or other white blood cells.

It must not be used during pregnancy or breastfeeding. Women who are pregnant, planning a pregnancy or breastfeeding should discuss this with their doctor.

Available Guidance

• National Institute for Health and Care Excellence (NICE) guidance
• Scottish Medicine Consortium guidance
• All Wales Medicines Strategy Group
• Department of Health,(Northern Ireland)

Marketed by

Dimethyl fumarate is known commercially as Skilarence ® and is marketed in the UK by Almirall

Reviewed: August 2026

Version ID: 2/DIM/PST/08/26

Methotrexate  was discovered to be effective in clearing psoriasis in the 1950s and was eventually approved for this use by the FDA in the 1970s. Methotrexate is an immunosuppressant medicine that reduces activity in parts of the immune system involved in psoriasis.

How does it work?

Methotrexate works by reducing the activity of the immune system. It interferes with processes involved in the growth and multiplication of cells and reduces inflammation. In psoriasis, this helps reduce the excessive growth of skin cells and the inflammation that causes red, thickened and scaly plaques.

In low doses methotrexate can also affect the division of normal, healthy cells, and it has the potential to produce serious side effects. For this reason, treatment with methotrexate is usually only initiated by hospital specialists, and regular blood tests are needed to monitor for potential side effects.

Who can get it?

Methotrexate may be prescribed for adults with moderate to severe psoriasis when topical treatments and/or phototherapy have not controlled the condition sufficiently and systemic treatment is appropriate.

How is it used?

Jylamvo oral solution

For the treatment of severe psoriasis  take 2.5-5mg test dose one week prior to therapy.  Then 7.5mg once weekly, increasing gradually as necessary; maximum 25mg weekly.  After desired response reduce gradually to lowest effective dose.

Maxtrex

For the treatment of severe psoriasis NICE recommends incremental dosing, for example starting at 5–10 mg once weekly. Dosage should be adjusted according to the patient's response and the haematological toxicity. The prescriber may specify the day of intake on the prescription.

Methofill

7.5mg by subcutaneous injection, increasing gradually depending on individual tolerance and disease activity up to a maximum weekly dose of 25mg.  The dose should be individualised according to response, tolerability and monitoring. After desired response reduce gradually to lowest effective dose.

Methotrexate

Methotrexate is taken once a week. The dose is adjusted according to response and side effects, with the lowest effective dose used. Important: Methotrexate for psoriasis is taken ONCE A WEEK, not every day. Taking methotrexate every day instead of once a week can cause serious illness and can be fatal. Always follow the dose and day specified by your healthcare professional.

Methotrexate oral solution
The usual dose is 10mg – 25mg (5ml – 12.5ml) taken once weekly. The planned weekly dose can be administered as three divided doses over 24 hours. As necessary, the total weekly dose can be increased up to 25mg. Thereafter the dose should be reduced to the lowest effective dose according to therapeutic response which is most cases is achieved within 4 to 8 weeks.

Metoject
Take 7.5mg by subcutaneous injection once weekly increasing gradually depending on individual tolerance and disease activity. Maximum weekly dose 25mg.  After desired response reduce gradually to lowest effect dose.

Nordimet

7.5mg by subcutaneous injection, increasing gradually depending on individual tolerance and disease activity up to a maximum weekly dose of 25mg  After desired response reduce gradually to lowest effective dose.

Ziatal
7.5 mg by subcutaneous or intramuscular injection once a week increasing gradually according to response with a maximum weekly dose of 25mg.  After desired response reduce gradually to lowest effect dose.

Important: Methotrexate for psoriasis is taken ONCE A WEEK, not every day. Taking methotrexate every day instead of once a week can cause serious illness and can be fatal. Always follow the dose and day specified by your healthcare professional.

What are the side effects?

Taking methotrexate can cause the following potential side effects:

• nausea and vomiting *
• diarrhoea
• mouth ulcers/stomatitis **
• headache
• tiredness
• changes in blood-cell counts
• increased susceptibility to infection
• liver problems
• kidney problems
• skin reactions/photosensitivity
• hair loss
• bruising/bleeding.

*Sometimes nausea can be helped by drinking milk or eating before taking the medication. Severe nausea may mean the dose is too high. Folic acid is often prescribed alongside methotrexate to help reduce some of its side effects, including effects on the mouth, stomach and blood cells. Your doctor or pharmacist will tell you how and when to take it. Do not change the dose or timing of folic acid without medical advice.

**Mouth ulcers can be a sign of methotrexate toxicity, but it doesn't necessarily mean that the dose is simply “too high”

Methotrexate can Methotrexate can cause serious bone-marrow suppression and liver toxicity, which is why regular blood monitoring is essential.

These side effects are generally manageable with careful monitoring and patient education.

Monitoring

You will need regular blood tests while taking methotrexate. These tests check your blood cells and how well your liver and kidneys are working. The dose may need to be changed or treatment stopped if the results show a problem. It is important to attend all monitoring appointments, even if you feel well.

Pregnancy and fertility

Methotrexate must not be taken during pregnancy. It can harm an unborn baby. If you are pregnant, planning a pregnancy or think you may be pregnant, speak to your doctor immediately. Methotrexate can also affect fertility in both women and men.

How do I get methotrexate?

Methotrexate is available on prescription and is usually started and monitored by a specialist healthcare professional experienced in treating psoriasis and using methotrexate.Further guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
Department of Health,(Northern Ireland)

Methotrexate is known commercially as Jylamvo which is marketed in the UK by Intrapharm, Maxtrex which is marketed in the UK by Pfizer Ltd, Methofill which is marketed in the UK by Accord,  Methotrexate oral solution which is marketed in the UK by Rosemont Pharmaceuticals Limited,  Metoject which is marketed in the UK by Medac, Nordimet which is marketed in the UK by Nordic and Ziatal which is marketed in the UK by Nordic.

Reviewed: August 2026

Version ID: 2/MET/PST/08/26

Apremilast belongs to a group of medicines called phosphodiesterase 4 (PDE4) inhibitors. It works by regulating inflammation involved in psoriasis.  It is used to treat adults with moderate to severe chronic plaque psoriasis who have failed to respond to, or are intolerant to other systemic therapies including ciclosporin, methotrexate or PUVA.

How does it work?

Apremilast blocks an enzyme called phosphodiesterase 4 (PDE4). This changes the levels of chemical messengers inside immune cells and helps regulate the production of substances involved in inflammation. This can reduce the inflammation and other symptoms associated with psoriasis.

Who can get it?

Apremilast is available on prescription and treatment should be started by a specialist experienced in treating psoriasis. It can be used in adults with moderate to severe plaque psoriasis and is also licensed for children and adolescents aged 6 years and over who weigh at least 20 kg and are candidates for systemic therapy.

How is it used?

Apremilast is administered orally and is started with a low dose and is gradually increased over the first 6 days of treatment to twice daily doses. Your dermatologist will assess how well the treatment is working. It is recommended that apremilast is stopped  if there has not been an adequate response after 16 weeks.

What are the side effects?

Very common side effects (may affect more than 1 in 10 people)

• diarrhoea
• nausea

Common side effects (may affect up to 1 in 10 people)

• cough
• back pain
• vomiting
• feeling tired
• stomach pain
• loss of appetite
• frequent bowel movements
• difficulty sleeping (insomnia)
• indigestion or heartburn
• headaches, migraines or tension headaches
• upper respiratory tract infections such as cold, runny nose, sinus infection
• inflammation and swelling of the tubes in your lungs (bronchitis)
• common cold (nasopharyngitis)
• depression

Uncommon side effects (may affect up to 1 in 100 people)

• rash
• Your weight may be monitored during treatment. Tell your doctor if you experience significant or unexplained weight loss.
• allergic reaction
• bleeding in the bowel or in the stomach

• Some people taking apremilast have experienced depression or suicidal thoughts or behaviour. Tell your doctor promptly if you notice changes in your mood or thoughts of harming yourself.

Apremilast is known commercially as Otezla and as generic apremilast tablets and is marketed in the UK by Amgen Limited

Reviewed: August 2026

Version ID: 2/APR/PST/08/26

Acitretin is an oral retinoid used to treat severe forms of psoriasis, particularly when other treatments have not been effective or are not suitable. It helps regulate the growth and development of skin cells, reducing the excessive growth and abnormal development associated with psoriasis.

How does it work?

Acitretin is a retinoid that affects the growth and development of skin cells. In psoriasis, this can reduce the excessive growth of skin cells and help reduce scaling and thickening of the skin.

Who can get it?

Acitretin should be prescribed by, or under the supervision of, a specialist experienced in the use of systemic retinoids. It is generally used for adults with severe psoriasis when other treatments have not been effective or are unsuitable.

How is it used?

Acitretin capsules are taken once daily with food or milk. The usual starting dose is 25–30 mg daily. The specialist may then adjust the dose according to the response to treatment and any side effects. The usual maintenance dose is 25–50 mg daily.

What are the side effects?

Acitretin commonly causes dryness of the skin and lips, peeling, itching, redness, dry eyes, dry mouth and nosebleeds. Hair thinning or hair loss, muscle or joint aches and increased sensitivity to sunlight can also occur. These effects are often related to the dose and may improve when the dose is reduced.

Acitretin can affect the liver and increase cholesterol and triglyceride levels, so regular blood tests are needed during treatment.

Pregnancy is particularly important. Acitretin can cause serious harm to an unborn baby. It must not be taken during pregnancy. Women who could become pregnant must use effective contraception for at least 1 month before treatment, throughout treatment and for 3 years after stopping acitretin. Regular pregnancy tests are required. Acitretin must not be used while breastfeeding.

Patients must not donate blood during treatment or for 3 years after stopping acitretin.

Alcohol should be avoided during treatment and for 2 months after stopping treatment. Vitamin A supplements and other retinoid medicines should not be taken unless specifically advised by a doctor.

Acitretin can increase sensitivity to sunlight, so excessive exposure should be avoided and appropriate sun protection used.

Marketed by

Acitretin is available on prescription only and is known commercially as Neotigason. It is marketed in the UK by Genus Pharmaceuticals.

Reviewed: August 2026

Version ID: 2/ACI/PST/08/26

This page is for reference only as this product is now discontinued

Tazarotene is a retinoid used for the topical treatment of plaque psoriasis. It binds to nuclear retinoic acid receptors inducing normal differentiation of keratinocytes and reducing hyperkeratosis. It also reduces the formation of cytokines and interleukins that are responsible for inflammation. Because tazarotene is applied to the skin, systemic exposure is generally low. However, irritation at the site of application is relatively common. It belongs to the group of medicines known as topical retinoids.

How does it work?

Tazarotene is a topical retinoid. It is applied directly to psoriasis plaques and helps regulate the growth and differentiation of skin cells and reduce inflammation. The clear, fast-drying, odourless, non-staining medication is available in two strengths, 0.05% and 0.1%. Your doctor will prescribe the appropriate strength for you, given such factors as your medical history, skin type and degree of psoriasis.

How is it used?

Tazarotene can be applied to most parts of the body, but should not be applied to intertriginous areas or to the face or to hair covered scalp. It should be applied once per day and usually about 30 minutes before bedtime. This allows the medication to dry sufficiently so it will not rub off on bedding, where it may come in contact with other skin during the night. Although it is not harmful to unaffected skin, Tazarotene can cause burning and itching. To prevent irritation, keep Tazarotene on the psoriasis plaques and avoid contact with unaffected skin.
Tazarotene should not be applied "liberally." In fact, a pea-sized amount of the gel is enough to cover a lesion the size of the open palm. Rub the medication thoroughly into the lesion, leaving no residue. If the gel does come in contact with normal skin, it can be washed off with water.

Using Tazarotene on the nails

Tazarotene is not routinely used for nail psoriasis. Your dermatologist can advise on appropriate treatments for nail involvement.

What are the side effects?

The main adverse effects are indeed local irritation, including:

• itching
• burning
• redness
• irritation
• peeling/scaling
• dry skin
• stinging

The most frequently reported adverse reactions in controlled clinical trials of Tazarotene in the treatment of psoriasis were pruritus (incidence 20-25%), burning, erythema, and irritation (10-20%), desquamation, non-specific rash, irritant contact dermatitis, skin pain, and a worsening of psoriasis (5-10 %).
More rarely observed were stinging and inflamed and dry skin (1-3 %).
The incidence of adverse reactions appears to be concentration-related and dependent on duration of use. Skin irritation may be more noticeable when treatment is started and can be more pronounced with higher-strength preparations.

Tazarotene must not be used during pregnancy or by women who are planning to become pregnant. If you are pregnant, think you may be pregnant or are planning a pregnancy, speak to your doctor. If you are breastfeeding, ask your doctor for advice before using tazarotene.

How do I get

Tazarotene is available on prescription. Treatment should be prescribed and monitored by a healthcare professional experienced in treating psoriasis.

Marketed by

Tazarotene is known commercially as Zorac and is marketed in the UK by Allergan Ltd.

Reviewed: August 2026

Version ID: 2/TAZ/PST/08/26

Mildison is a mild topical corticosteroid containing the active ingredient hydrocortisone. It is used to reduce inflammation, redness and itching associated with inflammatory skin conditions.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Hydrocortisone reduces inflammation by suppressing the body's inflammatory response in the skin. This helps relieve redness, swelling and itching.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition. The condition may return after treatment is stopped.

Who can get it?

Mildison is available on prescription for adults, older people and children.

Children, particularly infants, are more susceptible to the effects of topical corticosteroids. Treatment should therefore use the smallest amount necessary and for the shortest appropriate period.

How is it used?

Apply a small amount as a thin layer to the affected area two or three times a day, or as directed by your doctor or pharmacist. Gently rub it into the skin.

The formulation can be used on both dry, scaly areas and moist or weeping areas.

Wash your hands after application unless your hands are the area being treated.

In children and infants, prolonged treatment should be avoided. Treatment should generally be limited to short courses, as advised by the doctor.

Do not use more than recommended. Applying too much, too frequently or for too long can increase the risk of side effects.

What are the side effects?

Like all medicines, Mildison can cause side effects, although not everyone will experience them.

Possible side effects include:

• burning or irritation
• itching
• skin thinning, particularly with prolonged use
• stretch marks
• changes in skin colour
• inflammation of the hair follicles
• increased hair growth
• allergic contact dermatitis.

Prolonged or excessive use, particularly on large areas, in skin folds, in the nappy area or under occlusive dressings, can increase absorption of hydrocortisone through the skin.

In rare cases, significant absorption can affect the body's natural production of corticosteroid hormones. This risk is greater in infants and children.

Nappies can act as an occlusive dressing and may increase absorption.

Mildison contains cetostearyl alcohol, which may cause local skin reactions such as contact dermatitis, and methyl parahydroxybenzoate, which may cause allergic reactions, sometimes after a delay.

If you develop significant irritation, an allergic reaction or any other unusual symptoms, speak to your doctor or pharmacist.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor before using Mildison.

If treatment is considered necessary, the smallest amount needed should generally be used for the shortest appropriate period.

How do I get Mildison?

Mildison is available on prescription as a topical preparation containing hydrocortisone.

Marketed
by Mildison is marketed in the UK by Astellas Pharma Ltd

Reviewed: August 2026
Version ID: 2/MIL/PST/08/26

Eurax Hydrocortisone (Eurax HC) is an antipruritic and mild topical corticosteroid containing the active ingredients crotamiton 10% and hydrocortisone 0.25%.

It is used to relieve itching and inflammation associated with mild-to-moderate eczema, irritant or allergic contact dermatitis and insect-bite reactions. It is not licensed specifically for psoriasis.

Hydrocortisone belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Eurax HC combines the actions of two active ingredients.

Hydrocortisone is a mild topical corticosteroid that reduces inflammation, redness and itching by suppressing the body's inflammatory response in the skin.

Crotamiton is an antipruritic medicine that helps relieve itching. The combination therefore provides relief from both itching and inflammation.

The treatment controls symptoms while it is being used but does not cure the underlying skin condition.

Who can get it?

Eurax HC is available for use in adults and children aged 10 years and over. It should not be used in children under 10 years of age.

It should not be used by people who are allergic to hydrocortisone, crotamiton or any of the other ingredients.

Eurax HC should not be used on infected skin, broken skin or open wounds, or for untreated bacterial, viral or fungal infections.

How is it used?

Apply a thin layer sparingly to a small area of affected skin twice daily, or as directed by your doctor or pharmacist.

Treatment should be limited to a maximum of 1 week. Occlusive dressings should not be used.

Wash your hands after application unless your hands are the area being treated.

If the condition does not improve, or becomes worse, speak to your doctor or pharmacist.

What are the side effects?

Like all medicines, Eurax HC can cause side effects, although not everyone will experience them.

Possible side effects include:

• burning or irritation at the application site
• itching
• contact dermatitis or an allergic skin reaction
• worsening of skin irritation.

Severe irritation or sensitisation is a reason to stop treatment and seek medical advice.

Although hydrocortisone is a mild corticosteroid, prolonged or excessive use, particularly over large areas or under occlusive dressings, can increase absorption through the skin. This can increase the risk of corticosteroid-related effects such as skin thinning and, rarely, effects on the body's natural steroid production.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor or pharmacist before using Eurax HC.

How do I get Eurax HC?

Eurax HC is available as a cream on prescription

Marketed by

Eurax-Hydrocortisone is marketed in the UK by Thornton & Ross Ltd.

Reviewed: August 2026
Version ID: 2/EUR/PST/08/26

Dioderm is a mild topical corticosteroid containing the active ingredient hydrocortisone 0.1%. It is licensed for the topical treatment of eczema and dermatitis. Hydrocortisone is also used as a mild corticosteroid for short-term treatment of inflammatory psoriasis in sensitive areas such as the face, skin folds and genitals, where appropriate.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Hydrocortisone reduces inflammation by suppressing the body's inflammatory response in the skin. This helps reduce redness, swelling and itching.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition. The condition may return after treatment is stopped.

Who can get it?

Dioderm is available on prescription for adults, older people and children.

It should not be used if you are allergic to hydrocortisone or any of the other ingredients.

Dioderm should not be used to treat bacterial, viral or fungal skin infections, as corticosteroids can make some infections worse. It should also not be applied to open wounds, ulcers or broken skin.

How is it used?

Dioderm is for external use only.

Apply a thin layer to the affected area twice daily, or as directed by your doctor or pharmacist, and gently rub it into the skin.

Wash your hands after application unless your hands are the area being treated.

When used for psoriasis, treatment with a mild corticosteroid should generally be short term, particularly when treating the face, skin folds or genital area. NICE recommends a mild or moderate corticosteroid once or twice daily for a maximum of 2 weeks for psoriasis affecting these areas.

Do not use more than recommended. Applying too much, too frequently or for too long can increase the risk of side effects.

What are the side effects?

Dioderm is generally well tolerated when used correctly, but like all topical corticosteroids it can cause side effects.

Possible side effects include:

• burning or irritation
• itching
• dryness
• thinning of the skin, particularly with prolonged use
• stretch marks
• changes in skin colour
• increased hair growth
• inflammation of the hair follicles
• worsening of an existing skin infection.

Prolonged or excessive use, particularly over large areas, under dressings or in young children, can increase absorption of hydrocortisone through the skin. In rare cases this can affect the body's natural production of corticosteroid hormones.

Children are more susceptible to these effects because they have a larger skin surface area in relation to their body weight.

If your skin condition becomes worse during treatment, or you develop signs of infection or an allergic reaction, speak to your doctor or pharmacist.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor before using Dioderm.

If treatment is considered necessary, the smallest amount needed should generally be used for the shortest appropriate period.

How do I get Dioderm?

Dioderm is available on prescription.

Marketed by

Dioderm is marketed in the UK by Dermal Laboratories Ltd.

Reviewed: August 2026
Version ID: 2/DIO/PST/08/26

Eumovate contains the active ingredient clobetasone butyrate, a moderately potent topical corticosteroid. It is used to reduce inflammation, redness and itching associated with a number of steroid-responsive skin conditions.

It belongs to a group of medicines called topical corticosteroids. These medicines are applied to the skin to reduce inflammation, redness and itching. They should not be confused with anabolic steroids, which are sometimes misused by athletes.

Eumovate is available as a cream and an ointment. The cream is generally suitable for moist or weeping areas, while the ointment is particularly suitable for dry, thickened or scaly areas.

How does it work?

Clobetasone butyrate reduces inflammation in the skin and helps relieve symptoms such as redness, swelling and itching.

Topical corticosteroids control the inflammation and symptoms of skin conditions while they are being used, but they do not cure the underlying condition. Eumovate may also be used as maintenance treatment between courses of a more potent topical corticosteroid.

Who can get it?

Eumovate is available on prescription for adults, older people, children and infants when prescribed appropriately.

The product information lists its uses for inflammatory and itchy steroid-responsive skin conditions, including eczema, dermatitis, seborrhoeic dermatitis, nappy rash, photodermatitis, otitis externa, prurigo nodularis and insect-bite reactions.

How is it used?

Apply a thin layer to the affected area once or twice a day, using only enough to cover the affected skin, and gently rub it in.

Once the skin has improved, your doctor may advise reducing how often you apply it or changing to a less potent treatment.

If you are also using an emollient, allow enough time for Eumovate to be absorbed before applying the emollient.

The amount and duration of treatment will depend on the condition being treated. Do not use more than recommended, as using excessive amounts or prolonged treatment can increase the risk of side effects.

What are the side effects?

Most people can use Eumovate without problems when it is used correctly.

Some people may experience:

• burning, stinging or itching
• skin irritation
• changes in skin colour
• increased hair growth
• thinning of the skin
• stretch marks
• visible small blood vessels

Using topical corticosteroids for too long, over large areas or under dressings that prevent the skin from breathing can increase the amount of medicine absorbed through the skin. In rare cases this can affect the body's natural production of corticosteroid hormones. Children are more susceptible to these effects.

If your skin condition becomes worse during treatment, speak to your doctor or pharmacist. This could sometimes be due to an infection or a reaction to the treatment.

Rarely, prolonged or inappropriate use of a topical corticosteroid on psoriasis can cause the psoriasis to worsen or trigger a different form of psoriasis, such as pustular psoriasis.

Do not apply Eumovate to the eyes. Repeated exposure around the eyes can increase the risk of problems such as glaucoma or cataracts.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, speak to your doctor or pharmacist before using Eumovate.

Topical corticosteroids should be used during pregnancy only when necessary and for the shortest appropriate duration. Avoid applying Eumovate to the breasts before breastfeeding to prevent the baby accidentally swallowing the medicine.

Manufactured by

Eumovate is manufactured in the UK by Glaxo Wellcome UK Ltd /GlaxoSmithKline.

Reviewed: August 2026
Version ID: 2/EUM/PST/08/26

Fluocortolone is a moderate potent corticosteroid used to reduce inflammation, redness and itching associated with inflammatory skin conditions. It may be prescribed for conditions such as eczema and dermatitis and may also be used for psoriasis where a topical corticosteroid is appropriate.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids act on the skin to reduce inflammation, redness and itching.

How does it work?

Topical corticosteroids reduce inflammation and itching by suppressing the inflammatory response in the skin. They control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition.

Who can get it?

Fluocortolone is available on prescription as Ultralanum Plain 0.25% cream and ointment. It may be prescribed for adults and children, but the appropriate strength, amount and duration of treatment should take account of the person's age and the area being treated.

Moderately potent corticosteroids can be used for short periods on areas such as the face, flexures and genitals when clinically appropriate. NICE recommends corticosteroids of mild or moderate potency for psoriasis in these areas, generally for no more than 2 weeks.

How is it used?

Fluocortolone should be applied thinly and evenly to the affected areas, usually once or twice daily, as directed by your doctor or pharmacist.

Gently rub the cream or ointment into the skin until it has been absorbed.

The formulation chosen may depend on the condition and the area of skin being treated. Ointments are generally more suitable for dry, scaly or thickened skin, while creams may be preferred for less dry or more moist areas.

Do not use more than recommended or continue treatment for longer than advised. Using topical corticosteroids excessively or for prolonged periods can increase the risk of side effects.

For psoriasis, the potency and duration of corticosteroid treatment should be appropriate for the site being treated. Potent or very potent corticosteroids should not be used continuously without appropriate breaks and monitoring.

What are the side effects?

Most people experience no significant problems when a topical corticosteroid is used correctly. However, side effects are more likely if it is used for prolonged periods, in large amounts, over large areas of skin or under occlusive dressings.

Possible side effects include:

• thinning of the skin
• stretch marks (striae)
• changes in skin pigmentation
• increased visibility of small blood vessels
• burning, irritation or itching
• inflammation of the hair follicles (folliculitis)
• increased hair growth (hypertrichosis)
• allergic contact dermatitis
• worsening or masking of a skin infection.

Prolonged or extensive use can occasionally allow enough corticosteroid to be absorbed through the skin to cause effects elsewhere in the body, including suppression of the body's natural steroid production. This risk is greater in children and when large areas of skin or occluded areas are treated.

When treating psoriasis, prolonged or inappropriate use of topical corticosteroids can also cause psoriasis to become unstable.

Fluocortolone is known commercially as Ultralanum Plain and is available as a cream or an ointment. It is marketed in the UK by Meadow Laboratories Limited.

Reviewed: August 2026
Version ID: 2/FLU/PST/08/26

Fludroxycortide (Haelan) is a moderately potent topical corticosteroid. It is used to reduce inflammation, redness and itching associated with certain inflammatory skin conditions.

It belongs to a group of medicines called topical corticosteroids. These medicines are applied to the skin to reduce inflammation and itching. They should not be confused with anabolic steroids, which are sometimes misused by athletes.

How does it work?

Fludroxycortide reduces inflammation in the skin. This helps relieve symptoms such as redness, swelling and itching.

Topical corticosteroids work by reducing the activity of substances involved in the body's inflammatory response. They control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition.

Who can get it?

Haelan is available on prescription for adults and children.

Haelan Cream is used for a range of inflammatory skin conditions, including eczema and dermatitis. The current UK product information does not specifically list psoriasis as an indication.

Haelan Tape is used for chronic, localised and resistant inflammatory skin conditions that respond to topical corticosteroids, particularly dry, scaling lesions.

Your doctor will decide whether Haelan is suitable for your particular skin condition.

How is it used?

Haelan Cream or Ointment

Apply a thin layer to the affected areas two or three times a day, or as directed by your doctor. Gently rub it into the skin.

Haelan Tape

The skin should be clean, dry and free of hair before the tape is applied. The tape is cut to cover the affected area and is normally left in place for 12 hours out of every 24 hours.

The tape should be used only as directed by your doctor because it provides an occlusive effect, which can increase the absorption of the corticosteroid.

Wash your hands after applying Haelan Cream or Ointment, unless the hands themselves are being treated.

What are the side effects?

Most people can use Haelan without problems when it is used correctly.

Possible side effects of topical corticosteroids include:

• burning, stinging or irritation
• thinning of the skin
• stretch marks
• changes in skin colour
• increased hair growth
• inflammation of the hair follicles
• visible small blood vessels
• allergic skin reactions

Using a topical corticosteroid for too long, over large areas or under an occlusive dressing or tape can increase the amount absorbed through the skin. This can increase the risk of side effects.

Children may be more susceptible to these effects than adults.

If your skin condition becomes worse during treatment, or you develop significant irritation or an allergic reaction, speak to your doctor or pharmacist.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, speak to your doctor before using Haelan.

Topical corticosteroids should generally be used during pregnancy only when necessary and for the shortest appropriate duration. Avoid applying the treatment to the breasts immediately before breastfeeding.

Marketed by

Fludroxycortide is known commercially as Haelan and is available as a cream, an ointment or impregnated onto tape. It is marketed in the UK by Typharm Ltd.

Reviewed: August 2026
Version ID: 2/FLU/PST/08/26

Alphaderm is a mild topical corticosteroid and moisturising treatment containing the active ingredients hydrocortisone 1% and urea 10%.

It is used for inflammatory skin conditions where the skin is dry, thickened or scaly. The hydrocortisone helps reduce inflammation, redness and itching, while urea helps soften and moisturise dry, rough skin.

Alphaderm belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes.

How does it work?

Hydrocortisone is a mild topical corticosteroid. It reduces inflammation in the skin and helps relieve symptoms such as redness and itching.

Urea is a moisturising ingredient that helps the skin hold on to water. It also has a mild keratolytic action, which means it helps soften and loosen thickened or scaly skin.

The combination can therefore be particularly useful where inflammation is accompanied by dry, thickened or scaly skin.

Topical corticosteroids control inflammation and symptoms while they are being used, but they do not cure the underlying skin condition.

Who can get it?

Alphaderm is available on prescription for adults and children.

Do not use Alphaderm if you have previously had an allergic reaction to hydrocortisone, urea or any of the other ingredients.

It should not be used on untreated bacterial, viral or fungal skin infections, unless specifically advised by your doctor.

How is it used?

Wash and dry the affected areas before applying the cream.

Apply a thin layer to the affected skin twice a day, or as directed by your doctor. Gently rub the cream into the skin.

Avoid getting the cream in the eyes.

Because Alphaderm contains urea, it can sometimes cause stinging or irritation when applied to cracked or broken skin.

Your doctor may occasionally advise covering the treated area with a dressing, but occlusive dressings should not be used unless specifically recommended by a healthcare professional. Occlusion can increase the amount of corticosteroid absorbed through the skin and therefore increase the risk of side effects.

What are the side effects?

Alphaderm is generally well tolerated when used as directed.

Some people may experience:

• stinging or irritation, particularly when applied to cracked or inflamed skin
• worsening or spreading of an existing skin infection
• skin thinning with prolonged or excessive use
• stretch marks
• changes in skin colour
• increased hair growth
• acne-like changes
• inflammation around hair follicles

Using a topical corticosteroid for too long, over large areas or under an occlusive dressing can increase the amount absorbed through the skin and increase the risk of side effects.

Children, particularly young children, can be more susceptible to these effects.

If your skin condition becomes worse during treatment, or you develop significant irritation or another unusual reaction, speak to your doctor or pharmacist.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, speak to your doctor before using Alphaderm.

Topical corticosteroids should generally be used during pregnancy only when necessary and for the shortest appropriate duration.

Marketed by

Alphaderm Cream is marketed in the UK by Alliance Pharmaceuticals Ltd.

Reviewed: August 2026
Version ID: 2/ALP/PST/08/26

Alclometasone is a moderately potent topical corticosteroid used to reduce redness, swelling and itching caused by certain inflammatory skin conditions. It contains the active ingredient alclometasone dipropionate.

It belongs to a group of medicines called topical corticosteroids. These medicines are applied to the skin to reduce inflammation, redness and itching. They should not be confused with anabolic steroids, which are sometimes misused by athletes.

Alclometasone is classed as a moderately potent corticosteroid.

How does it work?

Alclometasone reduces inflammation in the skin, helping to relieve redness, swelling and itching.

Topical corticosteroids control the inflammation and symptoms of skin conditions while they are being used, but they do not cure the underlying condition. If treatment is stopped after prolonged or inappropriate use, the original condition can sometimes flare up again.

Alclometasone may be prescribed when an emollient alone is not enough to control inflammation.

Who can get it?

Alclometasone is available on prescription for adults and children. The product information states that it is used for inflammatory and itchy skin conditions that respond to topical corticosteroids.

It is important not to use alclometasone on skin infections, acne, rosacea, perioral dermatitis or certain viral skin conditions unless specifically advised by a healthcare professional.

If you or your child has previously had an allergic reaction to alclometasone or any of the ingredients, do not use it.

How is it used?

Apply a thin layer of alclometasone cream to the affected area two or three times a day, or as directed by your doctor. Gently massage it into the skin until it disappears.

Do not use more than recommended. Using topical corticosteroids for too long, over large areas or under dressings that prevent the skin from breathing can increase the amount absorbed through the skin and increase the risk of side effects.

Long-term continuous treatment should be avoided where possible, particularly in babies and children.

What are the side effects?

Alclometasone is generally well tolerated when used as directed.

Some people may experience:

• itching
• burning or stinging
• redness
• dryness or irritation
• a rash

With prolonged or excessive use, particularly on large areas or under dressings, topical corticosteroids can cause thinning of the skin, stretch marks, changes in skin colour, increased hair growth, acne-like changes or visible small blood vessels.

Children, particularly young children, can be more susceptible to side effects because they may absorb proportionally more of the medicine through their skin. Very rarely, excessive or prolonged use can affect the body's natural production of corticosteroid hormones.

If your skin becomes more irritated or you develop an allergic reaction, stop using the treatment and speak to your doctor or pharmacist.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, speak to your doctor before using alclometasone. Topical corticosteroids should be used during pregnancy only when the expected benefit outweighs any potential risk, and extensive or prolonged use should be avoided.

Marketed by

Alclometasone is known commercially as Modrasone and is available as a cream or an ointment. It is marketed in the UK by Aspire Pharma Ltd.

Reviewed: August 2026
Version ID: 2/ALC/PST/08/26

Trimovate® is a combination cream containing the moderately potent topical corticosteroid clobetasone butyrate, the antifungal nystatin and the antibiotic oxytetracycline. It is used for steroid-responsive inflammatory skin conditions where a bacterial or candidal infection is present, suspected or likely to occur.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Clobetasone butyrate reduces inflammation, redness and itching, while nystatin treats fungal infections caused by susceptible yeasts and oxytetracycline treats susceptible bacterial infections.

How does it work?

Clobetasone butyrate is a moderately potent topical corticosteroid that reduces inflammation, redness and itching in the skin.

Nystatin is an antifungal medicine that acts against susceptible yeasts and fungi, including Candida species.

Oxytetracycline is a broad-spectrum antibiotic that works against susceptible bacteria by interfering with bacterial protein production.

The combination is intended for inflammatory skin conditions where infection is present, suspected or likely to occur.

Who can get it?

Trimovate is available on prescription and can be used in adults, older people, children and infants when prescribed appropriately.

It is used for steroid-responsive dermatoses where candidal or bacterial infection is present, suspected or likely to occur. Licensed indications include atopic dermatitis, nappy rash, intertrigo, anogenital pruritus and seborrhoeic dermatitis.

How is it used?

Trimovate cream should be applied thinly and gently rubbed into the affected area once or twice daily, using only enough to cover the affected skin.

Treatment should normally be limited to up to 7 days. If the condition does not improve within 7 days, or becomes worse, the diagnosis and treatment should be reviewed by a healthcare professional. Treatment should not be continued for more than 7 days without medical supervision.

Creams are particularly suitable for moist or weeping areas.

Wash your hands after applying Trimovate, unless the hands themselves are being treated.

If an emollient is also being used, allow adequate time for Trimovate to be absorbed before applying the emollient.

What are the side effects?

Most people tolerate Trimovate when it is used correctly and for the recommended duration.

Possible side effects include:

• skin irritation or hypersensitivity
• opportunistic or secondary infection
• changes in skin colour
• increased hair growth
• thinning of the skin with prolonged or inappropriate use of corticosteroids
• widening of small blood vessels
• blurred vision or other visual disturbances, although these are uncommon/not known

Because clobetasone is a corticosteroid, applying excessive amounts, treating large areas or using it for prolonged periods can increase absorption and, rarely, cause effects throughout the body, including suppression of the body's normal adrenal function.

Prolonged or repeated use of topical antibiotics and antifungals can also increase the risk of sensitisation and resistance, so Trimovate should only be used for the recommended short course.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, speak to your doctor before using Trimovate. It should only be used during pregnancy when the expected benefit to the mother outweighs any potential risk, and the minimum amount should be used for the shortest possible duration.

If used during breastfeeding, it should not be applied to the breasts to prevent accidental ingestion by the baby.

Manufactured by

Trimovate is manufactured in the UK by Ennogen IP Ltd.

Reviewed: August 2026
Version ID: 2/TRI/PST/08/26

Synalar contains the active ingredient fluocinolone acetonide, a potent topical corticosteroid used to reduce inflammation in the skin. It is used to treat inflammatory, itchy and allergic skin conditions, including eczema, dermatitis and psoriasis, but is not normally used to treat large areas of psoriasis because of the increased risk of side effects.

Synalar belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Fluocinolone acetonide reduces inflammation by suppressing the body's inflammatory response in the skin. This helps reduce redness, swelling and itching associated with inflammatory skin conditions.

Synalar is a potent corticosteroid and is generally used when a less potent corticosteroid is not sufficiently effective. Potent corticosteroids have a greater potential to cause side effects, particularly when used for long periods, over large areas of skin or under dressings that cover the treated area.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition.

Who can get it?

Synalar is available on prescription for adults, older people and children over 1 year of age. It should not be used in children under 1 year of age.

Children can be more susceptible to the side effects of topical corticosteroids. A doctor may therefore prescribe a less potent corticosteroid or a shorter course of treatment.

Synalar should not normally be used to treat large areas of psoriasis, including widespread plaque psoriasis, because the risk of side effects is greater.

How is it used?

A small amount of Synalar cream, ointment or gel should be applied lightly to the affected areas two or three times a day, as directed by your doctor or pharmacist. Gently massage it into the skin.

Cream is particularly suitable for moist or weeping areas and areas where skin folds or flexures are affected. Ointment is generally more suitable for dry, scaly or thickened skin.

Do not use more Synalar than you have been advised to use. Using too much, applying it too frequently or using it for too long can increase the risk of side effects.

Occlusive dressings may sometimes be recommended by a doctor for certain conditions, but they should not be used in children or on the face.

What are the side effects?

Using a potent topical corticosteroid for too long, too frequently, over large areas or under an occlusive dressing can increase the risk of side effects.

Possible side effects where Synalar is applied include:

• thinning of the skin
• stretch marks
• changes in skin pigmentation
• burning or irritation
• increased hair growth
• visible small blood vessels
• inflammation of the hair follicles
• allergic skin reactions
• worsening of the skin condition
• development or worsening of a skin infection.
  
  

Although uncommon, more of the corticosteroid can be absorbed through the skin when it is used over large areas, for prolonged periods or under occlusive dressings. This can potentially cause effects throughout the body, including suppression of the body's natural production of corticosteroid hormones.

If you notice your skin condition getting worse or develop signs of an infection while using Synalar, speak to your doctor or pharmacist.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor or pharmacist before using Synalar.

Your doctor will consider the benefits and potential risks before recommending treatment during pregnancy or breastfeeding. The smallest amount needed should generally be used for the shortest appropriate period.

How do I get Synalar?

Synalar is available on prescription as a cream, ointment or gel. There is also a lower-strength 1:4 Synalar Ointment (0.00625%).

Marketed by

Synalar is marketed in the UK by Reig Jofre UK Ltd.

Reviewed: August 2026
Version ID: 2/SYN/PST/08/26

Metosyn contains the active ingredient fluocinonide, a potent topical corticosteroid used to reduce inflammation, redness and itching associated with inflammatory skin conditions. It can be used for conditions including eczema, dermatitis and psoriasis.

Metosyn belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Fluocinonide reduces inflammation by suppressing the body's inflammatory response in the skin. This helps reduce redness, swelling and itching associated with inflammatory skin conditions.

Metosyn is a potent corticosteroid and is generally prescribed when a less potent corticosteroid has not been sufficiently effective. Potent corticosteroids have a greater potential to cause side effects, particularly when used for long periods, over large areas of skin or under dressings that cover the treated area.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition.

Who can get it?

Metosyn is available on prescription for adults and children. In children, topical corticosteroids should be used carefully because children can be more susceptible to side effects. A doctor may prescribe a less potent corticosteroid or a shorter course of treatment where appropriate.

How is it used?

Apply a thin layer of Metosyn to the affected areas three or four times a day, or as directed by your doctor or pharmacist, and gently rub it into the skin.

As the condition improves, your doctor may advise reducing the frequency of application, for example to twice a day or once a day.

Do not use more Metosyn than you have been advised to use. Using too much, applying it too frequently or using it for too long can increase the risk of side effects.

What are the side effects?

Using a potent topical corticosteroid for too long, too frequently, over large areas or under an occlusive dressing can increase the risk of side effects.

Possible side effects where Metosyn is applied include:

• thinning of the skin
• stretch marks
• changes in skin pigmentation
• burning or irritation
• acne or acne-like eruptions
• increased hair growth
• visible small blood vessels
• inflammation of the hair follicles
• allergic skin reactions
• worsening of the skin condition
• development or worsening of a skin infection.

Although uncommon, more of the corticosteroid can be absorbed through the skin when it is used over large areas, for prolonged periods or under occlusive dressings. This can potentially cause effects throughout the body, including suppression of the body's natural production of corticosteroid hormones.

Do not apply Metosyn to the face unless your doctor has specifically advised you to do so, as facial skin is particularly susceptible to side effects from potent topical corticosteroids.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor or pharmacist before using Metosyn.

Your doctor will consider the benefits and potential risks before recommending treatment. If treatment is considered necessary, the smallest amount needed should generally be used for the shortest appropriate period.

If used while breastfeeding, Metosyn should not be applied to the breasts to prevent the baby accidentally coming into contact with the medicine.

How do I get Metosyn?

Metosyn is available on prescription as a cream or ointment.

Marketed by

Metosyn is marketed in the UK by Reig Jofre UK Ltd.

Reviewed: August 2026
Version ID: 2/MET/PST/08/26

Lotriderm contains two active ingredients: betamethasone dipropionate, a potent topical corticosteroid, and clotrimazole, an antifungal medicine. It is used for the short-term treatment of certain fungal infections of the skin when redness and itching are also present.

Lotriderm belongs to a group of medicines called topical corticosteroids and antifungal medicines. Topical corticosteroids should not be confused with anabolic steroids, which are sometimes misused by athletes.

How does it work?

Betamethasone dipropionate is a potent corticosteroid. It reduces inflammation, redness and itching in the skin.

Clotrimazole is an antifungal medicine that works against fungi and yeasts responsible for certain skin infections.

The combination therefore treats the fungal infection while also reducing associated inflammation, redness and itching.

Lotriderm is intended for short-term treatment of fungal infections. It should not be used simply to treat psoriasis or other inflammatory skin conditions where there is no fungal infection. Using a potent corticosteroid when it is not needed can mask or worsen some skin infections.

Who can get it?

Lotriderm is available on prescription for adults and children over 12 years of age.

It should not be used in children under 12 years of age.

If Lotriderm is prescribed for a child over 12, it should not be used on any part of the body for more than 5 days.

How is it used?

Apply a thin layer of Lotriderm cream to the affected and surrounding skin twice a day, in the morning and evening, and gently massage it into the skin.

Treatment will usually last for 2 or 4 weeks, depending on the type of fungal infection. Your doctor will tell you how long to use it.

The infection should normally start to improve within the first few days. If it does not improve, or becomes worse, speak to your doctor.

Do not use Lotriderm:

• in or around the eyes
• on large areas of the body for prolonged periods
• under dressings such as plasters or bandages unless specifically advised by your doctor
• on large areas of damaged or broken skin
• on the face for more than 5 days
• in skin folds, such as behind the knees, for prolonged periods.

Do not use more cream, or use it more frequently, than recommended. Using too much or using it for too long can increase the amount of corticosteroid absorbed through the skin and increase the risk of side effects.

What are the side effects?

Like all medicines, Lotriderm can cause side effects, although not everyone will experience them.

Possible side effects include:

• burning or stinging
• redness or irritation
• itching
• rash
• swelling
• peeling or dryness of the skin
• inflammation of the hair follicles
• increased hair growth
• changes in skin colour
• allergic skin reactions
• thinning of the skin
• stretch marks
• development or worsening of another skin infection.

Using a potent corticosteroid for too long, too frequently, over large areas or under a dressing can increase the risk of side effects. In some circumstances, corticosteroids applied to the skin can be absorbed into the bloodstream and affect the body's natural steroid production, particularly in children.

If your psoriasis becomes worse while using Lotriderm, or you develop raised bumps containing pus, contact your doctor.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant, are planning a pregnancy or are breastfeeding, speak to your doctor or pharmacist before using Lotriderm.

How do I get Lotriderm?

Lotriderm is available on prescription as a cream.

Manufactured by

Lotriderm is manufactured in the UK by Organon Pharma (UK) Limited.

Reviewed: August 2026
Version ID: 2/LOT/PST/08/26

Locoid contains the active ingredient hydrocortisone butyrate, a topical corticosteroid used to reduce inflammation, redness and itching associated with inflammatory skin conditions including eczema, dermatitis and psoriasis.

Locoid belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

Locoid is a potent topical corticosteroid. It is suitable for inflammatory skin conditions, including psoriasis, although topical corticosteroids should not normally be used for widespread plaque psoriasis.

How does it work?

Hydrocortisone butyrate reduces inflammation by suppressing the body's inflammatory response in the skin. This helps reduce redness, swelling and itching.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition. If treatment is stopped, the skin condition may return.

Who can get it?

Locoid is available on prescription for adults, older people, children and infants over 3 months of age.

It is available in several formulations, including:

• Locoid Cream
• Locoid Lipocream
• Locoid Ointment
• Locoid Crelo
• Locoid Scalp Lotion.
  
  

The different formulations are designed to be suitable for different types and locations of skin conditions. Locoid Crelo, for example, is particularly suitable for the scalp and hairy areas and can be used on both scaly and moist or weeping lesions.

How is it used?

Apply a thin and even layer to the affected areas once or twice a day, as directed by your doctor or pharmacist.

Locoid should be applied sparingly and gently rubbed into the skin.

In adults and older people, the same dosage is generally used.

In children, long-term treatment, large amounts and the use of occlusive dressings should be avoided. In infants, treatment should be limited to a maximum of 7 days.

In some resistant areas, such as thickened psoriasis plaques on the elbows and knees, a doctor may recommend applying the medicine under an occlusive dressing. This should only be done when specifically advised by a healthcare professional.

Locoid Crelo is particularly suitable for the scalp and hairy areas, while its formulation also makes it suitable for both scaly and moist or weeping lesions.

What are the side effects?

Using a potent topical corticosteroid for too long, applying too much, treating large areas or using occlusive dressings can increase the amount of steroid absorbed through the skin and increase the risk of side effects.

Possible side effects include:

• thinning of the skin
• stretch marks
• changes in skin pigmentation
• irritation or burning
• inflammation of the hair follicles
• increased hair growth
• worsening of an existing skin infection or development of a new infection
• allergic skin reactions.
  
  

Skin thinning and other local changes are more likely when topical corticosteroids are used for prolonged periods, particularly in skin folds or under occlusion.

In some circumstances, enough hydrocortisone butyrate can be absorbed through the skin to affect the body's natural production of corticosteroid hormones. This is more likely in infants and children, when large areas are treated, during prolonged treatment or when occlusive dressings are used.

Some Locoid formulations contain ingredients that can cause skin reactions. For example, Locoid Lipocream contains cetostearyl alcohol, which may cause local skin reactions such as contact dermatitis, and propyl parahydroxybenzoate, which may cause allergic reactions that can sometimes be delayed.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor before using Locoid.

Your doctor will consider the benefits and potential risks before recommending treatment. The smallest amount needed should generally be used for the shortest appropriate period.

How do I get Locoid?

Locoid is available on prescription as a cream, Lipocream, ointment, Crelo or scalp lotion. The products contain 0.1% hydrocortisone butyrate.

Marketed by

Locoid is marketed in the UK by Neon Healthcare Ltd

Reviewed: August 2026
Version ID: 2/LOC/PST/08/26

Fluticasone propionate is a potent topical corticosteroid used to reduce inflammation, redness and itching associated with inflammatory skin conditions. It is available in the UK as Cutivate and can be used for conditions including eczema, dermatitis, psoriasis, insect bite reactions and prickly heat. For psoriasis, it should not be used for widespread plaque psoriasis.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Fluticasone propionate reduces inflammation by suppressing the body's inflammatory response in the skin. This helps reduce redness, swelling and itching.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition. If treatment is stopped suddenly, the original skin condition can sometimes return or become worse, particularly after prolonged treatment with potent corticosteroids.

Who can get it?

Fluticasone propionate is available on prescription for adults, older people, children and infants aged 3 months and over. Children and infants are more susceptible to the side effects of topical corticosteroids and generally require shorter courses and, where possible, less potent treatments.

Cutivate ointment is indicated for inflammatory skin conditions including psoriasis, excluding widespread plaque psoriasis. In children, specialist advice should be sought before using it for conditions other than atopic dermatitis.

How is it used?

Apply a thin layer to the affected areas once or twice a day, as directed by your doctor or pharmacist, and gently rub it into the skin. Only enough should be used to cover the affected area.

Treatment is normally continued until the condition has improved. Once the condition is under control, your doctor may advise reducing the frequency of application or changing to a less potent corticosteroid.

For adults, treatment should generally not continue for more than 4 weeks without the treatment being reviewed. If the condition becomes worse or has not improved within four weeks, the diagnosis and treatment should be reviewed.

In children, if there is no improvement within 7–14 days, treatment should be stopped and the child reassessed. Continuous daily treatment for longer than four weeks is not recommended.

What are the side effects?

Most people experience no problems when fluticasone propionate is used correctly and for the recommended length of time.

Possible side effects include:

• itching
• burning or irritation where the medicine is applied
• skin thinning
• stretch marks
• changes in skin colour
• increased hair growth
• visible small blood vessels
• inflammation of the hair follicles
• allergic skin reactions
• worsening of the skin condition
• development or worsening of a skin infection.

Prolonged or intensive treatment with potent topical corticosteroids can increase the risk of skin thinning and other local side effects.

Although uncommon, enough fluticasone propionate can be absorbed through the skin to cause effects throughout the body, particularly when large amounts are used, large areas are treated, treatment is prolonged or occlusive dressings are used. These effects can include suppression of the body's natural production of corticosteroid hormones and features of excessive corticosteroid exposure. The risk is greater in infants and children.

Treatment with a topical corticosteroid can occasionally trigger or worsen pustular psoriasis.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor before using fluticasone propionate.

Your doctor will consider the benefits and potential risks before recommending treatment. The smallest amount necessary should generally be used for the shortest appropriate period.

How do I get Fluticasone propionate?

Fluticasone propionate is available on prescription.

Marketed by

Fluticasone is known commercially as Cutivate and is marketed in the UK by GlaxoSmithKline.

Reviewed: August 2026
Version ID: 2/FLU/PST/08/26

Diflucortolone valerate is a potent topical corticosteroid used to reduce inflammation, redness and itching associated with inflammatory skin conditions, including eczema, dermatitis and psoriasis.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Diflucortolone valerate reduces inflammation by suppressing the body's inflammatory response in the skin. This helps reduce redness, swelling and itching associated with inflammatory skin conditions.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition. After treatment is stopped, the original condition may return.

Diflucortolone valerate is a potent corticosteroid and should be used in the smallest amount necessary to control the condition and for the shortest appropriate period.

Who can get it?

Diflucortolone valerate is available on prescription for adults and children. Children are more susceptible to the side effects of topical corticosteroids and may require shorter courses of treatment.

Your doctor or pharmacist will advise whether diflucortolone is suitable, particularly for young children or when treatment is required on sensitive areas such as the face.

How is it used?

Apply a thin layer to the affected areas once or twice daily, as directed by your doctor or pharmacist, and gently rub it into the skin.

As the condition improves, the frequency of application may be reduced.

Do not use more than recommended. Applying too much, using it too frequently or continuing treatment for too long can increase the risk of side effects.

Treatment on the face and in children should be limited and should follow your doctor's instructions. Occlusive dressings should not be used unless specifically advised by a healthcare professional.

What are the side effects?

Like all medicines, diflucortolone valerate can cause side effects, although not everyone will experience them.

Possible side effects include:

• burning or irritation
• itching
• dryness
• thinning of the skin
• stretch marks
• changes in skin colour
• increased hair growth
• visible small blood vessels
• inflammation of the hair follicles
• acne or acne-like eruptions
• allergic skin reactions
• worsening of the skin condition
• development or worsening of a skin infection.
  
  

Using a potent topical corticosteroid for prolonged periods, over large areas, under occlusive dressings or on areas where the skin is thin can increase the amount absorbed through the skin and the risk of side effects.

Although uncommon, significant absorption can affect the body's natural production of corticosteroid hormones. This risk is greater in children.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor or pharmacist before using diflucortolone valerate.

If treatment is considered necessary, the smallest amount needed should generally be used for the shortest appropriate period.

How do I get Diflucortolone valerate?

Diflucortolone valerate is available on prescription as a topical preparation.

Marketed by

Diflucortolone valerate is known commercially as Nerisone Forte and is marketed in the UK by Meadow Laboratories Ltd.

Reviewed: August 2026
Version ID: 2/DIF/PST/08/26

Dermovate® is a very potent topical corticosteroid containing the active ingredient clobetasol propionate. It is used for the short-term treatment of severe or resistant inflammatory skin conditions, including psoriasis that has not responded adequately to less potent corticosteroids. Dermovate cream and ointment are not indicated for widespread plaque psoriasis.

Dermovate belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Clobetasol propionate reduces the inflammation associated with inflammatory skin conditions. This helps relieve symptoms such as redness, swelling and itching.

Dermovate is available in different formulations. The ointment has a greasy, moisturising base and is particularly suitable for dry, scaly or thickened skin. The cream is generally more suitable for moist or weeping areas. Dermovate is also available as a scalp application for steroid-responsive scalp conditions such as psoriasis.

Because clobetasol is a very potent corticosteroid, it is normally used for short periods. If treatment needs to continue for longer than 4 weeks, a less potent corticosteroid should generally be considered. Repeated short courses may sometimes be prescribed to control flare-ups.

Who can get it?

Dermovate cream and ointment are available on prescription for adults, older people and children over 1 year of age.

Dermovate Scalp Application is also licensed for adults, older people and children over 1 year of age. Children are more susceptible to corticosteroid side effects and generally require shorter courses and less potent corticosteroids where possible.

How is it used?

Cream and ointment

Apply a thin layer once or twice daily to the affected areas and gently rub in, using only enough to cover the affected skin.

Once the condition has improved, your doctor may reduce the frequency of application or change you to a less potent corticosteroid.

Treatment should not normally continue for more than 4 weeks. If your condition does not improve within 2–4 weeks, the diagnosis and treatment should be reviewed.

In particularly thickened or resistant areas, your doctor may occasionally recommend covering the treated area with an occlusive dressing for a short period. This increases absorption and therefore also increases the risk of side effects, so it should only be done when specifically advised.

Scalp application

Dermovate Scalp Application is for use on the scalp only.

Apply a small amount to the affected areas morning and evening until improvement is noticeable. Once the condition has improved, it may be possible to maintain control by applying it once a day or less frequently, as advised by your doctor.

To apply:

1. Unscrew the cap and place the nozzle on the affected area of the scalp.
2. Gently squeeze the bottle until the affected area is covered with a thin layer.
3. Massage gently into the scalp if required.
4. Allow the liquid to dry naturally.
5. Wash your hands after use.

Do not use more than is needed to cover the affected areas.

The scalp application is flammable, so keep it away from flames and other sources of ignition, including smoking. Avoid using a hairdryer immediately after application.

What are the side effects?

Most people do not experience serious problems when Dermovate is used correctly and for the recommended length of time.

Using a very potent corticosteroid for too long, applying too much, treating large areas or using occlusive dressings can increase the amount absorbed through the skin and the risk of side effects.

Possible side effects include:

• thinning of the skin
• stretch marks (striae)
• increased visibility of small blood vessels
• changes in skin colour
• increased hair growth
• inflammation of the hair follicles (folliculitis)
• irritation or burning
• allergic reactions
• worsening of the underlying skin condition.

In some circumstances, enough clobetasol can be absorbed through the skin to cause effects elsewhere in the body, including suppression of the body's natural steroid production and features of excessive corticosteroid exposure. This risk is greater in children, when large areas are treated and when the skin is covered with an occlusive dressing.

In rare cases, treatment of psoriasis with a corticosteroid, or stopping corticosteroid treatment, may trigger pustular psoriasis.

If your condition becomes worse during treatment, or you develop significant irritation, an allergic reaction or signs of infection, speak to your doctor or pharmacist.

Marketed by

Dermovate cream, ointment and Scalp Application is manufactured in the UK by GlaxoSmithKline UK.

Reviewed: August 2026
Version ID: 2/DER/PST/08/26

Betacap contains the active ingredient betamethasone valerate, a potent topical corticosteroid used to reduce inflammation, redness and itching associated with inflammatory skin conditions, including scalp psoriasis.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Betamethasone valerate reduces inflammation by suppressing the body's inflammatory response in the skin. This helps reduce redness, swelling and itching associated with inflammatory skin conditions.

Betacap is formulated as a scalp application, making it easier to apply to areas of the scalp affected by psoriasis and other inflammatory skin conditions.

The formulation contains alcohol, which helps the preparation dry quickly on the scalp. It also contains ingredients that help condition the scalp.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition. The condition may return after treatment is stopped.

Who can get it?

Betacap is available on prescription for adults, older people and children over 1 year of age.

Children are more susceptible to the side effects of topical corticosteroids. Treatment in children should therefore use the smallest amount necessary and for the shortest appropriate period.

How is it used?

Betacap Scalp Application is for external use on the scalp only.

For adults and older people:

1. Carefully invert the bottle over the scalp, holding the nozzle over the area to be treated.
2. Gently squeeze the bottle until the affected area is covered with a thin layer of the preparation.
3. Gently massage it into the scalp if necessary.
4. Allow the scalp to dry naturally.
5. Wash your hands after applying the preparation.

Treatment is normally applied twice a day, in the morning and evening, until the scalp condition improves.

Once the condition has improved, it may be possible to maintain control by reducing treatment to once a day or less frequently, using the minimum frequency needed to control the condition.

If treatment coincides with hair washing, Betacap should be applied after the hair has been dried.

Take care to prevent the preparation from getting into the eyes.

For children over 1 year, the preparation should be used sparingly and only enough should be applied to cover the affected area. The treated scalp should not be covered with an airtight dressing unless specifically advised by a doctor.

Do not use more than recommended. Using too much, too frequently or for too long can increase the risk of side effects.

What are the side effects?

Like all medicines, Betacap can cause side effects, although not everyone will experience them.

Possible side effects of topical corticosteroids include:

• burning, stinging or irritation
• itching
• dryness
• thinning of the skin
• stretch marks
• changes in skin colour
• increased hair growth
• visible small blood vessels
• inflammation of the hair follicles
• acne or acne-like eruptions
• allergic skin reactions
• worsening of the skin condition
• development or worsening of a skin infection.

Using a potent corticosteroid for prolonged periods, over large areas or under an occlusive dressing can increase the amount of steroid absorbed through the skin.

Although uncommon, significant absorption can affect the body's natural production of corticosteroid hormones. This is more likely in children, when large amounts are used or when treatment is prolonged.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor before using Betacap.

Betacap should only be used during pregnancy or breastfeeding if your doctor considers treatment necessary. The smallest amount needed should generally be used for the shortest appropriate period.

How do I get Betacap?

Betacap Scalp Application is available on prescription and is intended for use on the scalp.

Manufactured by

Betacap Scalp Application is manufactured by Dermal Laboratories Ltd.

Reviewed: August 2026
Version ID: 2/BET/PST/08/26

Mometasone furoate is a potent topical corticosteroid used to reduce inflammation, redness and itching associated with inflammatory skin conditions, including eczema, dermatitis and psoriasis.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Mometasone furoate reduces inflammation by suppressing the body's inflammatory response in the skin. This helps reduce redness, swelling and itching.

Topical corticosteroids control the symptoms and signs of inflammatory skin conditions while they are being used, but they do not cure the underlying condition. The original skin condition may return after treatment is stopped.

Mometasone furoate is a potent corticosteroid and is generally used when a less potent corticosteroid is not sufficiently effective. Potent corticosteroids should be used in the smallest amount necessary and for the shortest appropriate period.

Who can get it?

Mometasone furoate is available on prescription for adults and children.

It is available in different formulations, including cream, ointment and scalp lotion. The appropriate formulation will depend on the area being treated and the nature of the skin condition.

Children are more susceptible to the effects of topical corticosteroids and may require shorter courses of treatment and careful monitoring.

How is it used?

Cream and ointment

Apply a thin layer to the affected areas of skin once daily, as directed by your doctor or pharmacist, and gently rub it in.

The ointment is particularly suitable for dry, scaly or thickened areas, while the cream may be more suitable for less dry areas.

Avoid contact with the eyes.

Scalp lotion

Apply a small amount of the lotion to the affected areas of the scalp once daily, as directed by your doctor or pharmacist.

Part the hair where necessary and apply the lotion directly to the affected areas. Avoid getting the lotion into the eyes or on the face.

Treatment should be reviewed if there is no improvement or if prolonged treatment is required.

Do not use more than recommended. Using a potent corticosteroid too frequently, for too long or over large areas can increase the risk of side effects.

What are the side effects?

Like all medicines, mometasone furoate can cause side effects, although not everyone will experience them.

Possible local side effects include:

• burning, stinging or tingling
• itching
• irritation or dryness
• inflammation of the hair follicles (folliculitis)
• thinning of the skin
• stretch marks
• changes in skin colour
• increased hair growth
• acne or acne-like eruptions
• perioral dermatitis
• allergic contact dermatitis
• secondary skin infection.

Using a potent topical corticosteroid for prolonged periods, over large areas, under occlusive dressings or on areas where the skin is thin can increase the amount absorbed through the skin.

Although uncommon, significant absorption can affect the body's natural production of corticosteroid hormones and can cause features associated with excessive corticosteroid exposure.

Children are particularly susceptible because they have a larger skin surface area in relation to their body weight. Prolonged or excessive use in children may also affect growth and development.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant or are breastfeeding, speak to your doctor before using mometasone furoate.

If treatment is considered necessary, the smallest amount needed should generally be used for the shortest appropriate period.

How do I get Mometasone furoate?

Mometasone furoate is available on prescription as a cream, ointment and scalp lotion.

Marketed by

Mometasone is available as a lotion, cream and also an ointment and is known commercially as Elocon. It is marketed in the UK by Schering-Plough Ltd

Reviewed: August 2026
Version ID: 2/MOM/PST/08/26

Bettamousse is a potent topical corticosteroid containing betamethasone valerate. It is used to treat steroid-responsive skin conditions of the scalp, such as scalp psoriasis. Topical corticosteroids reduce inflammation, redness and itching. They should not be confused with anabolic steroids, which are sometimes misused by athletes.

How does it work?

Betamethasone valerate is a potent topical corticosteroid. It reduces inflammation and suppresses the body's inflammatory response in the skin, helping to relieve symptoms such as redness, itching and irritation.

Topical corticosteroids control symptoms while they are being used but are not a cure for psoriasis. With psoriasis, corticosteroids should be used carefully because stopping treatment can sometimes result in a rebound flare.

Who can get it?

Bettamousse is available on prescription for adults, older people and children over 6 years of age. It should not be used in children under 6 years.

How is it used?

Apply the mousse sparingly to the affected areas of the scalp and massage it in gently. Adults and children over 6 years should use no more than a golf-ball-sized amount in total (approximately 3.5 g), twice a day, in the morning and evening, until the condition improves. Children should use proportionately less.

If there is no improvement after 7 days, treatment should be stopped. Once the condition has improved, treatment can usually be reduced to once a day and, if appropriate, less frequently. Use the smallest amount needed to control the condition and for the shortest possible time.

The hair should not be washed immediately after application, allowing the mousse to work through the day or overnight. Wash your hands after applying it.

Important: Bettamousse is highly flammable because it contains a large amount of ethanol. Keep it away from naked flames, lit cigarettes and sources of ignition, including during and shortly after application.

What are the side effects?

Tell your doctor or pharmacist if your scalp becomes more irritated or if your condition gets worse after using Bettamousse.

Common side effects include:

• itching
• burning or pain at the application site.

Other possible side effects include skin thinning, redness, rash, skin dryness, stretch marks, changes in skin colour, increased hair growth and worsening of the underlying condition. Very rarely, topical corticosteroids can cause effects elsewhere in the body, particularly when large amounts are used, over large areas or for prolonged periods.

Bettamousse can make some skin infections worse or mask their symptoms. It should not be used on an infected scalp unless appropriate treatment for the infection has also been started. Avoid contact with the eyes.

Manufactured by

Bettamousse is manufactured in the UK by RPH Pharmaceuticals AB.

Reviewed: August 2026
Version ID: 2/BEM/PST/08/26

Diprosone is a potent (strong) topical corticosteroid containing betamethasone dipropionate. It is used to treat inflammatory skin conditions, including eczema and dermatitis, and is also effective for less responsive conditions such as scalp psoriasis and chronic plaque psoriasis affecting the hands and feet. It should not be confused with anabolic steroids, which are sometimes misused by athletes.

How does it work?

Betamethasone dipropionate is a potent topical corticosteroid. It reduces inflammation in the skin and helps relieve symptoms such as redness and itching.

Topical corticosteroids control inflammation and symptoms while they are being used but do not cure the underlying condition. They should be used at the appropriate potency and for the shortest duration necessary to control the condition.

Who can get it?

Diprosone is available on prescription for adults and children. Extra care is needed when using potent topical corticosteroids in children, on the face, or over large areas of skin. Prolonged continuous treatment should be avoided.

How is it used?

Diprosone is available as a cream, ointment and lotion. The formulation prescribed will depend on the area being treated and the type of skin condition.

Diprosone Cream and Ointment:
Apply a thin film to the affected area once or twice daily. In most cases, application twice daily is recommended initially. For some people, once-daily or less frequent treatment may be sufficient once the condition is controlled.

Diprosone Lotion:
For scalp conditions, including scalp psoriasis, apply a few drops to the affected areas twice daily and massage gently and thoroughly into the scalp. Once the condition is controlled, treatment may be reduced to less frequent application.

Use Diprosone sparingly and avoid getting it into the eyes. Wash your hands after application.

What are the side effects?

Diprosone is generally well tolerated when used correctly, but side effects can occur, particularly with prolonged use, excessive amounts, treatment of large areas, or use under occlusive dressings.

Possible local side effects include:

• burning or stinging
• itching or irritation
• dryness
• folliculitis
• acne-like eruptions
• increased hair growth
• changes in skin colour
• allergic contact dermatitis
• stretch marks
• thinning of the skin
• visible small blood vessels
• secondary skin infection.

Long-term or excessive use can increase absorption of the corticosteroid into the body and may cause systemic effects. The risk is greater when treating large areas, damaged skin, skin folds or when using occlusive dressings.

Pregnancy and breastfeeding

If you are pregnant, planning to become pregnant or breastfeeding, speak to your doctor before using Diprosone. Potent topical corticosteroids should be used only when necessary and at the lowest effective amount and for the shortest appropriate duration.

Manufactured by

Diprosone is manufactured in the UK by Organon Pharma (UK) Limited.

Reviewed: August 2026
Version ID: 2/DIP/PST/08/26

Etrivex is a very potent topical corticosteroid containing the active ingredient clobetasol propionate. It is used as a short-term treatment for moderate scalp psoriasis in adults.

It belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Psoriasis causes skin cells to be produced more quickly than normal, leading to areas of thickened, scaly and inflamed skin.

Clobetasol propionate reduces the inflammation associated with psoriasis. This helps to reduce redness, swelling, itching and scaling of the scalp.

Clobetasol propionate is a very potent corticosteroid, so Etrivex is intended for short-term use and should only be used as directed by your doctor.

Who can get it?

Etrivex is available on prescription for adults with moderate scalp psoriasis.

It is not recommended for use in children or adolescents under 18 years of age.

How is it used?

Etrivex Shampoo is applied once daily to the dry scalp.

The usual amount is approximately 7.5 ml (about half a tablespoon), or enough to cover the entire scalp.

1. Apply the shampoo to the affected areas of the dry scalp.
2. Gently massage it into the affected areas, making sure the scalp is adequately covered.
3. Wash your hands after applying the shampoo.
4. Leave the shampoo on the scalp for 15 minutes. Do not cover the scalp during this time.
5. Add water, work the shampoo into a lather and rinse the hair thoroughly.
6. Dry your hair as usual. If necessary, your normal shampoo can be used afterwards.

Do not use more Etrivex than necessary to cover the scalp.

Treatment should normally continue for no longer than 4 weeks. Your doctor will decide how long you need to use it and should review your progress if treatment is continued.

If your scalp psoriasis has not improved after the recommended course of treatment, speak to your doctor. Do not continue using Etrivex for longer than advised.

Etrivex should not be used on the face or on other areas of the body.

What are the side effects?

Most people do not experience serious problems when Etrivex is used correctly and for the recommended length of time.

Possible side effects include:

Common side effects (may affect up to 1 in 10 people):

• skin discomfort
• acne
• burning or stinging of the eyes if the shampoo comes into contact with them.

Uncommon side effects (may affect up to 1 in 100 people):

• skin irritation
• itching
• hives (urticaria)
• visible small blood vessels
• thinning of the skin around the treated areas.

Using too much Etrivex, applying it for too long or using it more frequently than recommended can increase the amount of clobetasol absorbed through the skin. This can increase the risk of side effects such as skin thinning and, particularly with prolonged or extensive use, effects elsewhere in the body caused by corticosteroid absorption.

Prolonged or repeated use of topical corticosteroids can also cause stretch marks, changes in skin colour, increased hair growth, inflammation of the hair follicles and other skin changes.

Treatment with topical corticosteroids can occasionally make psoriasis worse or cause pustular psoriasis.

If you develop significant irritation, swelling of the face or lips, worsening of your psoriasis or other unusual symptoms, stop using Etrivex and contact your doctor or pharmacist.

Avoid getting Etrivex in the eyes. If it does get into your eyes, rinse them thoroughly with water.

Marketed by

Etrivex is marketed in the UK by Galderma UK Ltd.

Reviewed: August 2026
Version ID: 2/ETR/PST/08/26

Clarelux is a very potent topical corticosteroid containing the active ingredient clobetasol propionate. It is used as a short-course treatment for steroid-responsive scalp conditions, including scalp psoriasis, when less potent corticosteroids have not worked well enough.

Clarelux belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids work on the skin to reduce inflammation, redness and itching.

How does it work?

Topical corticosteroids reduce inflammation by suppressing the release and activity of substances involved in the body's inflammatory response. This helps reduce the redness, swelling, itching and other symptoms associated with inflammatory skin conditions.

Clobetasol propionate is a very potent corticosteroid and therefore has a greater risk of side effects than milder corticosteroids. It is intended for short-term use.

Who can get it?

Clarelux is available on prescription for adults and adolescents aged 12 years and over.

It is not recommended for children under 12 years of age.

How is it used?

Clarelux is a pressurised cutaneous foam for use on the scalp only.

Apply a small amount to the affected areas twice a day, once in the morning and once in the evening.

Treatment should be limited to 2 consecutive weeks and no more than 50 g per week should be used. If treatment with a topical corticosteroid is needed beyond 2 weeks, a less potent corticosteroid should normally be considered. Short repeated courses may be used to control flare-ups when the patient is under regular medical supervision.

To apply:

1. Shake the canister well.
2. Hold the canister upside down and dispense a small amount of foam, approximately the size of a walnut or one teaspoon.
3. You can dispense the foam onto a cool surface such as the cap or a saucer rather than directly onto your hand, as it melts when it comes into contact with warm skin.
4. Move the hair aside and gently massage the foam into the affected areas of the scalp until it disappears.
5. Repeat as necessary until all affected areas have been treated.
6. Wash your hands after application.

Avoid contact with the eyes, nose and mouth. Do not use Clarelux on the face.

Do not use it near a naked flame, and do not smoke while using or handling the canister because the contents are flammable. The pressurised canister should also be protected from temperatures above 50°C and direct sunlight.

Do not cover the treated areas with a dressing or other covering unless specifically instructed by your doctor.

What are the side effects?

Most people tolerate Clarelux when it is used correctly and for the recommended length of time. Possible side effects include:

• burning or stinging
• itching
• redness or irritation
• thinning of the skin
• stretch marks (striae)
• increased visibility of small blood vessels
• changes in skin colour
• increased hair growth
• inflammation of the hair follicles (folliculitis)
• allergic contact dermatitis
• worsening of the underlying skin condition.

Prolonged or excessive use of very potent corticosteroids can allow the medicine to be absorbed through the skin and, particularly when large areas are treated, cause effects elsewhere in the body. These can include suppression of the body's natural steroid production and features of excessive corticosteroid exposure. The risk is greater in children and when treatment is used under occlusion.

Treatment with topical corticosteroids can occasionally cause pustular psoriasis or make an existing infection worse. Clarelux should not be used to treat a primary infected skin condition caused by bacteria, viruses, fungi or parasites.

If your scalp condition becomes worse, or you develop significant irritation or signs of infection, speak to your doctor or pharmacist.

Important: Clarelux should not be used on the face, and is contraindicated in conditions including rosacea, acne vulgaris, perioral dermatitis and perianal or genital itching. It should also not be used on ulcerated lesions or burns.

Marketed by

Clarelux is marketed in the UK by Pierre Fabre Ltd.

Reviewed: August 2026
Version ID: 2/CLA/PST/08/26

Betesil is a medicated plaster containing the potent topical corticosteroid betamethasone valerate. It is used for the treatment of chronic plaque psoriasis in localised areas that are difficult to treat, such as the knees, elbows and feet, when less potent corticosteroids have not been effective. Treatment should be limited to an area no greater than 5% of the body surface.

Betesil belongs to a group of medicines called topical corticosteroids. These should not be confused with anabolic steroids, which are sometimes misused by athletes. Topical corticosteroids reduce inflammation and can help relieve symptoms such as redness, itching and irritation.

How does it work?

Betamethasone valerate is a potent topical corticosteroid that reduces the inflammatory response in the skin.

Topical corticosteroids control inflammation and symptoms while they are being used but do not cure psoriasis. Stopping prolonged or intensive corticosteroid treatment suddenly can sometimes cause the condition to worsen or rebound.

Betesil is specially formulated as a medicated plaster to deliver a controlled amount of betamethasone valerate while the affected area is covered by the plaster.

Who can get it?

Betesil is available on prescription for adults.

If you are pregnant, planning to become pregnant or breastfeeding, speak to your doctor before using Betesil. It should only be used if specifically recommended by your doctor.

How is it used?

Apply one medicated plaster once a day to the affected area.

• Do not use more than six medicated plasters in 24 hours.
• Treatment should not normally continue for more than 30 days.
• A new plaster should be applied every 24 hours.
• Clean and carefully dry the affected area before applying the plaster.
• Cut the plaster to the required size if necessary so that it fits the affected area.
• Remove the protective film and apply the medicated adhesive surface to the affected skin.
• Wash your hands after applying the plaster.
• The treated area should not come into contact with water while the plaster is being worn, so bathing or showering is best done between applications.
• If the edges of the plaster lift, particularly over areas such as the knees or elbows, a small piece of adhesive tape can be used to secure the detached edge.
• Do not completely cover the medicated plaster with an additional occlusive dressing.

Once a significant improvement has been achieved, treatment can be stopped. Your doctor may recommend continuing with a less potent topical corticosteroid if further treatment is needed.

What are the side effects?

Like all medicines, Betesil can cause side effects, although not everyone gets them.

Side effects are usually local reactions affecting the skin underneath or around the plaster. These may include:

• redness
• itching
• skin irritation or burning
• dry or flaky skin
• skin thinning
• stretch marks
• small visible blood vessels
• skin erosion
• folliculitis or spots around hair follicles
• increased hair growth
• changes in skin colour
• allergic skin reactions

Because Betesil is a potent corticosteroid and the plaster provides occlusion, prolonged or excessive use can increase absorption of the steroid and the risk of side effects.

Stopping prolonged treatment suddenly may cause psoriasis to flare or become worse. In some cases, withdrawal of corticosteroid treatment can be associated with pustular psoriasis, which requires medical attention.

Manufactured by

Betesil is manufactured in the UK by Genus Pharmaceuticals

Reviewed: August 2026
Version ID: 2/BES/PST/08/26

Tacalcitol is the active ingredient in Curatoderm. It is a topical vitamin D derivative used to treat psoriasis vulgaris in adults.

How does it work?

Tacalcitol helps regulate the growth and development of skin cells. It slows down the excessive production of skin cells associated with psoriasis and helps reduce inflammation. This can help reduce the thickness and scaling of psoriasis plaques.

Who can get it?

Curatoderm is available on prescription and is intended for adults. Its safety and effectiveness in children and adolescents under 18 years have not been established.

Do not use Curatoderm if you are allergic to tacalcitol or if you have high levels of calcium in your blood or another disorder of calcium metabolism. Tell your doctor if you have kidney problems or take vitamin D supplements.

If you are pregnant, think you may be pregnant or are planning a pregnancy, speak to your doctor or pharmacist before using Curatoderm. The potential risk to an unborn baby is not known. If you are breastfeeding, speak to your doctor before use. The breast area should not be treated while breastfeeding.

How is it used?

Apply Curatoderm Ointment once a day, preferably at bedtime. Spread a thin layer over the areas affected by psoriasis. Do not use more than 10 g per day. If using the ointment on the scalp, it can be shampooed out the following morning. Wash your hands after applying it and avoid transferring the ointment to unaffected areas.

What are the side effects?

Curatoderm can cause temporary irritation where it is applied, including itching, burning and redness. Mild contact dermatitis or worsening of psoriasis may occasionally occur. Raised calcium levels in the blood can occur, particularly if too much is used.

Fire safety

Curatoderm Ointment contains paraffin. Keep away from naked flames and do not smoke while using this medicine. Clothing, bedding and dressings that come into contact with the ointment can catch fire more easily. Washing these items regularly can reduce the build-up of ointment but does not completely remove the risk.

Marketed by

Tacalcitol is known commercially as Curatoderm and is marketed in the UK by Almirall Limited.

Reviewed: August 2026

Version ID: 2/TAC/PST/08/26

Calcipotriol is a synthetic vitamin D analogue used as a topical treatment for plaque psoriasis.

How does it work?

Calcipotriol helps regulate the growth and development of skin cells. It reduces the excessive growth of skin cells associated with psoriasis, helping to flatten plaques and reduce scaling.

Who can get it?

The cream is available on prescription for those over 6 years of age and the scalp solution can be used for people over 18 years of age.

How is it used?

Calcipotriol cream should be applied twice daily directly to psoriasis lesions. Calcipotriol can irritate unaffected skin. It is important to follow your doctor's directions in applying Calcipotriol. Patients should always wash their hands thoroughly after applying the medication to avoid spreading it to unaffected areas of skin.

Using Calcipotriol on the scalp
Calcipotriol scalp solution is a water- and alcohol-based formulation specifically designed for treating scalp psoriasis. 
The solution should be used twice a day, once in the morning and once in the evening. Do not use more than 60 mL of scalp solution per week. It should be put on the parts of the scalp that are affected by psoriasis. It is recommended that children should not use the solution.
When using the solution the head should be tilted to make sure the solution does not run on to the face. It may help to part the hair before using the solution. Position the nozzle close to the scalp then squeeze the bottle gently and apply a few drops on to the affected area. Rub the solution in gently. One or two drops is enough to cover an area about the size of a postage stamp.
Avoid getting the mixture on the face or around the eyes, where it can cause irritation. Sweat can carry the medication onto the face and neck as well, so it is important to protect unaffected areas of skin.

The scalp solution contains alcohol and is flammable. Keep it away from fire, flames and sources of heat. Treatment with the scalp solution should normally not continue for more than 22 weeks, unless your doctor advises otherwise.

Using Calcipotriol for nail psoriasis
Calcipotriol is not specifically licensed for the treatment of nail psoriasis. A dermatologist may sometimes recommend it for this purpose based on individual circumstances.

What are the side effects?

 Most side effects are mild and occur where the medicine is applied.

• burning or stinging
• itching
• redness
• dry skin
• peeling
• rash
• dermatitis
• worsening of psoriasis.

Using more calcipotriol than recommended can cause the level of calcium in your blood to become too high. Always follow the recommended dose and do not use more than instructed. The safety of calcipotriol during pregnancy has not been established. If you are pregnant, think you may be pregnant or are planning a pregnancy, speak to your doctor before using calcipotriol. Speak to your doctor before using calcipotriol while breastfeeding. It should not be applied to the breast or nipple area. Treatment over large areas or for prolonged periods is not recommended during breastfeeding.

How do I get Calcipotriol?

Available by prescription.

Marketed by

Calcipotriol ointment is known commercially as Dovonex® and is marketed in the UK by Leo Laboratories Limited.

Calcipotriol scalp solution is marketed in the UK by Sandoz Ltd.

Reviewed: August 2026

Version ID: 2/CAL/PST/08/26

Calcitriol is the active ingredient in Silkis. Silkis is a topical treatment for mild to moderately severe plaque psoriasis affecting up to 35% of the body's surface area. It belongs to a group of medicines called vitamin D analogues.

How does it work?

Calcitriol helps regulate the growth and development of skin cells. It reduces the excessive growth of skin cells associated with psoriasis and also has an effect on inflammation. This helps reduce the thickness and scaling of psoriasis plaques. An improvement may be noticed from around 4 weeks after starting treatment.

Who can get it?

Silkis is available on prescription. It should not be used by people who are allergic to calcitriol or any of its ingredients, or by people with high blood calcium levels, abnormal calcium metabolism, kidney disease or liver disease.

The safety and effectiveness of Silkis have not been established in people under 18 years of age.

If you are pregnant, planning a pregnancy or breastfeeding, speak to your doctor before using Silkis. It should only be used during pregnancy if clearly necessary and in restricted amounts. Silkis should not be used while breastfeeding.

How is it used?

Wash and dry the affected areas before applying the ointment. Apply a thin, even layer to the psoriasis twice a day, once in the morning and once in the evening. Wash your hands after applying it and replace the cap.

Do not use more than 30 g per day or apply it to more than 35% of your body surface area. Do not cover treated areas with an occlusive dressing.

What are the side effects?

Silkis can cause irritation where it is applied. Common side effects include itching, skin discomfort, skin irritation and redness. Dry skin, worsening of psoriasis and allergic skin reactions can also occur.

Using more Silkis than recommended can increase calcium levels in the blood or urine. Do not use more than the prescribed amount.

Tell your doctor or pharmacist if you take calcium supplements, high-dose vitamin D or medicines that can affect calcium levels.

Fire safety

Silkis contains paraffin-based ingredients. Keep away from naked flames and do not smoke while using this medicine. Clothing, bedding and dressings that come into contact with the ointment can catch fire more easily. Washing clothing and bedding may reduce the build-up of ointment but does not completely remove the risk.

Marketed by

Calcitriol is known commercially as Silkis and is marketed in the UK by Galderma (U.K.) Ltd

Reviewed: August 2026

Version ID: 2/CAP/PST/08/26

Lotions are good for hairy or damaged areas of skin (such as weeping eczema – where pus is seeping out of damaged areas of skin). This is because lotions are thin and spread easily, but they're not very moisturising.

Reference https://www.nhs.uk/tests-and-treatments/emollients/

Reviewed: August 2026

Creams are good for daytime use as they're not very greasy and are absorbed quickly.

Reference https://www.nhs.uk/tests-and-treatments/emollients/

Reviewed: August 2026

Ointments are good for very dry, thickened skin and night-time use as they're greasy, thick and very moisturising. Ointments are usually free of preservatives so are suitable for sensitive skin, but should not be used on weeping eczema.

Reference https://www.nhs.uk/tests-and-treatments/emollients/

Reviewed: August 2026

Sprays are good for hard-to-reach areas and sore or infected skin that should not be touched, and are absorbed quickly.

Reference https://www.nhs.uk/tests-and-treatments/emollients/

Reviewed: August 2026

Everyday soaps, shampoos and shower gels usually dry out the skin and can make skin conditions like eczema worse.

It's recommended to use leave-on emollients as a soap substitute if you have dry or itchy skin.

Emollient soap substitutes that are used instead of normal soap in the bath or shower are not usually available on the NHS.

Reference https://www.nhs.uk/tests-and-treatments/emollients/

Reviewed: August 2026

There are lots of different types of leave-on emollient that can be put directly on the skin.

Some create a protective barrier over the skin to lock in moisture. Some have added ingredients to reduce itching or prevent infection.

Reference https://www.nhs.uk/tests-and-treatments/emollients/

Reviewed: August 2026