Psoriasis treatments: Combination Therapies

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

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