Prescription Topical Retinoids
Tazarotene (Tazorac) is the only topical retinoid that’s approved for psoriasis by the U.S. Food and Drug Administration (FDA), Lam says. It comes in two strengths — 0.1 and 0.05 percent — as a foam, gel, and lotion that should be applied in a thin layer to affected skin once daily at bedtime.
“Tazarotene is a fairly powerful retinoid. It works like all retinoids do — by stopping skin cells from dividing too fast and calming down the immune system,” he says.
Dermatologists often pair tazarotene with a topical corticosteroid, says Marisa Garshick, MD, a dermatologist in New York and New Jersey and a clinical assistant professor of dermatology at NewYork-Presbyterian Weill Cornell Medicine.
Using both can reduce the skin irritation that typically comes with using a retinoid. The combination can also provide longer-lasting results and a longer remission time compared with using a retinoid on its own. In people whose skin clears, remission may last up to three months.
Tazarotene isn’t for everyone, though. “It can be considered for patients with thick, stubborn, scaly psoriasis plaques that aren’t responding to topical steroid treatment alone,” Dr. Garshick says.
It’s also saved for people with limited disease, Lam says. “If lots of skin is involved, it’s not practical to put all over,” he says.
You can ease your way into using tazarotene by starting with a lower concentration, applying the ointment every other day, or using a cream instead of gel if you have sensitive skin, Lam says. Stay away from layering it with retinols, abrasive soaps and detergents, and products with a high alcohol content, he says.
Common side effects include burning and stinging, changes in color on treated skin, dryness, itching, peeling and redness, skin rash, and pain and swelling.
If tazarotene is causing significant irritation, or if the treated skin is sunburned, speak with your dermatologist before changing how you use it, Lam says.
Some people see improvements as early as within a week, Lam says. “The best results are seen after about two to three months of use,” he says.
Women who are pregnant shouldn’t use tazarotene because of the risk of birth defects.
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