Psoriasis : topical therapy NICE guidance summary

A summary of topical therapy treatment of psoriasis by NICE

Recommendation	Key Messages
First-line Treatment (Topical Therapy)	• Offer topical therapy as the initial treatment option.
Second- or Third-line Treatment Options	• Consider phototherapy or systemic therapy alongside topical therapy for cases where topical treatment alone may not be sufficient, such as extensive disease, moderate severity, or ineffective topical therapy (e.g., nail disease).
Topical Agents	• Consider patient preference, practicality, and the extent of psoriasis when choosing the formulation (cream, lotion, gel, ointment) and application site.
Review Appointments After Starting Topical Treatment	• Schedule a review appointment 4 weeks after starting topical treatment in adults and 2 weeks in children to assess tolerability, response, and reinforce adherence.
Lack of Improvement in Topical Treatment	• If there is little or no improvement, discuss the next treatment option with the patient.
Importance of Continuing Topical Treatment	• Emphasize the importance of continuing treatment until achieving a satisfactory outcome or up to the recommended maximum treatment period for corticosteroids.
Potential for Relapse After Treatment Stopping	• Inform patients that relapse is common after discontinuing treatment.
Maintenance Treatment After Initial Period	• After the initial treatment period, topical treatments can be used as needed...

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