Hello and welcome to healthcaremagic Treatment of Psoriasis is individualized. While topical treatment alone suffices for limited disease, oral + topical treatment are together useful for disease involving more than 20% of the body surface area. Methotrexate is just one of the several options for treatment of psoriasis. It is an immunosuppressive. It has a long history of use in psoriasis and with proper monitoring and follow up , it is considered to be one of the safest drugs. Serious side effects that are reported with its use in psoriasis are bone marrow suppression, liver abnormalities (fatty liver, cirrhosis) etc. Cyclosporin is another immunosupressive that can be used for rapid control of severe widespread erthrodermic or pustular psoriasis. However, it can cause raised blood pressure and raise serum creatinine, therefore requires monitoring for BP as well as serum creatinine levels. It is a sort of a rescue drug for severe widespread psoriasis, not for limited disease. Phototherapy, particularly NB-UVB phototherapy is one of the several treatment options for psoriasis. It is effective and well tolerated by most. Moreover, NB-UVB Phototherapy is one of the safest options for treatment of psoriasis and can also be used even in pregnant females as well as children. Oral retinoids e.g Acitretin can also be used for widespread psoriasis either alone or together with phototherapy. Finally Biologics like Infliximab, Adalimumab, Etanercept are newer remedies and includes monoclonal antibodies, interleukins, interferons and colony stimulating factors etc. Unlike extensive psoriatic disease for which both oral and topical treatment is required, for limited disease topical treatment alone is effective. Specific topical treatment options for psoriatic plaques consist of ointments containing potent steroid with or without salicylic acid. These are available in ointment form for plaques involving the body and as lotions/gels/foam form for scalp psoriasis. Topical Vitamin D analogues like calcipotriol, calcipotriene etc are also effective for localized plaque psoriasis. Besides specific remedies for psoriasis, moisturisers form an important part in the management of psoriasis because of the thick scaly nature of the plaques. Moisturizers enhance the penetration of topical active ingredients as well as prevents or delays side effects like skin atrophy etc. Hope this helps Regards