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Is prolonged use of Topisal safe for psorasis treatment?

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Posted on Tue, 8 Jul 2014
Question: Hello Sir, I am 27 old female.I am basically from XXXXXXX XXXXXXX i have been diagnosed with Psoriasis problem on scalp, usually appears and visible on behind ear area and sometimes i see its spots on my chest, hands and leg. Doctor has prescribed me:- Topisal Lotion (3%). I am using it since 8 years and many time it works if i use it daily for relief but when i reduce its consumption it Psoriasis starts again.
I am concern about any side effect of this lotion.Please suggest me any alternative or more effective medicine. One more thing direct me for its proper use.
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Answered by Dr. Johny Chacko (19 minutes later)
Brief Answer:
Scalp psoriasis

Detailed Answer:
Hello,
Welcome to healthcare magic.
I understand from your query that you have been having psoriasis, predominantly on the scalp and have been using Topisal 3% lotion on and off during flares.

Topisal contains Clobetasol propionate, which is a potent steroid. It should not be continuously for more than 3 weeks. It could cause thinning of skin, whitening of skin and other side effects.

Psoriasis, as you may be knowing is a chronic problem which has remissions and relapses. You need to some some non steroidal alternatives to maintain the disease in remission or to prevent the disease from flaring up.

In your case, you will need a strong medication like a steroid lotion only for 5-10 days during flare ups of the disease. You could use a lotion containing a less potent steroid like Betamethasone ( e.g- Diprovate lotion) or Mometasone (e.g- Momate lotion). Use this only on the thick patches twice a day for 5 - 10 days till the patches disappear.

However, to prevent the disease from coming back, you could use a lotion containing coal tar and salicylic acid (e.g- Ionax T lotion). This comes in a shampoo base. Apply it on the patches for 15 -20 minutes before bath and then rinse it off. Do this on alternate days regularly. This will prevent the patches from becoming worse.

You could also use a lotion containing Calcipotriol (e.g- Calpsor lotion - Biocon company) at bedtime on the areas where you get patches ( even after all the patches have disappeared). This does not contain a steroid and is safe for long term use to prevent flare ups.

However, even with this regime, you could get flare ups during winter, during bouts of infection/ stress. During the flare ups, use the steroid lotion in a manner I have mentioned above.

Try to cut down stress by yoga/ meditation.

Do not scratch your scalp.

Have lots of anti-oxidant rich food ( fruits and vegetables) and foods containing Omega- 3 fatty acids ( walnuts, salmon, flax seeds,etc). This will help your psoriasis.

Hope this helps you.

If you have any more queries, I will be glad to assist.

Take care,
Dr. Johny Chacko
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Johny Chacko

Dermatologist

Practicing since :2005

Answered : 1916 Questions

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Is prolonged use of Topisal safe for psorasis treatment?

Brief Answer: Scalp psoriasis Detailed Answer: Hello, Welcome to healthcare magic. I understand from your query that you have been having psoriasis, predominantly on the scalp and have been using Topisal 3% lotion on and off during flares. Topisal contains Clobetasol propionate, which is a potent steroid. It should not be continuously for more than 3 weeks. It could cause thinning of skin, whitening of skin and other side effects. Psoriasis, as you may be knowing is a chronic problem which has remissions and relapses. You need to some some non steroidal alternatives to maintain the disease in remission or to prevent the disease from flaring up. In your case, you will need a strong medication like a steroid lotion only for 5-10 days during flare ups of the disease. You could use a lotion containing a less potent steroid like Betamethasone ( e.g- Diprovate lotion) or Mometasone (e.g- Momate lotion). Use this only on the thick patches twice a day for 5 - 10 days till the patches disappear. However, to prevent the disease from coming back, you could use a lotion containing coal tar and salicylic acid (e.g- Ionax T lotion). This comes in a shampoo base. Apply it on the patches for 15 -20 minutes before bath and then rinse it off. Do this on alternate days regularly. This will prevent the patches from becoming worse. You could also use a lotion containing Calcipotriol (e.g- Calpsor lotion - Biocon company) at bedtime on the areas where you get patches ( even after all the patches have disappeared). This does not contain a steroid and is safe for long term use to prevent flare ups. However, even with this regime, you could get flare ups during winter, during bouts of infection/ stress. During the flare ups, use the steroid lotion in a manner I have mentioned above. Try to cut down stress by yoga/ meditation. Do not scratch your scalp. Have lots of anti-oxidant rich food ( fruits and vegetables) and foods containing Omega- 3 fatty acids ( walnuts, salmon, flax seeds,etc). This will help your psoriasis. Hope this helps you. If you have any more queries, I will be glad to assist. Take care, Dr. Johny Chacko