Managing Mild-to-Moderate Psoriasis in Elderly Patients: Role of Topical Treatments

The approach to managing mild-to-moderate psoriasis in the elderly (ages > 65 years) should be no different to that in the younger population. Topical agents are frequently prescribed for elderly patients as first-line therapy because of their localized impact and minimal systemic effects. Although topical therapy remains the mainstay treatment of mild-to-moderate psoriasis, the elderly population may be at a higher risk of steroid-induced adverse events, including atrophy, purpura, telangiectasia, secondary skin infections, rebound phenomenon, and tachyphylaxis. In addition, offering photo- and systemic therapy to elderly patients with mild-to-moderate psoriasis may pose challenges due to the presence of comorbidities, patient adherence, and reduced physical functioning. Nonetheless, topical therapy remains first-line therapy for elderly and younger patients with mild-to-moderate psoriasis as standalone therapy or in combination with oral and biologic agents. Effective use of topical treatments should be prioritized to ensure elderly patients can be effectively managed prior to advancing to photo- or systemic treatment modalities.