Add on Topical 5% Caffeine Enhances Short-Term Psoriasis Treatment Outcomes: Study

A new study published in the journal of Psoriasis: Targets and Therapy showed that incorporating topical 5% caffeine into the FAC (fixed-dose combination) therapy led to a more significant short-term decrease in psoriasis severity compared to using FAC by itself.

Plaque psoriasis is a long-lasting inflammatory skin condition marked by red, scaly patches that can greatly impact quality of life. While topical corticosteroids continue to be a conventional treatment, supplementary therapies might enhance clinical results. This study assesses the effectiveness and safety of combining 5% topical caffeine with 0.025% fluocinolone acetonide cream in treating plaque psoriasis.

This clinical trial involved 40 patients with chronic plaque psoriasis who were treated at the dermatology outpatient clinic of Sina Hospital, Tabriz, Iran. Participants were randomly assigned in a 1:1 ratio to receive either a topical combination of 5% caffeine plus 0.025% fluocinolone acetonide (intervention group, n=20) or topical 0.025% fluocinolone acetonide alone (control group, n=20). The severity of psoriasis was evaluated using the Psoriasis Area and Severity Index (PASI) at baseline and weekly for 4 weeks. Both treatment outcomes and any adverse effects were documented.

Initial PASI scores were similar between the intervention and control groups (3.41 ± 1.86 vs 3.79 ± 1.51, respectively; P=0.484). PASI scores were notably lower in the intervention group at every post-treatment evaluation. At week 4, the average PASI was 0.39 ± 0.17 in the intervention group when compared to 2.29 ± 1.31 in the control group (P=0.001).

The average decrease from baseline to week 4 was 3.01 ± 1.48 with 5% caffeine plus FAC and 1.49 ± 1.01 with FAC alone (P< 0.001). Complete clearance, defined as PASI=0, was observed in 14 out of 20 patients (70%) in the intervention group versus 1 out of 20 (5%) in the control group (P=0.001). No adverse effects were reported throughout the study.

Overall, topical 5% caffeine combined with FAC resulted in greater short-term improvement in chronic plaque psoriasis compared to FAC alone over a 4-week period, showing a more significant decrease in PASI scores and a higher rate of complete clearance. No adverse effects were observed during the treatment. These results indicate that caffeine could be a beneficial addition to topical corticosteroid therapy for plaque psoriasis. However, due to the small, single-center sample size and brief follow-up duration, these findings should be viewed as preliminary.

Source:

Mamizadeh, H., Herizchi Ghadim, H., & Pourasghary, S. (2026). Efficacy and safety of 5% topical caffeine added to 0.025% fluocinolone acetonide cream for plaque psoriasis: A randomized controlled trial. Psoriasis (Auckland, N.Z.), 16, 647017. https://doi.org/10.2147/PTT.S647017