Hello. Thank you for writing to us at healthcaremagic I agree with the line of treatment of your doctor. Psoriasis is characterized by red, scaly plaques at various body sites, predominantly extensor skin surfaces like elbow, knee, back etc. Scalp is invariably involved. The disease is chronic and there may be recurrences after seemingly complete cure. Joint involvement is also part of psoriasis. Methotrexate has long history of efficacy and safety in psoriasis and is commonly used together with topical preparations. The dose of methotrexate is once weekly and it takes 6-8 weeks to show noticeable improvement. It is effective against both skin and joint involvement with psoriasis. Methotrexate should be monitored at regular intervals with blood tests as it can rarely cause marrow suppression. The topical that you were already using contains a potent topical steroid along with salicylic acid. Salicylic acid is keratolytic and helps exfoliate thick scaling that usually accompanies psoriasis. Psoriasis is steroid responsive and potent topical steroids are very effective. However, steroids cannot be used for ever because of side effects of potent topical steroids like skin thinning/ atrophy. Therefore it is better to switch over from potent topical steroids to safer topical options like Vitamin D analogues which unlike topical steroids can be used long term. The new topical ointment that has been changed to contains topical vitamin D analogue e.g calcipotriol and it is a good decision. Regards