BACKGROUND: Psoriasis is a common inflammatory skin condition that varies in severity. Most patients have limited disease amenable to topical treatment; however, poor treatment adherence limits efficacy. The purpose of this study was to assess patients’ psoriasis treatment experience, expectations, and preferences. METHOD: The National Psoriasis Foundation conducted a 17-question survey in March 2022 assessing psoriasis severity, bothersome signs and symptoms, current treatment modalities, frequency of topical therapy use, and vehicle preferences. Statistical analysis of the qualitative data was performed using descriptive analysis and calculations of relative frequencies. RESULTS: Most participants self-reported moderate psoriasis (83.9%). The most common bothersome symptoms were scaly appearance (78.8%), bleeding/oozing (60%), itch (55%), and flaking (37.4%). For treatment, 72.5% of participants disclosed using oral medication, while 8% used topical treatment alone. Most participants (76%) reported using topical therapy at least once weekly. Nearly 80% of participants said they would allow 2 weeks for a medication to become effective before considering discontinuation. Participants preferred water-based creams (75.7%), followed by oil-based foam (70.8%), gel (48.7%), solution (42.8%), lotion (21.2%), non-oil-based foam (17.5%), ointment (16.5%), and spray (6.3%). The formulation attributes rated most important were application feel (55.2%), non-staining (49.9%), quick absorption (46.7%), non-sticky texture (39.7%), ease of application (28.5%), no unpleasant smell (22.4%), non-greasy (16.8%), works quickly (14.1%), absent sting or burn (10%), no adverse skin reaction (9.7%), and once daily treatment (6.8%). If participants did not like a topical treatment's formulation, most (74.7%) said they would continue to use the medication for a week before discontinuation. CONCLUSION: Topical treatments continue to be a mainstay of psoriasis treatment. Patients expect to see rapid improvement with topical treatment; otherwise, they report that they will discontinue treatment. The characteristics of psoriasis treatment vehicles also affect patients’ reported willingness to use treatment and may be an important consideration in treatment planning. J Drugs Dermatol. 2023;22(4): doi:10.36849/JDD.7372 Citation: Curcio A, Kontzias C, Gorodokin B, et al. Patient preferences in topical psoriasis treatment. J Drugs Dermatol. 2023;22(4):326-329. doi:10.36849/JDD.7372.