Psoriasis is a common, frustrating problem for dermatologists and patients. Long-held notions about the need to use thick, greasy corticosteroid ointments for psoriasis contributed to frustration for many patients. Fortunately, the general approach to managing psoriasis is changing. The purpose of this article is to describe key components of psoriasis management with a focus on the changing paradigm for treating the disease. In addition to making the right diagnosis and prescribing the right treatment, key elements of psoriasis management include establishing a strong physician-patient relationship, educating patients about the disease and recognizing the importance of adherence to topical treatment. In light of the tendency toward poor adherence, use of a fast-acting agent in a vehicle that patients are willing to use is critically important for successful disease management.