Microneedle Technology in Psoriasis Management: Mechanistic Insights, Technological Innovation, Clinical Progress, and Challenges

Psoriasis is a chronic dermatological disorder that affects millions worldwide, impairing their quality of life. Current therapeutic modalities, topical, conventional systemic, and biologic, present significant limitations. Topical agents often exhibit inadequate penetration through psoriatic plaques, yielding suboptimal outcomes. Systemic therapies and biologics, while more potent, carry risks of serious adverse effects, necessitating rigorous monitoring and limiting their long-term utility. Despite these challenges, optimizing existing treatment strategies remains valuable. Microneedle technology has emerged as a minimally invasive, skin-targeted approach offering enhanced drug delivery, localization, and patient compliance. This review provides an in-depth analysis of microneedle-based strategies tailored for psoriasis, beginning with current therapy shortcomings, unmet needs in psoriasis management, and principles of microneedle technology. We then critically evaluate microneedle integration across diverse therapeutic domains, from topical formulations to biologics, off-label therapies, and phytomedicines, alongside emerging therapeutic innovations. Additionally, we highlight microneedle potential in psoriasis diagnosis and monitoring, underscoring its versatility and growing significance in psoriasis management. The review wraps up by discussing key limitations of microneedle technology, outlining strategic pathways for clinical translation, and offering a comparative perspective of various microneedle types in psoriasis care. Altogether, microneedles represent a paradigm shift toward precision dermatology, with the potential to revolutionize psoriasis management.