INTRODUCTION: Psoriasis is characterized by abnormal differentiation and hyperproliferation of epidermal keratinocytes. This condition presents significant challenges for effective drug delivery. In addition to overcoming the thickness of the skin, topical treatments must navigate the complex hydrophobic and hydrophilic properties of the skin barrier. Recent advancements in nanocarrier technologies, including energy-driven methods and microneedles that penetrate the stratum corneum, present promising strategies for enhancing drug permeation through tailored physicochemical properties. A literature search was performed using the databases of Google Scholar, PubMed, and ScienceDirect. AREAS COVERED: This review highlights recent studies on novel topical delivery methods for psoriasis treatment, addressing current therapeutic options and their limitations. We provide a comprehensive overview of chemical nanoformulations and explore physical strategies to improve delivery rates. Furthermore, we discuss the advantages of various formulations that can carry different types of payloads, offering patients diverse strategies for symptom management. The review covers conventional treatments, emphasizing advancements in nanoparticle design and novel macromolecular drugs. This includes Ribonucleic acid (RNA)-based therapies that protect macromolecular drugs from rapid clearance in the body. EXPERT OPINION: We argue that intelligent design approaches can enhance efficacy across delivery applications while allowing for precision in treatment strategies, ultimately improving patient outcomes.