Psoriasis is a persistent, immune-complex skin disease, which is manifested by overgrowth of keratinocytes and inflammation throughout the body. Topical therapy is still the key of psoriasis treatment, particularly in mild to moderate cases. Yet, traditional topical preparations are usually associated with poor penetration rate, efficacy in the patient, and effectiveness as a treatment method. Over the past years, there have been major advancements in the design of sophisticated topical drug delivery systems to improve drug localization and efficacy and reduce systemic exposure. The chapter draws a review of the state-of-the-art innovations of nanocarriers, liposomes, solid lipid nanoparticles, nanoemulsions, and microneedle-based delivery systems. These novel advanced platforms have their mechanisms, benefits, constraints, and clinical potential in the setting of psoriasis pathophysiology. In addition, new tendencies in customized and reactive topical medications are mentioned, which presents a future outlook on precision dermatology.