Psoriasis can have a large impact on a patient’s quality of life, yet adherence to psoriasis treatment often is poor. A large international study was conducted in adults with psoriasis and/or psoriatic arthritis to characterize the disease burden of psoriasis and its relationship to treatment adherence using a detailed, self-administered questionnaire. The results presented in this article represent the subset of US respondents who were currently taking prescription medication (N=193). The impact of psoriasis was graded as moderate to extremely high by 71% of US survey respondents. Among the respondents who did not adhere to prescribed treatments, approximately 50% attributed their nonadherence to forgetfulness and reported using the medication when they deemed it necessary. Respondents expressed a strong willingness to adhere to medications that were effective and to try multiple new treatments to find an optimal therapy. Of the respondents who were currently taking prescription medication, 88% were using topical therapies. The greatest unmet needs associated with topical psoriasis treatment were identified as fewer side effects, more rapid onset of action, and increased efficacy. The majority of respondents described positive relationships with their physician and a positive outlook with regard to physician communication, indicating an opportunity for the physician to directly influence patients’ perceptions of disease burden and quality of life. When treating psoriasis with topical therapies, physicians should focus on improving and maintaining patients’ quality of life, as this practice can be expected to improve treatment adherence and efficacy.