Background Limited health outcomes information exists for patients with mild to moderate plaque psoriasis (hereafter, referred to as psoriasis) prescribed topical treatment(s). Aim We evaluated clinical characteristics of patients with systemic-naïve mild to moderate psoriasis after topical use in the United States. Methods Data were drawn from 2017 to 2018 Adelphi Psoriasis Disease Specific Programme™, a point-in-time survey of physicians and adult psoriasis patients, capturing data on topical treatment at time of consultation prescribed to systemic-naïve patients with mild to moderate psoriasis (i.e. body surface area [BSA] ≤ 10%) at current treatment initiation. Patient clinical characteristics before/after topical use were evaluated descriptively. Results Among 304 patients (median age 43.0 years; 53.6% female), mean time since diagnosis was 60.9 months. After a mean 6.9 months on their current topical, 14.5% of patients achieved ≥75% BSA reduction, 38.9% ≥50% BSA reduction, and 50.2% no BSA reduction. Residual psoriasis symptoms included scaling (76.5%), inflamed skin (65.9%), and itching (60.4%). Most patients (71.2%) had residual psoriasis in special body areas: nails (92.3%), palmoplantar (78.9%), scalp (75.9%), and face (65.8%). Conclusion We found unmet need in topical treatment effectiveness in mild to moderate psoriasis patients, in terms of BSA reduction, symptoms, and special body areas affected.