If you're worried about psoriasis, or want more information about psoriasis treatment, the following article will provide you with invaluable information:
Dithranol ointment or cream often works well to clear plaque psoriasis. One drawback is that it can irritate skin and stain clothing. These effects can be minimised if dithranol is used for a short period every day and the strength is gradually increased to the strongest tolerated. Follow the instructions carefully that come with the brand you are prescribed for best chance of success and minimal problems.
What is dithranol and short contact dithranol treatment?
Dithranol is a drug that has been used in the treatment of psoriasis for over 50 years. There are various brands of ointments and creams that contain different strengths of dithranol. Dithranol is usually a safe treatment and will clear psoriatic plaques in many people with psoriasis.
As a rule, dithranol is only used to treat the classical large plaques of psoriasis. It is not usually suitable for widespread small patches of psoriasis that some people develop. Also, it should not be used in the skin flexures (front of elbows, behind knees, etc) or on the face.
Dithranol can irritate if it comes into contact with normal skin around areas of treated patches of psoriasis. It can also stain clothing and furnishings that come into contact with it. These problems can be minimised if dithranol preparations are used for a short period every day ('short contact') and the strength is gradually increased so that the skin becomes used to the treatment.
How to use dithranol for short contact treatment
Follow the instructions carefully that come with the brand you are prescribed. Also, persevere with the treatment as success often takes several weeks. The instructions may include the following:
- Wear plastic disposable gloves when applying dithranol cream or ointment. Wash hands thoroughly after applying dithranol.
- Apply the cream or ointment only to the plaques of psoriasis. Carefully avoid putting it on normal skin. For creams, apply sparingly, rub in well and wipe off any excess. For ointments, apply sparingly.
- Avoid getting any in or near the eyes. If eye irritation occurs wash thoroughly with water and if it persists, see your doctor.
- Leave the cream or ointment on for as long as directed by your doctor. For short contact treatment, this may be anything from 5-60 minutes. Then wash it off.
- Be aware that dithranol may stain skin or clothes (see below).
A common treatment plan is to start with 0.1% dithranol. If there is no irritation then apply daily as directed (often for about 30 minutes each day) for a few days. The strength is then often increased to a 0.25% preparation which is continued for a further few days before moving on to a higher strength, etc. The aim is to gradually build up the strength (the % concentration) to the strongest preparation you can tolerate. The strongest of the brands that can be prescribed is 3%. However, hospital skin departments sometimes use even higher strengths for difficult cases.
If irritation or burning occurs at any time, stop using dithranol and apply a moisturiser until the skin has settled. Then start again at a lower strength. Some people are more sensitive to the irritating and burning effects than others. So, different people end up using different strengths.
Carry on with the treatment until the skin feels almost normal to the touch. Continue for a further two weeks then stop. Any staining of the skin will clear, usually in about two weeks.
If you have problems with skin irritation, or if there is no improvement after three weeks at the highest strength you can tolerate, then see your doctor for advice.
Dithranol can stain
Dithranol stains normal skin a brownish colour. This is temporary and will gradually fade. It may also stain clothes, sheets, furnishings, etc, if they come into contact with dithranol. This staining can be permanent. So, when using dithranol, wear old clothes that you don't mind if they become stained.
Baths may also be stained. If possible, have a shower rather than a bath after using dithranol treatment. If you have a bath, clean it immediately with detergent. A little vinegar added to rinse water helps to reduce staining.
If staining of the skin occurs in the centre of the plaques of psoriasis, this means the psoriasis is starting to clear.
©EMIS and PIP 2005
