Apply dithranol once a day only. Wash it off after it has been in contact with your skin for the required time.
Remember to wash your hands well after using it. This will help to prevent accidentally getting it on other areas of your skin.
Dithranol commonly produces a feeling of warmth on your skin. If burning or soreness occurs, this can mean that the strength is too high for you or that it has been left on for too long.
Dithranol can stain your skin, hair and clothing.
|Used for||Chronic plaque psoriasis|
|Also called||Dithrocream®; Micanol®; and as an ingredient in dithranol paste|
|Available as||Cream, ointment and paste|
Dithranol is used to treat chronic plaque psoriasis - this is the most common type of psoriasis. It is a condition where red scaly patches called plaques develop on your skin. The most common areas affected are over your elbows and knees, the scalp, and the lower part of your back. The patches may vary in size from time to time, and can be itchy. Treatment for psoriasis aims to clear the plaques as much as possible.
Psoriasis is caused by cells in the outer layer of your skin multiplying faster than normal. This causes the older and dead skin cells to build up on the surface of your skin, causing the scaly patches. Dithranol helps to control psoriasis by slowing down the production of new skin cells.
Dithranol is available on prescription, and you can also buy some preparations without a prescription at a pharmacy. Some dithranol preparations also contain other ingredients, such as salicylic acid, zinc and coal tar.
Before using dithranol
To make sure this is the right treatment for you, before you start using dithranol it is important that your doctor or pharmacist knows:
- If you are pregnant or breast-feeding. This is because, while you are expecting or feeding a baby, you should only use medicines on the recommendation of a doctor.
- If any of the areas of psoriasis are sore, inflamed or have blisters filled with pus. This is because more severe forms of psoriasis like these should be treated by a skin specialist.
- If you are using any other skin preparations. This includes any which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to apply dithranol
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about applying dithranol and a full list of the side-effects which you may experience from using it.
- There are several strengths of dithranol preparations. The aim is to find the strength which gives you the most benefit, but which doesn't lead to irritation/burning. Start by applying a low-strength preparation (such as 0.1% dithranol) for a week, and then increase the strength gradually over the next few weeks until you find the strength that suits you best. Then continue to use this strength. It should be possible to clear the patches within about 4-6 weeks of treatment.
- Apply a thin layer of dithranol and rub it into your skin gently. Apply it to the affected areas of your skin only - it is important that you try to avoid getting it on any healthy areas of your skin. Use it once a day only - you can choose a time of day that suits you best.
- It is usual to use dithranol for a 'short contact' time. This means leaving it on your skin for no more than an hour, and then washing it off in a shower or bath. More intensive treatment with dithranol involves leaving it on overnight under a dressing. This is usually only done under the supervision of a specialist skin doctor or nurse.
- Remember to wash your hands well after applying dithranol. This will help to prevent it accidentally getting on healthy areas of your skin. Some people choose to apply it using gloves to protect their hands.
- Dithranol is not suitable for use on your face, or in the creases of your skin (flexures) such as your armpits, groin, or under breasts. Do not apply it to these areas.
Getting the most from your treatment
- You will be given a low-strength preparation to start with and then a higher-strength preparation if you are not having any problems. Although it is normal to feel a sensation of warmth when dithranol is applied, if you begin to feel a burning sensation this can mean that it has been left on too long or the strength is too high for you. Let your doctor or pharmacist know if this happens.
- If you are using a preparation on your scalp, be careful to avoid getting any in your eyes as you wash it off. If this does happen, rinse it out with warm water straightaway.
- Try to keep any regular appointments with your doctor. This is so your doctor can check on your progress.
- Dithranol can stain your skin, hair and clothing. You should try to avoid any contact between the preparation and your clothes and furniture, as this could cause permanent staining. It can also stain the bath or sink, so it is best to clean these straightaway after use. Any skin staining will disappear soon after the treatment is finished.
Can dithranol cause problems?
Dithranol can cause skin irritation, such as redness, itching and a burning sensation. If this continues or if it becomes severe, stop using dithranol and ask your doctor or pharmacist for advice.
Dithranol can stain your skin, hair and clothing. Skin staining will disappear within a few days after you stop using the product. Stained hair will grow out. Wear old clothing and use old bed linen when using dithranol.
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store dithranol
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
This preparation is for external use only. If someone swallows some of it by accident, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Dithrocream®; Dermal Laboratories Limited, The electronic Medicines Compendium. Dated November 2014.
- British National Formulary; 71st Edition (Mar-Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.
Mr Michael Stewart
Dr Helen Huins