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Thanks anyway, i always remember it being messy and used to have to sit in the nuddy for about an hour so it didn't get anywhere. Â Not looking forward to that in this weather. Â Hope noone comes to the door.
Dithranol, also know as anthralin, is a highly reactive chemical compound which is a synthetic derivative of the crude drug chrysarobin which occurs naturally in some plant extracts. How Dithranol works is not entirely understood but research suggests that it works by damping down the excessive rate of growth in the cells of the epidermis, albeit this is not a full explanation of exactly how it works or whether it is the Dithranol or a derivative that is formed in the skin when it is applied. Chemically Dithranol is very unstable and so needs to be mixed with stabilizers to stop it deteriorating, hence the short shelf life of most creams.Dithranol is normally used as a cream or a paste with the content percent ranging from the 0.1% up to (although I have never seen it) 10%. As with Psoriasis in general some people are more subjetable to Dithranol and are only unable to tolerate low concentrations whilst others may not see a benefit until moved onto the higher strength creams. One of the many drawbacks of Dithranol is the way that it stains both good skin and any clothing it come's into contact with, although this usually disappears with a week or two. Until recently Dithranol was purely used as an in-patient treatment using a method called THE INGRAM METHOD (after the doctor who pioneered it) which when combined with UVB light treatment could produce an almost total clear within 3 weeks even with some one with severe Psoriasis. However now a days the same method is widely used in what is known as SHORT CONTACT THERAPY where by the patient attends an outpatient clinic and has the Dithranol applied and left on for approx 30mins and then washed off. The patient may also have a UVB session prior to the application of Dithranol which would appear to make the skin more subjectable to the Dithranol. My experience with this method is that you will start with a 0.1% mix and this is applied for 3 days in a row. On the 3rd day providing no side effects a test patch of the next strength (0.25%) is given. The following session, again providing no side effects, the cycle starts again and repeated until a max tolerable strength is found. If at anytime any side effects are occurred the patient may be held at the strength for a week, or depending on severity have the strength reduced. As with all Psoriasis treatments the use of a good emolument, such as diprobase, is recommended. I have had a 95% clear using this method, reaching a max strength of 4%, in approx 6 weeks with others attending the same clinic experiencing the same level in around the same time.The side effects can be very distressing with the chemical burn being the worst however I have found that Betnovate RD (1/4 strength) very helpful and have also used Eumovate to reduce the sting. Due to the risk of side effects Dithranol should under no circumstances be used on the face, the genitals or any folds of skin (armpits etc) and great care MUST be taken in its application to prevent good skin from being harmed. Although the above may put some off from using this therapy It has been proven (so my Derm and derm nurse's tell me) that a clear on Dithranol will last far longer then on most, if not all, other treatments so the extra work may well be worthwhile with this treatment in order to stay clear.
