Dithranol has been used to treat psoriasis for many years, and was traditionally applied by nurses in a hospital ward. Modern dithranol preparations mean that people are able to use it themselves at home, although it can be time-consuming and messy.
Dithranol has been used in the treatment of psoriasis since the nineteenth century. Dithranol is thought to have anti-inflammatory properties, and slows down the over-production of skin cells, which is a problem in psoriasis.
It was traditionally used in a hospital and applied by a Dermatology Nurse. As the availability of ready-made applications of Dithranol improved, people were able to use it at home.
Unfortunately, the ready-made applications are no longer available and so dithranol treatments are now only available via a prescription from your doctor requesting that a special-order is made by the pharmacist. The type of dithranol made via special-order prescription comes as an ointment. Dithranol treatments are no longer manufactured for general sale in pharmacies. Dithranol can be an effective treatment for some if used correctly, with no significant long-term side effects, although it is not often prescribed currently
Dithranol can irritate skin that does not have psoriasis on it, so it is most appropriate for well-defined plaques of psoriasis on the limbs or torso.
Dithranol is usually not suitable for psoriasis plaques that are small or widespread across the body, such as in guttate psoriasis. Dithranol is also not suitable for pustular forms of psoriasis.
You should not use dithranol treatments on sensitive areas of the body, such as the face, genitals or skin folds, unless specifically told to by a doctor and it should be kept away from your eyes.
Dithranol should always be started with the lowest strength treatment. Increased strengths can be introduced gradually if needed unless an irritation occurs. The cream or ointment should usually be applied to psoriasis once a day for anywhere between ten minutes and an hour before being washed off.
The length of time will depend on how your doctor or nurse has advised you, or what is stated on the treatment’s patient information leaflet. In most cases, dithranol should be used every day until the skin is clear. At this point, some staining may be left on the skin, but areas where psoriasis once was should feel the same as normal skin when touched. This can take up to six weeks. If clearance isn’t seen in four to six weeks, it could be that a higher strength of dithranol is needed.
The use of dithranol should be regularly reviewed by a healthcare professional involved in your psoriasis care. As dithranol treatments are no longer manufactured for general sale in pharmacies any further increase in strength would also only be available via a special-order prescription. It is thought that ‘active’ topical treatments, including dithranol, work better when the skin is well moisturised.
Therefore, it is recommended that an emollient (moisturiser) should be applied and allowed to sink in before using a dithranol treatment. Dithranol is a time-consuming treatment, and so is not suitable for everyone. However, it can be an effective treatment for those who wish to use it.
Some mild skin irritation is common in the areas the dithranol has been applied to. If you experience burning or soreness that does not get better, stop treatment and consult your doctor. In many cases, using a lower strength treatment helps to improve side effects.
Be aware that the treated areas of skin may gradually become stained purple or brown. This is harmless and will gradually disappear after the end of treatment. Do not attempt to scrub the colour from the skin, as this may damage the skin and make psoriasis worse. Staining of the skin in the centre of the plaques of psoriasis is common when the psoriasis is starting to clear.
Tips for using dithranol treatments
Dithranol treatments are now only available via a prescription from your doctor requesting that a special-order is made by the pharmacist.
The type of dithranol made via special-order prescription comes as an ointment.
The information in this resource is not intended to replace that of a healthcare professional: If you have any concerns or questions about your treatments, do discuss this with your doctor or pharmacist and always read the patient information leaflet to make sure you are using them
For information on the different types of dithranol treatments available to treat psoriasis, take a look at our dithranol information sheet.