Dithranol paste

How does it work?

Dithranol paste contains the active ingredient dithranol in a salicylic acid and zinc paste, also known as Lassar's paste. Dithranol and salicylic acid are both medicines that are applied to the skin to treat psoriasis.

Psoriasis is a condition in which thickened, scaly patches or plaques of skin form. These are the result of excessive production of skin cells.

Dithranol works by slowing down the process of skin cell production. It is applied only to the psoriasis plaques and not to normal healthy skin. The dithranol is absorbed into the skin cells and inhibits DNA replication in these cells. This slows down cell division and stops the cells from multiplying excessively. In turn, this reduces the thickening and scaling of the skin and clears up the psoriasis plaques.

Salicyclic acid is a type of medicine known as a keratolytic. It works by breaking down keratin, a protein that forms part of the skin structure. This helps the skin cells shed from the treated area and helps reduce the thickening and scaling of the psoriasis plaques. It can also help the dithranol to penetrate into the lower layers of skin.

Zinc has astringent properties and can also aid healing.

Dithranol can irritate and stain the skin, so the treatment is usually only applied for a short time every day. This is called 'short contact therapy'. The strength of dithranol used is gradually increased so that the skin becomes used to the treatment.

Alternatively, specialist nurses may apply intensive treatment with dithranol paste, which is covered by stockinette dressings and left on overnight before washing off.

Dithranol paste comes in a variety of different strengths, ranging from 0.1% to 1% of dithranol. Treatment should normally start with 0.1% paste on small patches of affected skin only. If your skin has not improved after one to two weeks and you don't have any signs of skin irritation, the strength of paste used can be increased gradually every few days as needed. If your skin gets irritated by using any strength paste you should go back to using a lower strength.

For 'short-contact therapy', dithranol paste should be applied to the affected areas of skin once every 24 hours and washed off after 5 to 60 minutes.

You can also use dithranol paste to treat psoriasis on the scalp, though other products (see end of factsheet) may be less messy. First comb the hair to remove any scales, then part the hair as necessary and rub the paste into the affected areas. Leave in contact for up to 60 minutes and then wash off.

The daily treatment should be continued until the psoriasis plaques have cleared up, as long as your skin doesn't become irritated by the paste.

What is it used for?

Psoriasis

Warning!

Follow the instructions provided with this medicine carefully. Dithranol paste should only be applied to the areas of skin affected by psoriasis, as it can cause severe irritation to the surrounding normal skin. Take care to avoid getting the paste on normal healthy skin and avoid contact with the eyes and face. Use only a small amount of paste and rub it in gently and thoroughly until it is completely absorbed. You should wash your hands thoroughly immediately after applying the paste, or wear gloves to apply it.

The paste should be washed off usually after no longer than 60 minutes, using warm water and ordinary soap or shampoo in a bath or shower.

Take care that the paste doesn't get into the eyes or on the face, especially when washing it out of the hair. If you accidentally get the paste in the eyes or on the face, wash it off with plenty of lukewarm water.

Dithranol stains skin and hair. This is not harmful and will gradually fade within one to two weeks after you stop using the paste. To avoid staining the bath or shower, always rinse it with hot water after you have washed off your paste. If any deposits of dithranol are left on the surface of the bath or shower you can use a suitable cleanser to remove them.

Dithranol may also stain fabric such as clothing, bed linen and furniture. This staining may be permanent, so when using the paste, wear old clothes that you don't mind getting stained.

Dithranol can cause skin irritation, such as redness or a burning sensation. If any irritation becomes severe, either leave the paste on for less time, use it less frequently, or go back to using a lower strength. If any skin irritation persists, or if you get irritation of the healthy skin around the psoriasis, stop using the paste and consult your doctor.

Use with caution in

Children.

Not to be used on

Infants and young children

Pustular psoriasis

Inflamed, broken, blistered, raw or oozing areas of skin

Skin on the face, genitals, flexures or in skin folds.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine for use during pregnancy has not been established. It should only be used by pregnant women if clearly necessary. Seek medical advice from your doctor before using this medicine if you are pregnant.

Women who are breastfeeding should not apply this paste to the breast area, to avoid the infant accidentally ingesting it. Make sure that the paste does not come into contact with the baby's skin or mouth. Seek further medical advice from your doctor.

Label warnings

This medication is to be spread thinly and sparingly on the skin.

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