Psoriasis - Topical Medications

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Highlights	Diagnosis	Managing Psoriasis
Introduction	Treatment	Outlook
Types of Psoriasis	Topical Medications	Resources
Causes	Systemic Medications	References
Risk Factors	Phototherapy

Coal Tar

Coal tar preparations have been used to treat psoriasis for about 100 years, although their use has declined with the introduction of topical vitamin D3-related medicines. Crude coal tar stops the action of enzymes that contribute to psoriasis, and helps prevent new cell production. Tar is often used in combination with other drugs and with ultraviolet B (UVB) phototherapy.

Coal tar preparations have the following drawbacks:

They stain clothing
They cause skin irritation
People using coal tar have increased sun sensitivity and increased risk of sunburn for up to 24 hours after use

Anthralin

Anthralin (Dritho-Scalp, Drithocreme, Micanol) slows skin cell reproduction and can produce remissions that last for months. It is recommended only for chronic or inactive psoriasis, not for acute or inflamed eruptions. People with kidney problems should use anthralin with caution.

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As with tar, anthralin's use has also declined since the introduction of the topical vitamin D-related medicines, but newer formulations, such as Micanol, have made its use more tolerable. Micanol (Psoriatec) is an anthralin formulated in microcapsules, which dissolve and allow the drug to be delivered directly to the target skin areas. It is particularly useful for scalp psoriasis, and it is less likely than other formulations to stain.

Side Effects and Drawbacks. Anthralin may cause the following problems:

Skin irritation and burning
Staining of clothes, hair, fabrics, plastics, and other household products

Patients should not use anthralin on the face. Fair-skinned people should generally avoid it.

Triethanolamine (CuraStain) is a chemical that can neutralize anthralin and help reduce irritation from short-contact anthralin treatment. It should be applied 1 or 2 minutes before washing off the anthralin. It is then reapplied after drying the skin.

Washing stained items with hypochlorite (Clorox) detergents can help remove stains. Many people use disposable gloves while applying the treatment to avoid staining their hands.