An older psoriasis cream
Dithranol
An older but effective psoriasis cream applied carefully to plaques, often for a short time then washed off.
What is Dithranol?
Dithranol is a long-established and effective treatment for stable plaque psoriasis, applied carefully to the plaques. It works on the skin to slow the rapid build-up of skin cells behind the thick, scaly patches. Its main drawback is that it stains skin, hair, clothing, the bath and surfaces a purple-brown colour and can irritate normal skin, so it is dabbed only onto the plaques, often left on for a short time and then washed off (short-contact treatment). It is fiddly but works well for many people. Wash your hands after applying it.
Education and reference only. This is a plain-language guide to Dithranol — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Dithranol is one of the oldest and most effective treatments for plaque psoriasis, the type with thick, raised, scaly patches. It is applied directly to the plaques as a cream and is often used as short-contact treatment, where it is left on for a limited time then washed off. It has been somewhat overtaken by cleaner modern treatments because it stains and can irritate, but it remains a valuable option for stable, well-defined plaques. It is used as part of a wider psoriasis plan, sometimes in specialist or day-treatment settings.
How it works
Dithranol acts on the skin to slow the over-fast production of skin cells that makes psoriasis plaques thick, red and scaly, helping them flatten and clear over time. It works only where it is applied, which is why it is dabbed precisely onto plaques and kept off normal skin. The same activity that helps the plaques also irritates and stains healthy skin, so careful, accurate application — and often washing it off after a set time — is central to using it well.
Company & origin
Originated / developed by: Generic (long-established).
A long-established and effective treatment used in the UK for stable plaque psoriasis.
Practical use
How to take Dithranol
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Apply it carefully and only to the psoriasis plaques, keeping it off the healthy skin around them.
- Protect the surrounding normal skin, for example with a barrier such as soft white paraffin, to reduce staining and irritation.
- For short-contact treatment, leave it on only for the time you are told, then wash it off thoroughly.
- Use old towels and clothing and rinse the bath or shower straight after, as it stains a purple-brown colour.
- Keep it well away from your eyes, face, genitals and skin folds, where it irritates more.
- Wash your hands thoroughly after applying it, unless your hands are the area being treated.
Weighing it up
Advantages & disadvantages of Dithranol
Advantages
- A long-established, genuinely effective treatment for stable plaque psoriasis.
- Works directly on the skin, avoiding the body-wide effects of tablet treatments.
- Short-contact use, washed off after a set time, can give good results with less irritation.
Disadvantages
- Stains skin, hair, nails, clothing, towels, the bath and surfaces a purple-brown colour.
- Can sting and redden normal skin, so it must be applied very precisely to the plaques.
- More fiddly and messy than modern treatments, needing careful, patient application.
Practical use
Good to know
The big practical points with dithranol are staining and irritation. It turns skin, hair, nails, clothing, towels, the bath and surfaces a purple-brown colour, so apply it only to the plaques, protect the skin around them (for example with a barrier such as soft white paraffin), use old towels and clothing, and rinse the bath afterwards. It can sting and redden normal skin, so accuracy matters; with short-contact use it is left on only for a set time then washed off, which reduces irritation. Build up slowly as advised so your skin gets used to it. Keep it well away from the eyes, face, genitals and skin folds, and wash your hands thoroughly after applying it unless you are treating them.
Who should not take it / use with caution
- It should not be used on the face, genitals, skin folds or near the eyes, where it irritates badly.
- People with unstable, widespread or pustular psoriasis should not use it without specialist advice.
- Those with very sensitive or broken skin around the plaques should use it with great care or avoid it.
Monitoring
- Reviewing how the plaques respond and how well the skin tolerates the strength used.
- Building up gradually and adjusting strength or contact time if the skin becomes too sore.
- Checking it is being applied accurately to plaques only, to limit staining and irritation.
Side effects
- Purple-brown staining of skin, hair, nails, clothing, towels, bath and surfaces.
- Stinging, burning and redness of normal skin if it spreads beyond the plaques.
- Local irritation that is worse on the face, genitals and in skin folds.
Key interactions
- Other irritating skin products on the same area can add to soreness and redness.
- Strong soaps or astringents nearby may worsen skin irritation.
- Tell your prescriber about other psoriasis creams so applications can be kept separate.
Available as: A cream applied to the skin, used either left on or as short-contact treatment.
Answers
Dithranol: frequently asked questions
Why does dithranol stain everything?
It naturally turns skin, hair, clothing, towels, the bath and surfaces a purple-brown colour, so apply it only to the plaques, use old towels, and rinse the bath straight after.
What is short-contact treatment?
It means leaving the cream on the plaques only for a set time, often quite short, then washing it off; this can give good results with less skin irritation.
Can I put it on my face?
No, it should be kept off the face, genitals, skin folds and the area around the eyes, where it irritates badly.
It stings my normal skin — what can I do?
Apply it precisely to the plaques only and protect the skin around them, for example with a barrier such as soft white paraffin, and build up the strength slowly as advised.
Is it still worth using when newer treatments exist?
Yes, although it is messier, dithranol remains a long-established and effective option for stable, well-defined plaques.
Authoritative sources
- BNF
- NICE CKS
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