Treatment for Alopecia Areata

University Teaching Trust

Dithranol (Dithocream®) treatment for alopecia areata

Irving Building The Dermatology Centre 0161 206 9880

© G20123001W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2020. Document for issue as handout. Unique Identifier: CS72(20). Review date: March 2023. What is Dithranol Who can have dithranol treatment? treatment? Dithranol is a licensed cream At Salford Royal NHS Foundation originally used to treat the Trust, people are considered skin condition psoriasis. It is a eligible for dithranol treatment if chemical made from tree bark. In they have scalp alopecia areata. addition to its use in psoriasis, it Dithranol is a safe option for is known to cause skin irritation children and can also be used in when applied to normal skin. pregnancy.

How does Dithranol work What have I been in alopecia areata? prescribed? It is these irritant effects when You have been prescribed two applied to the scalp skin that strengths of Dithranol. are useful in treating alopecia These are 0.5% Dithrocream® areata. It appears to work by (=purple 50g tube) and 1% “distracting” your immune Dithrocream® (=brown 50g tube): system away from attacking the hair roots by causing irritation and inflammation on the scalp skin surface. However, the exact way it works is not fully understood.

©© G20123001W.G20123001W. DesignDesign Services,Services, SalfordSalford RoyalRoyal NHSNHS FoundationFoundation Trust,Trust, AllAll RightsRights ReservedReserved 2020.2020. DocumentDocument forfor issueissue asas handout.handout. 1 UniqueUnique Identifier:Identifier: CS72(20).CS72(20). ReviewReview date:date: MarchMarch 2023.2023. How do I use it? Does it work? The aim of treatment is to l REMEMBER: You are aiming The aim is to maintain the skin As with many treatments for produce skin irritation (i.e. for twenty-four hours of itch irritation (itch and redness) for alopecia areata dithranol has a redness and itch) on your scalp and redness twenty-four hours. As your skin relatively low success rate but it for about twenty-four hours. gets “used to” the treatment can be helpful in stimulating hair If there is no skin irritation After 2 weeks it is likely that you may need to adjust the growth in some people. the treatment is unlikely to be the treatment will need some treatment again. Reports suggest about a 25% successful. adjustment to get the correct When you are at the correct chance of cosmetically acceptable amount of redness and itch. If there is too much irritation, level of redness and itch please hair regrowth in those with you will be uncomfortable. This is done initially by increasing continue at the same level extensive hair loss. Unfortunately it is difficult to the time of application, and (i.e. you don’t need to keep This re-growth rate is likely to be predict how each person will then, if necessary, the strength of increasing the treatment after higher in those people with less respond to this treatment (i.e. treatment. this point). hair loss. how much irritation will occur). The following steps should For this reason it is best to start be taken to reach the correct slowly and gradually build-up the treatment level. Please only adjust How long should I use it? Are there any other treatment over time. The way to the treatment every 2 weeks. It can take a number of weeks treatment options do this is explained below: l First: Increase time of before new hair growth is seen - available? so don’t give up too soon. If hair l Start by thinly applying the application (i.e. 20 mins  40 Yes. There are a number of re-growth occurs it is important lower strength dithranol (i.e. mins  60 mins (=maximum)) reported treatments for hair loss. to continue the treatment until 0.5% Dithrocream®) to the l Next (if needed): Increase the Feel free to discuss what bald areas on the scalp for acceptable growth is achieved. strength of treatment to 1% alternative treatment options are twenty minutes. It is best to If no new hair growth has Dithranol and start again by available with your Consultant. do this in the evening. Do not applying the cream for 20 mins occurred after 6 months the cover the scalp with hats, wigs, per day for 2 weeks. Again, treatment is usually stopped. etc. during treatment slowly build up the treatment l Wash the treatment off after duration to a maximum of 60 twenty minutes mins / day l You should aim to repeat this process daily

© G20123001W. Design Services, Salford Royal NHS Foundation Trust, 2 All Rights Reserved 2020. Document for issue as handout. 3 Unique Identifier: CS72(20). Review date: March 2023. What are the side effects What if I develop side If you have problems Notes of dithranol treatment? effects that worry me? or other unexplained Dithranol stains the skin and Before starting treatment you symptoms, please contact light-coloured hair a purple/ will be given our contact details. the department. brown colour. If you wear a You can contact us at any time wig or hat regularly you should during normal working hours to Contact details be able to hide this effect. The obtain advice or to organise an staining is not permanent and urgent review if necessary. The Dermatology Centre, will gradually fade within a If you develop a worrying side Salford Royal NHS Foundation Trust, couple of weeks. effect over the weekend, you Stott Lane, Dithranol may also stain clothing may need to seek medical advice Salford, and bathroom furniture. Be from your local GP out of hours M6 8HD, careful to wash your sink/shower/ service. Dr Matthew Harries bath after each use to prevent If you are unwell and require staining. 0161 206 9880 urgent treatment you should Dithranol is an irritant and so attend your local Accident & [email protected] it will irritate any skin it comes Emergency department. into contact with. The treatment should only be used on the scalp. Wash your hands after each application and avoid contact with eyes. You should also avoid excessive sunlight exposure to the scalp during a course of dithranol treatment. Other side effects include skin spots (folliculitis) and enlargement of lymph glands in the neck.

© G20123001W. Design Services, Salford Royal NHS Foundation Trust, 4 All Rights Reserved 2020. Document for issue as handout. 5 Unique Identifier: CS72(20). Review date: March 2023. © G20123001W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2020 This document MUST NOT be photocopied University Teaching Trust Information Leaflet Control Policy: Unique Identifier: CS72(20) Review Date: March 2023

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