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University Teaching Trust

Dithranol (Dithocream®)
treatment for alopecia
areata

Irving Building
The Dermatology Centre
0161 206 0523

© G19021303W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2019.
Document for issue as handout. Unique Identifier: CS 13 (19). Review date: March 2021.
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.

©©G19021303W.
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2019. Document
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1
Unique
UniqueIdentifier:
Identifier:CS
CS13
13(19).
(19). Review
Reviewdate:
date:March
March2021.
2021.
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?
l Start by thinly applying the application (i.e. 20 mins  40 so don’t give up too soon. If hair
Yes. There are a number of
lower strength dithranol (i.e. mins  60 mins (=maximum)) re-growth occurs it is important
reported treatments for hair loss.
0.5% Dithrocream®) to the to continue the treatment until
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 Dithranol and start again by If no new hair growth has
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

2 © G19021303W. Design Services, Salford Royal NHS Foundation Trust,


All Rights Reserved 2019. Document for issue as handout.
3
Unique Identifier: CS 13 (19). Review date: March 2021.
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.
urgent treatment you should
0161 206 0523
Dithranol is an irritant and so attend your local Accident & matthew.harries@srft.nhs.uk
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.

4 © G19021303W. Design Services, Salford Royal NHS Foundation Trust,


All Rights Reserved 2019. Document for issue as handout.
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Unique Identifier: CS 13 (19). Review date: March 2021.
© G19021303W. Design Services
Salford Royal NHS Foundation Trust
All Rights Reserved 2019
This document MUST NOT be photocopied
University Teaching Trust
Information Leaflet Control Policy:
Unique Identifier: CS 13 (19)
Review Date: March 2021

For further information on this leaflet, it’s references and sources


used, please contact 0161 206 0523

Copies of this leaflet are available in If you need this information leaflet translated,
other formats (for example, large print please telephone:
or easyread) upon request. Alternative
formats may also be available via www.
srft.nhs.uk/for-patients/patient-leaflets/
In accordance with the Equality Act we
will make reasonable adjustments to
enable individuals with disabilities to
access this service. Please contact the
service/clinic you are attending by phone
or email prior to your appointment to
discuss your requirements.
Interpreters are available for both
verbal and non-verbal (e.g. British Sign
Language) languages, on request.
Please contact the service/clinic you are or Email:
visiting to request this. InterpretationandTrans@srft.nhs.uk

Salford Royal operates a smoke-free policy.


For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on 0161 206 1779

This is a teaching hospital which plays an important role in the training of future doctors. The part
patients play in this process is essential to make sure that we produce the right quality doctors for all
of our futures. If at any time you would prefer not to have students present please inform the doctor
or nurses and this will not affect your care in anyway.

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Stott Lane, Salford, become a Foundation this document could be improved in
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