What is Anthralin: Uses, Dosage, Side Effects and More

Anthralin is a topical medication specifically designed to treat psoriasis, a chronic skin condition that causes thick, scaly patches on your skin. This coal tar-derived medicine works by slowing down the rapid growth of skin cells that characterizes psoriasis, helping to reduce inflammation and clear those stubborn patches that can be so frustrating to deal with.

What is Anthralin?

Anthralin is a synthetic medication that belongs to a class of drugs called antipsoriatic agents. It's been used for decades to treat psoriasis because of its unique ability to normalize the way your skin cells grow and shed.

You'll find anthralin available as a cream, ointment, or paste that you apply directly to affected areas of your skin. The medication has a distinctive brownish color and can temporarily stain your skin, clothing, and anything else it touches. This staining is completely normal and will fade over time.

Unlike some other psoriasis treatments, anthralin is considered a moderate-strength medication that works gradually. It's particularly effective for thick, stubborn plaques that haven't responded well to milder treatments.

What is Anthralin Used For?

Anthralin is primarily prescribed to treat plaque psoriasis, the most common form of this chronic skin condition. It's especially helpful for treating thick, well-defined patches of psoriasis on your elbows, knees, scalp, and other areas where plaques tend to be particularly stubborn.

Your doctor might recommend anthralin when milder treatments like moisturizers or topical steroids haven't provided enough relief. It's often used as part of a comprehensive treatment plan that may include other medications or therapies.

In some cases, dermatologists also use anthralin for other scaling skin conditions, though psoriasis remains its primary use. The medication is particularly valuable because it can help break the cycle of rapid skin cell turnover that keeps psoriasis plaques thick and inflamed.

How Does Anthralin Work?

Anthralin works by slowing down the excessive production of skin cells that occurs in psoriasis. Normally, your skin cells take about 28 days to mature and shed, but in psoriasis, this process happens in just 3-4 days, creating those thick, scaly patches.

The medication penetrates into your skin cells and interferes with the DNA synthesis process, essentially telling your skin cells to slow down their rapid multiplication. This helps normalize the skin cell cycle and reduces the thickness of psoriatic plaques.

Additionally, anthralin has anti-inflammatory properties that help calm the redness and irritation associated with psoriasis. As a moderate-strength treatment, it's stronger than basic moisturizers but gentler than some of the more potent systemic medications used for severe psoriasis.

How Should I Take Anthralin?

Anthralin should be applied exactly as your doctor prescribes, typically once daily to affected areas only. Always wash your hands thoroughly before and after application, and be sure to apply it only to the psoriatic plaques, avoiding healthy skin around the patches.

Start with the lowest concentration your doctor recommends, usually 0.1% to 0.5%. Your doctor may gradually increase the strength as your skin becomes more tolerant. Apply a thin layer directly to the affected area and rub it in gently until it's absorbed.

Timing matters with anthralin. Many doctors recommend what's called "short contact therapy," where you apply the medication for 10-30 minutes and then wash it off completely. This approach can be just as effective as leaving it on longer while reducing the risk of irritation and staining.

You don't need to take anthralin with food or water since it's applied topically. However, avoid getting the medication near your eyes, mouth, or other sensitive areas. If you're treating scalp psoriasis, be extra careful to keep the medication away from your face.

How Long Should I Take Anthralin For?

The duration of anthralin treatment varies significantly from person to person, but you'll typically use it for several weeks to months. Most people start seeing improvement within 2-4 weeks of consistent use, though it may take 8-12 weeks to see the full benefits.

Your doctor will monitor your progress and may adjust the treatment schedule based on how your skin responds. Some people use anthralin for a few months to clear their plaques, then switch to a maintenance routine with milder treatments.

Since psoriasis is a chronic condition, you might need to use anthralin periodically when flare-ups occur. Your dermatologist will work with you to develop a long-term management plan that keeps your symptoms under control while minimizing potential side effects.

What Are the Side Effects of Anthralin?

Anthralin can cause several side effects, though most are manageable and temporary. The most common issue you'll encounter is skin irritation at the application site, which can range from mild redness to more significant burning or stinging sensations.

Here are the most frequently reported side effects you might experience:

• Skin irritation, burning, or stinging at the application site
• Temporary brown or purple staining of your skin and nails
• Dryness or peeling of treated skin
• Redness around the treated area
• Allergic contact dermatitis in sensitive individuals

The staining effect, while concerning to many patients, is completely harmless and will fade over several weeks after you stop using the medication. However, it can stain clothing, bedding, and bathroom fixtures permanently, so take precautions during treatment.

Less common but more serious side effects include severe burning, blistering, or signs of an allergic reaction like widespread rash, difficulty breathing, or swelling of your face or throat. If you experience any of these symptoms, stop using anthralin immediately and contact your healthcare provider.

Who Should Not Take Anthralin?

Anthralin isn't suitable for everyone, and certain people should avoid this medication entirely. If you have a known allergy to anthralin or any of its ingredients, you should not use this treatment.

You should also avoid anthralin if you have acute or actively inflamed psoriasis, as it can worsen the irritation. People with kidney disease need special consideration since anthralin can be absorbed through the skin and potentially affect kidney function.

Here are specific situations where anthralin may not be appropriate:

• Pregnancy and breastfeeding (safety not established)
• Active skin infections in the treatment area
• Severe kidney or liver disease
• Facial or genital psoriasis (too irritating for sensitive areas)
• Children under 12 years old (unless specifically prescribed by a pediatric dermatologist)
• People with a history of severe allergic reactions to coal tar products

Always discuss your complete medical history with your doctor before starting anthralin, including any other medications you're taking. Some drugs can interact with anthralin or make your skin more sensitive to its effects.

Anthralin Brand Names

Anthralin is available under several brand names, with Drithocreme being one of the most commonly prescribed formulations. You might also encounter it under names like Dithranol in some countries, though this refers to the same active ingredient.

Many pharmacies also carry generic versions of anthralin, which contain the same active ingredient but may have different inactive ingredients or concentrations. Your doctor will specify which formulation and strength is best for your particular situation.

The brand name and generic versions work equally well, so don't worry if your pharmacy substitutes one for the other. The most important factors are the concentration of anthralin and the base formula (cream, ointment, or paste) that works best for your skin type.

Anthralin Alternatives

Several other treatments can serve as alternatives to anthralin if you can't tolerate it or if it doesn't work effectively for your psoriasis. Topical corticosteroids are often the first-line treatment and may be gentler for some people, though they're not suitable for long-term use.

Vitamin D analogues like calcipotriene offer another effective option without the staining issues of anthralin. These medications work differently but can be equally effective for many people with plaque psoriasis.

Other alternatives include:

• Calcineurin inhibitors (tacrolimus, pimecrolimus) for sensitive areas
• Coal tar preparations, which work similarly to anthralin
• Tazarotene, a topical retinoid
• Combination products containing multiple active ingredients
• Phototherapy (light therapy) for widespread psoriasis
• Systemic medications for severe cases

Your dermatologist will help you find the best alternative based on your specific symptoms, lifestyle, and treatment preferences. Many people find that a combination approach works better than any single treatment alone.

Is Anthralin Better Than Calcipotriene?

Both anthralin and calcipotriene are effective treatments for psoriasis, but they work in different ways and have distinct advantages. Anthralin may be more effective for very thick, stubborn plaques that haven't responded to other treatments, while calcipotriene tends to be better tolerated and doesn't cause staining.

Calcipotriene is often easier to use in your daily routine since it doesn't stain and can be applied twice daily without the wash-off requirement. However, anthralin might provide more dramatic results for particularly resistant patches of psoriasis.

The choice between these medications often depends on your specific needs, lifestyle, and how your skin responds to each treatment. Some people do better with anthralin's more intensive approach, while others prefer the convenience and gentler nature of calcipotriene. Your dermatologist can help you determine which option suits your situation best.