Anthralin: The Ins and Out of This Hair Loss Medication

Most men have heard of all the common hair loss treatments. We know about Rogaine and Propecia. We’ve seen advertisements for hair transplants and laser light caps. We’ve read up on all the vitamins, supplements, and healthy diets designed to promote hair growth. While these types of treatments make up the majority of hair loss therapies today, there are some from years ago that are worth dusting off and reconsidering. Anthralin, a medication popular in the early 1980’s and 90’s, is one such treatment and warrants a second look.

What is Anthralin and How Does it Work?

Anthralin, also known as dithranol, is a synthetic tar-like substance used to treat psoriasis and different types of hair loss. Though anthralin has a tarry appearance, the medication does not contain coal tar or a corticosteroid. While the exact mechanism is not fully understood, anthralin is thought to slow down excessive cell division common to both psoriasis and alopecia. It works by accumulating inside the mitochondria and interfering with the cell’s energy supply.

The Uses for Anthralin

There are many uses for Anthralin that men can benefit from.

Psoriasis Treatment

Psoriasis is a chronic skin condition characterized by red inflamed patches of skin that may be covered with scaling spots. Skin can become dry and cracked with the potential to itch, burn or even bleed. Psoriasis causes skin cells to grow faster than normal cells and results in a build-up of extra cells on the surface of the skin. Symptoms can come and go based on a variety of factors and can last for a few weeks to several months.

While there is no cure for psoriasis, patients can manage symptoms through a variety of treatments and medications aimed at reducing outbreaks, the severity of scaling, pain, and inflammation. Anthralin works to reduce the build-up of extra skin cells and scales by slowing the skin cell growth cycle.

Anthralin Alopecia Areata Treatment

Anthralin

Alopecia areata is another skin disorder that affects nearly 6.8 million people in the United States alone. It is an autoimmune disease characterized by hair loss on the scalp, face, and other parts of the body. Alopecia areata can begin as small round patchy bald spots but may progress to total hair loss across the entire scalp (alopecia totalis) or all areas of the body (alopecia universalis).

Anthralin can be used to treat mild, patchy alopecia areata with less than 50% of scalp hair loss. Hair regrowth can occur in as little as 5 weeks but typically takes 8-12 weeks. White hair may appear first followed by darker hairs in the following weeks.

The goal of therapy is to create low-grade scalp irritation which induces hair regrowth. Anthralin has been shown to produce a cosmetic response in 11% to 25% of patients with severe alopecia areata.

Anthralin for Hair Loss

Anthralin’s use in other types of hair loss mimics the mechanism described for alopecia areata and psoriasis. The medication is thought to slow the hair growth phase and allow more hair to remain active for longer periods of time. Anthralin may also stimulate new hair growth by inducing a mild scalp irritation.

Anthralin is not FDA approved to treat hair loss but prescribers can use it off-label to treat some cases of alopecia. As with alopecia areata, results may be seen in 5 weeks but typically occur in 2 to 3 months. Anthralin works best in mild cases of alopecia. Treatments must continue indefinitely or hair loss will resume.

Is Anthralin Cream Safe to Use?

Anthralin is considered safe to use for most patients and side effects are rare. Patients with certain sensitivities to the components of the formulation, such as salicylic acid or parabens, should consult their primary care provider before using anthralin.

Patients should avoid contact with the eyes and any open, blistered or raw skin. Anthralin should not be applied to the face, sex organs, or in skin folds without talking with to a physician.

What Are the Anthralin Side Effects?

Anthralin’s most common side effect is skin irritation. While a mild reaction is expected in order for the medication to be effective, severe irritation or folliculitis is not normal and should be reported to your primary care provider.

Anthralin can also cause staining to the skin it is applied to as well as the fingers and hands. Hands should be washed immediately after applying anthralin to avoid staining. This can also be minimized by applying anthralin with latex gloves.

Contact with adjacent hair (especially light colored or white hair) and nearby clothing or towels can also result in discoloration. A localized burning sensation has also been reported by some patients. This, too, can be considered a “normal” side effect of anthralin. In the event of persistent burning or increased pain, the medication should be washed off immediately and the primary care provider should be contacted.

Side effects can be minimized by being attentive to treatment instructions and attempting gradual increases in dosing times and strengths. Tubs, sinks, and showers should also be cleaned immediately to avoid staining the tile, porcelain, or grout.

The Recommended Anthralin Dosage

Depending on where you are in the world, anthralin can be available in a variety of strengths and dosage forms. The most common dosage forms are ointments, creams, and shampoos. In the United Kingdom, anthralin is known commercially as Dithrocream. It is available in 5 color-coded strengths:

  • Pale blue – 0.1 percent
  • Red – 0.25 percent
  • Purple – 0.5 percent
  • Brown – 1 percent
  • Yellow – 2 percent

In the United States, anthralin is available as Drithocreme 1 percent. Other names for anthralin include Micanol, Psorlin, Dritho-Scalp, Anthraforte, Anthranol, and Anthrascalp.

Weaker strengths of anthralin (0.1-0.5 percent) can be applied and left on overnight. Stronger formulations are applied for 10 to 30 minutes (known as short contact therapy) and increased as tolerated.

Where to Buy Anthralin

As mentioned above, anthralin’s availability differs depending on where you live. Anthralin is available over-the-counter in the United Kingdom as Dithrocream. In the United States, Drithocreme is available by prescription only.

Similar coal tar products often appear in internet searches for anthralin. While these products do not contain anthralin, they do work in a similar fashion and may be a cheaper alternative. If a primary care provider has recommended anthralin, be sure to consult him or her before switching to a coal tar formulation.

Final Thoughts

Anthralin has been surpassed by other psoriasis and alopecia therapies in recent years. Patients tend to have better results with newer products without the risk of staining hair and clothing. Anthralin is usually reserved for patients who have tried and failed other therapies. Prescribers can and do use it in combination with other medications to achieve better results. If your current hair loss treatment regimen isn’t working or giving you the desired results, consider adding anthralin. It is a safe addition to alopecia therapies and can be effective if used properly.

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