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What is the Ingram Method?

Monday, October 12th, 2009

The Ingram Method is like the Goeckerman Regimen except even more hardcore.  The Goeckerman Regimen involves combining coal tar and UVB light to bombard the skin with anti-psoriasis treatment.  The Ingram Method adds one more step — a thick coat of anthralin paste to top it all off.

As you might have already deduced, this process is time-consuming and messy.  When the Ingram Method (or the Ingram Regimen) was invented, it was confined to psoriasis day-cares.  Now that UVB equipment is available for at-home use, however, the Ingram Method has the potential to be a bit less inconvenient.

The Ingram Method involves a heavy application of coal tar, then UVB light on affected areas of the skin.  Afterwards, antralin paste of different levels of potency is applied to skin lesions and left there for up to 24 hours. 

Antralin paste (available in brand name medications such as Drithocreme, Anthra-Derm and Micanol) can irritate the skin, so medication should start with a low concentration and then move up as the skin shows no signs of irritation.  Anthralin medications are available by prescription only.

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What is Anthralin (Dithranol)?

Saturday, October 10th, 2009

Anthralin (dithranol) is a synthetic compound used to control excessive skin cell creation, which is the main characteristic of plaque psoriasis. It is modeled after a natural extract found in Andira Araroba, a type of tree that grows abundantly in South America.

It is believed that is interacts with skin cells to reduce DNA-synthesis, which in turn prevents skin cell proliferation.

Anthralin is a powerful irritant and thus should not be applied to skin that is broken or to skin-folds.  It is recommended that it only remain on the surface of the skin for up to 30 minutest to start.  After confirming that it does not irritate the skin too much, anthralin solutions with varying degrees of potency can can be left on the skin for up to an hour before it needs to be washed off.

Anthralin comes in the form of cream, paste or ointment and is marketed under a variety of different brand names including Drithocreme, Anthra-Derm and Micanol.

Although Anthralin doesn’t start clearing psoriasis lesions as quickly as some other steroid-based alternatives, it tends to have farther reaching preventative effect on the skin once it does start taking effect.  There also tends to be less of a risk of severe break both during and after suspending use.

Anthralin-based medications such as Dritho-Scalp are yellowish creams that have a tendency to stain the skin, hair or clothing that comes in contact with it.

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What is Dovonex (Calcipotriene)?

Saturday, October 10th, 2009

Dovonex (a.k.a. calcipotriene or calcipotriol) is a topical psoriasis treatment used to control the excessive skin cell production (plaque psoriasis).  It a vitamin D derivative that is available by prescription only.   It is also known as calcipotriol, or calcipotriene.

The exact mechanism by which Dovonex controls skin cell production is not known, though it is thought to have a regulatory effect on T-cell activity.  T-cells are a part of the immune system that bring about excessive skin cell growth in response to psoriasis.

Typical dosage for Dovonex is twice daily to affected areas of the skin.

It was discovered that the corticosteroids helped to speed up the effects of Dovonex, so these two are sometimes prescribed simultaneously.  Mixing steroids with synthetic vitamin D brought about a new drug that was approved by the FDA in 2008 called “Taclonex.”

Dovonex has also been mixed with other topical treatments such as anthralin, Tazorac and coal tar to make it more effective.

Anyone on Dovonex should be careful about staying in the sun since it has been shown to increase the skin’s sensitivity to UV rays, in particular by speeding up the rate at which skin cancer develops.  Other side effects include excessive calcium absorption, irritation and a worsening of psoriasis symptoms.  Pregnant women are strongly advised against using this drug.  On rare occasions Dovonex has also been known to cause mood swings, a stretching / thinning of the skin, pair follicle pustules, dizziness and abdominal pain.

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