From the Guidelines
Ichthammol is considered a safe and effective treatment for atopic eczema, particularly when used as a 1% ointment or in paste bandages, due to its anti-inflammatory properties and lower irritancy compared to coal tar 1. When used appropriately, ichthammol has been shown to be beneficial in managing atopic eczema, with its shale-derived properties making it less irritant than coal tars. The following key points should be considered when using ichthammol:
- Ichthammol can be applied as an ointment, such as 1% ichthammol in zinc ointment, or in the form of paste bandages, which can be particularly useful for healing lichenified eczema 1.
- Coal tar solution is generally preferred to crude coal tar, and a strength of 1% hydrocortisone ointment is often adequate, without causing systemic side effects related to percutaneous absorption unless used extravagantly 1. Some important considerations when using ichthammol include:
- Potential skin irritation, redness, or allergic reactions in sensitive individuals, although these side effects are uncommon.
- The need to avoid applying ichthammol to large areas of broken skin and to discontinue use if irritation develops.
- The importance of consulting a healthcare provider before long-term use, especially for severe or persistent skin conditions. Overall, ichthammol's anti-inflammatory properties and lower irritancy make it a valuable treatment option for atopic eczema, as supported by the British Association of Dermatologists and the Research Unit of the Royal College of Physicians of London 1.
From the FDA Drug Label
Suggested Use • Treating insect bites and stings from mosquitoes, spider, and bees • Removing splinters and silvers • Treating plant irritations, such as nettles or poison ivy • Treating minor skin infections such as an ingrown toenail • Soothing skin relief • Apply to minor skin irritations Warnings • For external use only • Do not use in eyes • Ask a doctor before use if you have deep puncture wounds or serious burns • Stop use and ask doctor if redness, irritation, swelling or pain persists If swallowed, get medical help or contact a Poison Control Center immediately. Active ingredient Ichthammol 20%
The efficacy of ichthammol is suggested for treating various minor skin conditions, including:
- Insect bites and stings
- Removing splinters
- Plant irritations
- Minor skin infections
- Soothing skin relief However, the safety information provided includes warnings for:
- External use only
- Avoiding use in eyes
- Consulting a doctor for deep puncture wounds or serious burns
- Stopping use if redness, irritation, swelling, or pain persists 2, 2, 2
From the Research
Efficacy of Ichthammol
- Ichthammol has been used for over a century in the treatment of various dermatologic conditions, including psoriasis, eczematous dermatitis, leg ulcers, seborrheic dermatitis, and furuncles 3
- It is derived from shale oil and remains a useful topical medicament for these conditions
Safety of Ichthammol
- There is limited information available on the safety of ichthammol in the provided studies
- However, the studies do discuss the safety and efficacy of other topical medicaments, highlighting the potential for irritation or allergic contact dermatitis with certain agents 4, 5
- Patch testing is an important tool for diagnosing delayed hypersensitivity to corticosteroids and other topical agents, and can help identify potential safety concerns 6
Comparison with Other Topical Agents
- The provided studies compare the irritancy potential of various topical wound care products, including Aquaphor Healing Ointment, bacitracin, Biafine Topical Emulsion, Neosporin, and Polysporin 5
- These studies highlight the importance of considering the potential for irritation or allergic contact dermatitis when selecting topical agents for treatment
- Ichthammol is not specifically mentioned in these comparison studies, but its long history of use suggests that it may be a viable alternative to other topical agents for certain conditions 3