Topical Experiment

[Bill]

Occlusion means covering the treated area. It doesn't specify what treatment you use. An old but effective idea, and less mess to boot. It makes me wonder why there aren't better designed dressings for the purpose.

[D Foster]

I remember many years ago when I was in the hospital with the tar I got really good making a complete suit out of tubular bandage of various sizes.

[Fred]

I think most advise against occlusion Bill.

Dovobet and Dovonex do say.

Quote:

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Systemic reactions occur more frequently when applied under occlusion

[Bill]

Most topicals I wouldn't have a bar of, Fred, occluded or otherwise. I use Stockholm tar because of its low toxicity. I occlude because it makes the topical work better. I like to stick with things that work for me. I have read about occlusion being more toxic, but countering this is a reduced frequency of application. How would the systemic exposure differ between twice daily open application and occluded application once every two to three days? Would it be greater? Would it be less? At what body surface area and skin thickness does the absorption of a specific topical become pharmacologically significant? Also, I have cleared spots with occlusion in less than a few months, so I don't apply anything there now. The spots behind my ears that I haven't occluded are not healed: I have applied far greater amounts of topical to these spots over many years. Does long term topical application pose a risk?

I am skeptical of learned opinion without a body of evidence to support it. As with dimethyl fumarate, I suspect the reticence belies a lack of experience.

[Caroline]

I can connect to your way of thinking Bill.
What you can see in the history of DMF in the Netherlands is that at some point someone shouts something that he/she has read somewhere and before you know it, it is in the central guideline without "any" reference to proof or studies, while the studies that deny this conclusion are not mentinoned. You see it with the use of MEF in the combination pills, there is a proven study that it is useless but they keep going on with it.
And you see it in the max dose of 6x120... also nonsens except for with the combination pills. It unfortunately shows that there is a common lack of knowledge with dermatologists in relation to Psoriasis. Of course there are good ones, but they are rare.