Dermatology ↓

A summary of current studies of naltrexone used in a dermatologic practice was completed. Data suggest that naltrexone could be helpful in the treatment of a variety of inflammatory and acantholytic skin diseases that are refractory to other treatments.

J Am Acad Dermatol. 2019 Jun;80(6):1746-1752.

The uses of naltrexone in dermatologic conditions

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“Off label LDN has been shown to improve dermatologic conditions such as systemic sclerosis, Hailey-Hailey Disease, lichen planopilaris, and guttate psoriasis… “

“Atopic dermatitis (AD) is one of the most common chronic skin disorders, affecting up to 20% of children and 10% of adults in the industrialized world… A trial of a topical formulation of 1% naltrexone [cream] in 40 patients with severe atopic dermatitis revealed a 29% improvement after just 2 weeks of use.”

J Drugs Dermatol. 2019 Mar 1;18(3):235-238.

Low Dose Naltrexone in Dermatology

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Dermatology is encountering increasing rates of autoimmune disease manifesting in primary skin conditions that are difficult to treat without risk of immunosuppression. The ability of low doses of naltrexone (LDN), 1.5 to 4.0 mg/day orally, to influence a variety of systemic pathways, including the immune system.

A review of the literature from 1971 until April 2018 shows that LDN was effective in treating pruritus attributable to atopic dermatitis, prurigo nodularis, cholestasis, burn injury, systemic sclerosis, Hailey-Hailey disease, and lichen planopilaris. Serious side effects were not reported. They concluded that LDN has the potential for the treatment of chronic inflammatory skin conditions; however, additional evidence is needed for dosing and long-term treatment guidelines.

JAMA Dermatol. 2019 Feb 1;155(2):229-236.

Utility of Naltrexone Treatment for Chronic Inflammatory Dermatologic Conditions: A Systematic Review

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Low-Dose Naltrexone Therapy for Psoriasis

Low-dose naltrexone regulates lymphocyte responses, reduces cytokine production, and likely reduces mast cell activity. Two recent reports suggested that low-dose naltrexone is a beneficial and convenient therapy for psoriasis. Patients included 13 females, 2 males; mean age 57 years; mean psoriasis duration 16 years. Of the patients, 8 had psoriatic arthritis. In the past, 5 had completely failed and 10 had partially responded to =1 topical therapy. Patients used a self-assessed Likert scale and the response to 4.5 mg of oral naltrexone was as follows: 8/15 marked improvement; 2/15 somewhat improved, and 5/15 unchanged. Three adverse events included insomnia, diarrhea, and self-limited headache. In conclusion, marked improvement was seen by 53% of the 15 patients.

Int J Pharm Compd. Mar-Apr 2020;24(2):94-96.

Low-dose Naltrexone Therapy for Psoriasis

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Prurigo Excoriée Treated with LDN

A 53-year-old woman presented with a 25-year history of acne excoriée and prurigo excoriée. The pruritus affected her quality of life and disturbed her sleep. She had scarring on her face and body resulting from persistent scratching. The pruritus proved refractory to treatment despite a multi-modal treatment approach including multiple topicals, phototherapy, and systemic agents such as isotretinoin, antibiotics, anxiolytic agents, and neuromodulators. She was extremely frustrated that various treatments had been ineffective at controlling the itch-scratch cycle. After treatment with LDN, 3mg at bedtime, she became itch-free within a few weeks. She reported that the LDN had a beneficial impact on her quality of life.

BMJ Case Rep. 2021 Nov 19;14(11):e243773.

Prurigo excoriée treated with low dose naltrexone

Click here to access the PubMed abstract of this article.