Linotar > Pharmacy
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Psoriasis best & worst Food Choices

PSORIASIS BEST FOOD CHOICES

If you have psoriasis, what you eat and drink may make a big difference in how you feel. Scientists don’t know for sure if following a specific diet or staying away from certain foods can help reduce the frequency and severity of your flares. But a healthy diet high in fruits, vegetables, lean protein, and whole grains can boost your overall well-being and may ease the intensity of your psoriasis symptoms.

1. Eat more fatty fish:

The omega-3 fats in fish can help with inflammation and give your immune system a boost, so it’s a good idea to put fish on the menu at least twice a week. Go with cold-water fish like salmon, tuna, mackerel, sardines, herring, and trout.

2. Eat more spices and herbs:

When you flavour your dishes with these, you tend to sprinkle on less salt. That may help protect you from high blood pressure and may make you less likely to have a heart attack or stroke. Spices and herbs are also top sources of ingredients with anti-inflammatory and antioxidants properties.

3. Consume more olive-, nut- and avocado oil:

Not all cooking oils are created equal. Olive oil has anti-inflammatory omega-3 fats. It’s also a staple of the Mediterranean diet. Research shows that people who eat that way – focusing on fruits, vegetables, fish, beans and whole grains, along with olive oil – have less severe psoriasis. Not a fan? Nut and avocado oils also have these healthy fats. Use them in salad dressings and sautés.

4. Eat more fruit:

Satisfy your sweet tooth a different way. Fruits have antioxidants, fibre, and vitamins that fight inflammation. For the biggest boost, eat a variety of colours. Each has its own mix of nutrients. Berries, cherries and apples have antioxidants called polyphenols, while oranges and melons are high in vitamin C. Pineapple has an anti-inflammatory enzyme called bromelain.

5. Eat more beans:

These are good sources of protein, fibre, and antioxidants. They can help keep your weight in check and ease the inflammation in your body, and research suggests that a vegetarian diet can help with psoriasis symptoms. Try swapping them for meat once in a while: Use them in place of ground beef in chili or tacos. You can also add mashed beans to burgers and sandwiches.

6. Eat more whole grains:

Fiber-rich whole grains can ease inflammation. They can also help you slim down and research shows that losing weight can help with your psoriasis symptoms. Choose whole grain breads, cereals, pastas, and brown or wild rice. Labels like ‘multigrain’ can be misleading, so check that a whole grain is the first ingredient listed. Bulgur, quinoa and barley are other tasty options.

7. Eat more nuts:

They pack a lot of inflammation-fighting power in a small package. And they’re loaded with nutrients, healthy fats and fibre. Toss a handful of nuts on a salad, or have them as a snack.

PSORIASIS WORST FOOD CHOICES

Did you know? Research has yet to confirm a definitive link between diet and psoriasis flare-ups, but some people say that eliminating certain foods and drinks offers relief from symptoms. Food that may cause psoriasis flare-ups:

1. Eat Less fatty red meat:

This can trigger inflammation and may lead to more severe psoriasis symptoms. The saturated fat in red meat can also increase your chances of developing heart disease. People with psoriasis are already more likely to have a heart attack or a stroke. If you’re in the mood for red meat, opt for lean cuts, such as sirloin and top and bottom rounds. Also choose ground beef with the lowest percentage of fat.

2. Eat less dairy products:

Like red meat, dairy products also contain the natural inflammatory arachidonic acid. “Cow’s milk is one of the biggest culprits”, Bagel says, because it also contains the protein casein, which has been linked to inflammation. Egg yolks, too, are high in arachidonic acid, so consider nixing them from your diet.

3. Eat Less citrus fruits:

Sometimes an allergic reaction can cause psoriasis to flare up. Citrus fruits, such as grapefruit, oranges, lemons and limes, are a common allergen. If you notice that citrus fruits seem to trigger your symptoms, see if eliminating them from your diet improves your skin. This goes for their derivatives as well, such as lemonade and grapefruit juice.

4. Eat less condiments:

Some people with psoriasis find condiments and spices to be their enemy. The ones that seem to cause the most trouble for people with psoriasis are pimento, cinnamon, curry, vinegar, mayonnaise, paprika, hot sauce, Worcestershire sauce, and ketchup. These condiments are all on the no-no list because substances in each of them can increase inflammation.

Brought to you by Linotar:

WebMD Reference: https://www.webmd.com/skin-problems-and-treatments/psoriasis/ss/slideshow-psoriasis-foods?fbclid=IwAR14rDv_0Rmb1zOxs07hDu4Pj6SX8JHdvdw6aOFaQvADSY6cyUJwFhxNOq0

#Psoriasis #PsoriasisTreatment #Linotar #PsoriasisWarrior #PsoriasisRelief #PsoriasisCommunity #PsoriasisProblems #PsoriasisAwareness #PlaquePsoriasis #Eczema #PsoriasisFoodChoices

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Linotar – Patient Information Leaflet

PROPRIETARY NAME AND DOSAGE FORM:

LINOTAR GEL 1% Emulsion

COMPOSITION:

LINOTAR GEL 1 contains 1 g Coal Tar per 100 g = 10 mg/g; 1% w/w, wet weight).

Preservatives:

Sodium Propyl Paraben: 0.05 % m/m

Methyl Paraben: 0.1 % m/m

Vitamin E (DL-Alpha Tocopherol): 0.3 % m/m

Other ingredients:

Complex of esterified essential fatty acids; PEG-40 hydrogenated Castor Oil; Polysorbate 80; Xanthan Gum; Industrial Methylated Spirits; purified Water.

PHARMACOLOGICAL CLASSIFICATION:

A 13.9.1 Preparations for psoriasis

Coal Tar is an anti-pruritic.

INDICATIONS:

LINOTAR GEL 1 is used for:

  • The relief and treatment of PSORIASIS of the skin and scalp.
  • The relief and treatment of ECZEMATOUS conditions of the skin and scalp.
  • The relief of the symptoms of COLD SORES.

CONTRA-INDICATIONS:

Coal Tar sensitivity or allergy. Do not use on highly inflamed or broken skin.

WARNINGS AND SPECIAL PRECAUTIONS:

For external use only. Do not use this product in or around the rectum or genital area or groin. Avoid contact with the eyes. Upon accidental contact, flush eyes with water.

Special Precautions:

Coal Tar can enhance photosensitivity of the skin, and exposure to direct sunlight after application of LINOTAR GEL 1 should be avoided.

DOSAGE AND DIRECTIONS FOR USE:

To ensure adequate penetration of LINOTAR GEL 1, make sure the lesions are clean. Apply a thin layer of LINOTAR GEL 1 two to three times a day. Massage gently and leave to dry.

SIDE EFFECTS:

Coal Tar may cause irritation or acne-like eruptions of the skin. If irritation occurs, discontinue use and consult a doctor.

IDENTIFICATION:

A smooth mustard colored emulsion.

PRESENTATION:

Polyethylene squeeze bottles containing 250 ml of LINOTAR GEL 1.

STORAGE INSTRUCTIONS:

Store at or below 25 ?C

Keep out of reach of children

REGISTRATION NUMBER:

A 27/13.9.1/0357

NAME AND BUSINESS ADDRESS OF THE HOLDER OF THE CERTIFICATE OF REGISTRATION:

MeyerZall Laboratories (Pty) Ltd.

2nd Floor

121 Mitchell Street

George 6529, RSA

DATE OF PUBLICATION:

July 2015

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Linotar Range Treatment System

Background

Psoriasis is a common skin disorder affecting more than 2% of the global population. This means that well over 150 million people worldwide could be affected. Is it a disease caused by deficiencies in the immune system, inherited genes, or perhaps by a skin barrier (epidermis) that is leaky and not properly formed?

Looking at the skin of a psoriasis patient, the lesions are red and scaly. The epidermis is thickened because the cells in the bottom (basal) layer of the epidermis divide to rapidly giving the skin a scaly appearance. The red colour of the skin is due to inflammation, telling us the immune system is involved.

We know that genetics are involved. So it seems that there are at least two schools of thought, one considers the immune system to play the major role, the other thinks it is the skin barrier that calls the shots.

The question now arises: Does psoriasis start when the cells of the top layer of the skin (epidermis) behave abnormally and the immune system simply responds, or, does the immune system somehow react to disrupt the epidermis?

Is the answer perhaps that it is an interaction between the skin barrier, the immune system and the genes?

Structure and function of the epidermis

It is mostly made up of 4 layers as the stratum lucidum only occurs where the skin is thickened as in under the feet.

After the cells of the basal layer of the epidermis divided, the cells change shape and function and are modified to form a structure simulating a wall of brick and cement.The ?bricks? are held in position by protein rivets (corneodesmosomes) and are surrounded by lipids. All of this is to a large extent made possible by a remarkable protein called Filaggrin that is formed in the granular layer. Filaggrin plays a pivotal role in the differentiation of the epidermal cells to form a secure barrier.

Ref. 1: Filaggrin in the frontline: role in skin barrier function and disease Sandilands A et al Journal of Cell science 122, 1285-1294. Published by The Company of Biologists 2009 doi:10.1242 / jcs.033969.

Ref. 2: One remarkable molecule: Filaggrin Brown SJ and WH Irwin McLean J Invest Dermatol Mar 2012; 1329 PT 20 751-762.

The “bricks” are cells (corneocytes) made up of keratin and are surrounded by “cement”, lipids that are made up of free fatty acids, cholesterol and ceramides to form a barrier that keeps unwanted substances and organisms out. They also prevent excess water loss whilst at the same time fending harmful microbes from causing infection.

Ref. 3: Elias& Williams The inside-Out of the skin What is the skin barrier, and does it matter. )an 7,2013. Illustration by Jessica C. Kraft.

However, in skin diseases like psoriasis, the genetic material that allows for the formation of filaggrin is suppressed (or down regulated) and this means that the formation of the top layer of the epidermis, the stratum corneum (SC) is not properly formed.

The bricks and cement are not laid down; the rivets that hold the cells together are not formed resulting in the cells shedding prematurely. Natural moisturing factor that are usually contained within the cells of the stratum corneum is absent leaving the skin porous, dry and flaky resulting in more water loss. This usually referred to as Trans Epidermal Water Loss (TEWL).

Where it usually takes about 28 days for cells to move from the bottom (stratum basale) to the top (stratum corneum) to peel off, it can take as little as 3-4 days in the case of psoriasis.

With this cacophony taking place messages are sent to the basal layer of the epidermis to provide more cells to the top to help form a barrier, resulting in excess, immature cells arriving at the top causing more trouble. Whilst this is happening the immune system springs into action sending pro-inflammatory molecules in an emergency exercise to try and restore normality. A vicious circle of events, if ever there was one.

The Linotar Range Treatment System can help to restore the normal function of the epidermis

How is this possible you may well ask so, let’s return to the structure of the epidermis:

“……….it is important that we do not get so carried away with our new therapeutic tools that we forget some tried and trusted old friends. Coal tar is one such old friend that is of risk of becoming distinctly unfashionable in the era of biologics, but I suggest we do so at our peril”. (Richard Groves, Editor of the Journal of Dermatological Treatment (2004) 15,7).

Another important player is the patented Emzaloid trans dermal delivery system which ensures that the active ingredient in Linotar Gel 1%, coal tar passes through the top layer of the epidermis and when it gets to the granular layer it up-regulates or switches relevant genes on to activate filaggrin (our hero molecule). Filaggrin then orchestrates the proper formation of the upper layer of the epidermis to ensure a normal skin milieu. This is a bit like the Wizard of 0z who waves his magic wand to repair and restore the epidermis to its former glory.

Ref. 4: Saunders J. et al; A novel skin penetration enhancer: evaluation by membrane diffusion and confocal microscopy J Pharm Sci 199 Sep-Dec; 2 (3): 99-107.

Ref. 5: Epidermal Structure and Function; Van Den Bougaard EH et al, Journal of Investigative Dermatology (2013) 133,s 104? -s 128, dol: 10,1038 / jid.2013.99.

Thus the “brick and cement” wall is formed, with rivets that hold the cells of the stratum corneum together. By this stage filaggrin has been broken down into natural moisturizing factor (NMF) and urocanic acid to ensure a moist normal skin with an acid pH to help fight off any harmful microbes wandering about.

The Emzaloid® carrier system also helps to restore normality by providing some of the ingredients (ceramides and EFAs) to help make the “cement” thus ensuring a normally constituted epidermis. The essential fatty acids (linoleic acid {omega 6} and linolenic acid {omega 3} further contribute by helping to reduce inflammation.

To ensure there is enough ?cement? it is best to use Linocream and/or Linoscalp after applying Linotar Gel 1%. Even if the GP / dermatologist / patient use another anti-psoriasis medication, Linocream and Linoscalp should be the “Go To” moisturisers.

How to use the Linotar Range Treatment System?

ON THE BODY

– Gently wash the lesions with a hypoallergenic soap and towel dry the lesions.

– Apply Linotar Gel 1% to the Allow to dry. If the lesion is still wet after 2 minutes you have applied too much of the Linotar Gel 1%.

– Apply Linocream to the lesions and gentlv rub it into the affected areas.

– Apply Linotar Gel two to three times a day and Linocream as often as you need to keep the skin soft and moisturised.

ON THE SCALP

– Wash your hair with a hypoallergenic shampoo and towel

– Apply Linotar Gel 1% to the Allow drying. If the lesion is still wet after 2 minutes you have applied too much.

– Apply Linoscalp to the lesions and massage in

– Apply Linotar Gel two to three times a day (if practical) and Linoscalp as often as you need to keep the scalp soft and

So what have we achieved by using the Linotar Range Treatment System?

– Arrested rapid division of cells in the basal layer of the epidermis

– Reduced inflammation

– Assisted in repairing the epidermis, resulting in a patient who can manage his/her psoriasis

Thus we have satisfied the rule of thumb set by Prof. Albert Kligman and acknowledged the wisdom of Richard Groves:

“Whenever you see inflamed skin, regardless of cause, the stratum corneum is leaky and permeable. But, if you repair the stratum corneum, that tells the underlying tissues that they don’t have to keep reacting like there is danger in the environment”. (Albert Kligman M.D. Ph.D.; 1919 –2010).

References:

1. Open Dermatol journal 2010, 4, 48-52

2. Journal of Investigative Derm 2012, 132, 2320-2331

3. J Clin Invest , Jan 25, 2013, online

4. Journal of Investigative Derm 2011, 131, 2263-2270

5. J Invest Derm 2003, 120, (3) 456-464

6. J Clin Aesthet Dermatol 6 (11): 20- 27

7. US Pharmacopeia Dispensing Information

8. Product Package Inserts and/or Patient Information Leaflet

9. British Journal of Dermatology 2003; 149; 350-353

10 Journal of Dermatological Treatment (2003),14, 1-9

11. Link: Skintherapyletter/fp/2011/7.5/3.html

12. Psoriasis treatment guidelines: SA and USA Dermatological Association recommendations

 
  
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Linocream and Eczema

Linocream® – barrier repair moisturizer, powered by Vitamin F and Meyer-Zall Laboratories’ (MZL) Emzaloid® Technology

The skin is the body’s largest organ, weighing almost 4 kg, covering 2 m2, but is only 2 mm thick. Without it we cannot survive, as it protects us from water loss that leads to dry skin and against irritants, bacteria and fungi that can cause skin infections. A healthy epidermis also provides natural protection against UV rays of the sun. It is the skin’s job to waterproof human beings and that task is performed by the epidermis. The top layer of the skin (stratum corneum) is similar to a wall of bricks and mortar. These “bricks” consist of keratin (same material as your nails) and the “mortar” is a combination of fats (ceramides, fatty acids) and cholesterol. Together they form a formidable protective barrier. Chronic skin conditions such as eczema and psoriasis are:

  • unpleasant
  • embarrassing
  • annoying
  • have a negative impact on quality of life.

In the UK more than a million people suffer from eczema; affecting 20% of children and 3% of adults. The basic cause of eczema is complex with many interrelated biological pathways including disruption of the skin barrier and the reaction thereto by the body’s immune system.

  • More and more evidence points to the one fueling the other.
  • Some experts say inflammation is the primary reaction whilst others say it is a leaky skin.

A leaky epidermis (skin) is much like a leaky roof: unless you stop the leak it is not going to get better. The leakage can, however, be stopped by what experts call physiological moisturisers that supply the ingredients that the skin requires to stop the loss of water.

One of the problems with a leaky epidermis is that the skin cannot make two of the essential ingredients it requires. They are Omega 3 (Linolenic acid) and Omega 6 (Linoleic acid) and have to be taken orally or preferably applied topically to ensure a healthy skin. Without these essential lipids, the barrier is weakened; simply put, it is leaky.

A weak or damaged barrier allows harmful things like allergens, bacteria, and irritants to pass through into the deeper layers of skin, causing symptoms of dryness, itching, and irritation and is the trigger for a variety of skin diseases like eczema.

Linocream can help repair the epidermis because it contains Vitamin F

Vitamin F was discovered as far back as the 1920’s and in the same Laboratory where Vitamin E was discovered a few years earlier and ?is one of the best kept secrets for skincare. Vitamin F is a combination of different types of omegas which make up the barrier of your skin. Without vitamin F the skin’s barrier is compromised.

The indispensable Omega 6 (Linoleic acid) is probably the Super Star of the skin as it also helps with the formation of another critically important epidermal fat, Ceramide 1.

“The essential fatty acid, linoleic acid is of particular significance to skin health as it contributes to the formation of ceramides essential for the structure of the epidermal barrier”. (Dr Kendall, Univ. of Manchester, Biomembranes Journal).

In addition to the benefits provided by Vitamin F, Linocream is also boosted by the Emzaloid® transdermal delivery system which aids the penetration of the ingredients into the epidermis.

Linocream can be of help in restoring the epidermis to its normal function

  • Topical corticosteroids (TCS) are part and parcel of treating eczema and psoriasis
  • TCS are excellent for short-term use but doctors and patients alike are concerned about the negative effects that long-term use of TCS bring about.
  • Continuous application of TCS cause visible side effects such as atrophy, bleeding into the surface of the skin, spider veins and irreversible stretch marks.
  • All of this means that it makes sense to limit the ongoing/chronic use of topical corticosteroids (TCS).
  • These side effects can to a large extent be prevented by using a steroid sparing physiological moisturiser like Linocream in conjunction with TCS when treatment is started and to persist with Linocream when TCS treatment is discontinued; almost like a buddy system.

Linocream will continue to moisturize the skin, maintain a healthy epidermis and keep inflammation in check. All brought about by the wonders of Vitamin F; powered by Emzaloid® technology.

“Whenever you see an inflamed skin, regardless of cause, the stratum corneum is leaky and permeable. But if you repair the stratum corneum, that tells the underlying tissues that they don’t have to keep reacting like there’s danger in the environment”. (Albert Kligman, M.D., Ph.D.; 1919-2010).

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Clinical Studies Summary

1. EXOREX® (100% EQUIVALENT TO LINOTAR®) IS SUPERIOR TO A CONVENTIONAL 5% COAL TAR

Exorex Lotion 1% (= Linotar Gel 1%) is superior to a conventional coal tar lotion (5%) for treatment of mild to moderate psoriasis, and may be preferred as a first-line topical treatment, according to a study published in the 2003 issue of the Journal of Dermatological Treatment.

These are the key results of this clinical study:

  • Exorex (Linotar) is superior to a conventional coal tar lotion in treating psoriasis.
  • Exorex (Linotar) may be the preferred option for first-line topical treatment.
  • Doctors’ and patients’ assessments showed a preference for using Exorex.
  • Exorex (Linotar) is well tolerated and produced fewer skin reactions.
  • Exorex (Linotar) was cosmetically acceptable to patients.

Conclusion:

Based on these results the study concluded that Exorex Lotion 5% ww (Linotar Gel 1%) is significantly more effective than a conventional coal tar lotion in mild to moderate psoriasis and may be preferred for first-line topical treatment.

Reference:

Journal of Dermatological Treatment (2003) 14, 1-9.

2. EXOREX® (LINOTAR®) IS AS EFFECTIVE AS CALCIPOTRIOL (DOVONEX®, DAIVONEX®)

Exorex (Linotar) has been found to be as effective as Calcipotriol (Dovonex®, Daivonex®) in treating psoriasis in a study published in the August 2003 issue of the British Journal of Dermatology.

These are the key results of this clinical study:

– Exorex (Linotar) is as effective as Dovonex (Daivonex®) in treating psoriasis.

– Exorex (Linotar) provided the same length of psoriasis remission as Dovonex® (Daivonex®) .

– The cosmetic properties of Exorex® (Linotar®) were greatly improved over other coal tar products.

– Exorex® (Linotar®) is several times less expensive than Dovonex® (Daivonex®).

Conclusion:

Based on these results the study concluded that Exorex® (Linotar®) is a very useful alernative topical treatment for chronic moderate-to-severe plaque type psoriasis.

Reference:

British Journal of Dermatology 2003; 149: 350-353.

 

临床研究总结

Exorex优于传统煤焦油乳液
Exorex优于传统的煤焦油乳液（5％），用于治疗轻度至中度牛皮癣，根据20003年發佈在皮肤病治疗杂志的研究, Exorex是作为第一线的局部治疗药物的首选。

这些是本临床研究的主要结果：
1. Exorex在治疗牛皮癣是优于传统煤焦油制剂。
2. Exorex可能是一线局部治疗药物的首选。
3.医生和病人的评估表示, 偏爱使用Exorex。
4. Exorex有很好的接受性和产生较少的皮肤反应。
5. Exorex是病人可以接受的化妆品。

结论：
基于这些结果，研究的结论是Exorex是比传统煤焦油乳液明显有效, 在针对轻度至中度牛皮癬更有效，可能是一线局部治疗药物的首选。
参考文献：皮肤病杂志的治疗（2003年）14，1-9。

Exorex效果和Dovonex（Daivonex）一樣有效。
Exorex已发现和Dovonex（Daivonex）治疗牛皮癣一样有效，发表在2003年8月英国皮肤科杂志发的一项研究。

这些都是本次临床研究的主要结果：
1. Exorex治疗牛皮癣和Dovonex一样有效。
2. Exorex提供牛皮癣缓解作用和Dovonex的时间长度相同。
3. Exorex的化妆品性质比其他煤焦油产品进步很多。
4. Exorex比Dovonex（Daivonex）便宜好几倍。

结论：
基于这些结果，研究的结论是Exorex对治疗局部慢性、中度至重度斑块型牛皮癣非常有用。
参考文献：2003英国皮肤病学杂志; 149：350-353

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Clinical Study Exorex and Dovonex

Observer-blind, randomized, intrapatient comparison of a novel 1% coal tar preparation (Exorex®) and Calcipotriol Cream (Dovonex®) in the treatment of plaque type psoriasis.

Authors: S. Tzaneva, H. Hönigsmann, A. Tanew.

Division of Special and Environmental Dermatology, Department of Dermatology, University of Vienna Medical School, Austria.

ABSTRACT

Summary

In a recent pilot study a novel, patented fatty acid-based 1% coal tar preparation (Exorex®) has been found to be similar in efficacy to Calcipotriol Cream in the treatment of psoriasis.

Objectives

Our aim was to investigate the therapeutic efficacy, safety and cosmetic acceptability of the new 1% coal tar preparation Exorex®, in comparison with Calcipotriol Cream in a larger patient cohort.

Patients and methods

Fourty patients with chronic plaque type psoriasis were included in this randomized, observer-blind, intrapatient comparison trial. In each patient two comparable target plaques were treated twice daily with 1% coal tar preparation or Calcipotriol Cream. At the onset of therapy and at weeks 2, 4, 6 and 8, the response to treatment was determined by the psoriasis severity index (PSI) that assesses the degree of erythema, infiltration and scaling of the psoriatic lesions on a five-point scale.

In addition, all treatment-related side-effects were recorded and cosmetic acceptability of both treatments was rated every second week by the patients. After complete or near complete clearing the patients were followed up until relapse or for a maximum period of 18 months.

Results

Thirty-eight patients completed the study. At termination of the trial the mean ± SD baseline PSI score of 9.2 ± 1.5 was reduced to 3.0 ± 2.9 by 1% coal tar preparation and to 2.8 ± 2.7 by Calcipotriol Cream.

The mean PSI reduction between baseline and final assessment did not differ significantly between 1% coal tar preparation and Calcipotriol cream (P = 0.77). The mean intraindividual difference in reduction of PSI score between 1% coal tar preparation and calcipotriol was 0.1 score points (95% confidence interval -0.84 to +0.63). No difference between either preparation was observed with regard to time until relapse. Itching was caused by 1% coal tar preparation in four patients and by Calcipotriol Cream in one patient. Unpleasant odour or staining of the 1% coal tar preparation was reported by six patients, whereas one patient complained about the smell of the Calcipotriol Cream.

Conclusions

The novel 1% coal tar preparation was found to be comparably as effective as Calcipotriol Cream in treating psoriasis. Tolerability and cosmetic acceptability was better for Calcipotriol Cream. Taking into consideration that the coal tar preparation is considerably less expensive than Calcipotriol Cream this new product appears as a very useful topical medication for chronic plaque type psoriasis.

Acknowledgments

This study was supported by a grant from Meyer Zall Laboratories, Owner and Patent Holder of the Exorex® and Linotar® brands, George, South Africa.

References

Dodd, W.A. Tars. Their role in the treatment of psoriasis. Dermatoligal Clinic 1993; Jan 11(1): 131-5.

Arnold, W.P. Tar. Clinical Dermatolology 1997; 15: 739?44.

Valk, P.G.M. van der, E. Snater, Verbeek-Gijsbers, P. Duller, P.C.M. van der Kerkhof. Out patient treatment of atopic dermatitis with crude coal tar. Dermatology 96; 193: 41-44.

Veronikis, I.E., Malaban, A.O., Holick, M.F. Comparison of calcipotriene (Dovonex) with a coal tar emulsion (Exorex) in treating psoriasis in adults: a pilot study. Arch Dermatol. 1999; 135: 474-475.

Source: British Journal of Dermatology. Volume 149 (2003), Pages 350-353.

Web link to full text: https://pubmed.ncbi.nlm.nih.gov/12932242/

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Coal Tar Shown to be Safe

NO INCREASED RISK OF CANCER AFTER COAL TAR TREATMENT IN PATIENTS WITH PSORIASIS OR ECZEMA

Abstract

Coal tar is an effective treatment for psoriasis and eczema, but it contains several carcinogenic compounds.

Occupational and animal studies have shown an increased risk of cancer after exposure to coal tar.

Many dermatologists have abandoned this treatment for safety reasons, although the risk of cancer after coal tar in dermatological practice is unclear.

This large cohort study included 13,200 patients with psoriasis and eczema.

Information on skin disease and treatment, risk factors, and cancer occurrence was retrieved from medical files, questionnaires, and medical registries.

Proportional hazards regression was used to evaluate differences in cancer risk by treatment modality.

Patients treated with coal tar were compared with a reference category of patients treated with dermato-corticosteroids (assumed to carry no increased cancer risk).

The median exposure to coal tar ointments was 6 months (range 1-300 months).

Coal tar did not increase the risk of non-skin malignancies (hazard ratio (HR) 0.92; 95% confidence interval (CI) 0.78-1.09), or the risk of skin cancer (HR 1.09; 95% CI 0.69-1.72).

This study has sufficient power to show that coal tar treatment is not associated with an increased risk of cancer.

These results indicate that coal tar can be maintained as a safe treatment in dermatological practice.

Authors

Judith H J Roelofzen, Katja K H Aben, Ursula T H Oldenhof, Pieter-Jan Coenraads, Hans A Alkemade et al.

Source

Journal of Investigative Dermatology (2010) 130, 953-961; doi:10.1038 / jid.2009.389; published online 17 December 2009.

Web link to full text coal tar safe: https://www.jidonline.org/article/S0022-202X(15)34771-0/fulltext

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How to Use the Linotar System?

Linotar Gel 1%:

Distilled Coal Tar, 10 mg/g (= 1% w/w, wet weight). Topical penetrating emulsion for the treatment of psoriasis and eczema of the skin and scalp

Main Body:

Lightly apply the Linotar Gel 1% to the affected areas. The Linotar Gel 1% will dry within 2 to 3 minutes. Linocream Moisturising Cream can now be applied to those affected areas. Repeat 2 to 3 times daily.

Scalp:

Towel dry hair after it has been washed with a hypo-allergenic shampoo. Apply Linotar Gel 1% to affected areas and allow to dry for 2 to 3 minutes. Apply Linoscalp leave-in Scalp Conditioner to affected areas on the scalp. Blow dry or let hair dry naturally. Linotar Gel 1% and Linoscalp leave-in Scalp Conditioner can be applied without washing hair. Repeat 2 to 3 times daily.

Fingernails:

Cut the nails as short as possible. Apply the Linotar Gel 1% under the nail as far as possible and around the nail bed. Allow to dry for 2 to 3 minutes, then apply the Linocream Moisturising Cream to the same areas. Avoid peeling potatoes, tomatoes, onions etc. Wear cotton gloves when working with chemicals.

Notes:

  • If your skin becomes increasingly sensitive to the Linotar treatment, please e-mail us at helpdesk@linotar.com, call our Linotar Helpdesk (Canada & US toll-free:1-888-604-4561), or consult a physician.
  • Soaps and shampoos should be mild, hypo-allergenic and deodorant free. Ask your pharmacist or Help Line for suggestions.
  • Coal Tar is a photosensitizer. Avoid overexposure to sunlight.

Directions for use:

For adults and children over 12 years of age:

Make sure that all areas of the affected skin are clean.
Apply a thin layer of Linotar Gel 1% Penetrating Emulsion two to three times per day to these areas. Massage gently and leave to dry.

For use in children under 12 year of age and the elderly:

Linotar Gel 1% can be diluted in the palm of the hand by mixing with a few drops of freshly boiled water.

Make sure to keep the bottle closed after use and stored out of sight and reach of children!

In the morning:

Clean the affected area. Sparingly apply a thin layer of Linotar Gel 1%.
After Linotar Gel 1% Emulsion has dried (2-3 minutes), apply a thin layer of Linocream Moisturising Cream.

In the afternoon:

Sparingly apply a thin layer of Linotar Gel 1% onto the affected skin area, including the scalp.

Treatment of the skin: After applying Linotar Gel 1% Penetrating Emulsion (2-3 minutes), apply at thin layer of Linocream Moisturising Cream.

Treatment of the scalp: after Linotar Gel 1% Penetrating Emulsion has dried, gently rub in Linoscalp leave-in Scalp Conditioner and leave to dry.

In the evening:

Repeat the treatment of the afternoon.

Along with the recommendations given in the brochure to adapt to an appropriate life-style, this treatment regimen is the optimal Lino-range products therapy for psoriasis and eczema sufferers. Any deviations from this scheme may lead to a longer duration of treatment.

Directions for use on the scalp: apply Linoscalp leave-in Scalp Conditioner after washing the hair and rub gently when hair is still wet and leave to dry.

What is Linotar Gel 1% used for?

Psoriasis and eczema of the skin and scalp.

Linotar Gel 1% – how does it work?

Coal tar is mildly antiseptic and relieves itching.
It also acts as a ‘keratolytic’, which works to break down a protein which forms part of the skin structure called keratin. Skin thickening occurs due to the deposition of keratin. Coal tar helps to reduce the excessive hardening, thickening and scaling of the skin.

Warnings!

– Avoid exposure to sunlight or sunlamps.
– If exposure to sunlight cannot be avoided, use protective measures such as?? sun-creams or protective clothing.
– This medicine will stain skin, hair and fabric.
– Avoid contact with eyes, mucous membranes, genital and rectal areas.
– This preparation is for external use only.

Use Linotar Gel 1% with caution:

– Avoid contact with eyelids and all other mucosal surfaces
– Avoid direct contact with the eyes

Linotar Gel 1% is not to be used in:

Acute psoriasis (is sudden, severe outbursts of psoriasis).

Linotar Gel 1% should not be used if:

– You are allergic to one or any of its ingredients listed below. Please inform your doctor or pharmacist a.s.a.p. if you have previously experienced such an allergy!

– If you feel you have experienced an allergic reaction, stop using Linotar Gel 1% and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding:

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding, provided the benefits to the mother outweigh the risks to the unborn baby.
Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine. No Linotar Gel 1% safety information is available in pregnancy. Seek medical advice. No safety information is available in breastfeeding. Discuss with your doctor.

Side effects:

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this type of medicine (coal tar). Because a side effect is stated here, it does not mean that all people using this medicine will experience that particular, or any, side effect.

– Abnormal reaction of the skin to light, usually a rash (photosensitivity)
– Staining of skin and clothes
– Skin irritation

The side effects listed above may not include all of the side effects reported by the drug’s manufacturer. For more information about any other possible risks associated with this medicine, please read the patient information provided with the medicine, or consult your doctor or pharmacist.

How can Linotar Gel 1% affect other medicines?

No known interactions, when applied to unbroken skin.

Composition:

Active substance: Distilled Coal Tar, 10 mg/g (= 1% w/w, wet weight).

Other ingredients:

Complex of esterified essential fatty acids; PEG-40 hydrogenated Castor Oil; Sodium Propyl Paraben 0.05 % m/m; Vitamin E (DL-Alpha Tocopherol) 0.3 % m/m; Methyl Paraben 0.1% m/m; Polysorbate 80; Xanthan Gum; Industrial Methylated Spirits; purified Water.

Posted on:

John’s Story

My name is John and my body was more than 85% covered with Psoriasis. I started using the Exorex treatment by using Exorex® Gel 1% Penetrating Emulsion, followed by Exorex® Moisturizing Cream.
During the healing process, the flaking and scaling disappeared and the red lesions began to fade.
I was relieved and thankful that 95% of my psoriasis lesions cleared up.
And now, years later, my psoriasis still remains under control !
Posted on:

Linotar – for Psoriasis and Eczema

LINOTAR® GEL 1% / EXOREX® LOTION 5% w/w / EXOREX® GEL 1% – PRODUCT PROFILE

Linotar® Gel 1%, also known as Exorex® Lotion 5% w/w (UK and Ireland) or Exorex® Gel 1% penetrating emulsion (U.S.A.), is a highly innovative topical dermatological preparation indicated for the treatment of Psoriasis and Eczema. The active ingredient is distilled coal tar. In addition, Linotar® Gel 1% features a sophisticated vehicle consisting of a specific combination of free essential fatty acids. Linotar®, as a result, has been successfully applied without most of the burdens that are usually associated with the use of some more conventional coal tar preparations.

Mode of action

Contrary to most traditional coal tar preparations, Linotar® Gel 1% produces an extremely rapid and almost complete penetration (1). The excipients have a transdermal carrier function, bringing coal tar much more efficiently through the affected skin. Thanks to this special feature and due to the general physical properties of Linotar® Gel 1%, the product does not provoke as much of the yellow staining that is common to coal tar products, nor does it produce the traditional strong coal tar smell: The product “disappears” within minutes, without leaving visible traces.

Linotar® Range Treatment System

Linotar® Gel 1% has been developed by Meyer Zall Laboratories of George, South Africa and was first launched in 1993 in its home market for both the indications psoriasis and eczema, as part of a complete treatment system that also included the specially developed compatible Linocream® Moisurising Cream and Linoscalp® leave-on Scalp Conditioner. Since 1993, the 100% equivalent product Exorex® Gel 1% has been successfully introduced in Australia, New Zealand, and in a number of African and Asian countries, as well as in the U.S.A., Canada, Israel, Ireland and the United Kingdom. In 1996 Exorex® Lotion 5% w/w was registered in Austria, Greece, The Netherlands and Luxembourg.

Clinically proven

Exorex® Gel 1% has been shown to be clinically and statistically equally effective as the vitamin D derivate calcipotriol (also known as Daivonex®, Dovonex® or Psorcutan® Cream) and superior to any coal tar in the treatment of psoriasis, through objective parameters and in patient preference scores. Results of a recently completed Austrian (University of Vienna, 2001) 40-patient clinical trial proves this point (2). These results closely match those of an earlier 18-patient US pilot study in which Exorex® Gel 1% is compared with the vitamin D derivate Dovonex® (calcipotriene) (3).

References

(1) Saunders James C J, Davis Henry J, Coetzee Linda, Botha Susan; Kruger Ansie E, Grobler, Anne. A Novel Skin Penetration Enhancer: Evaluation By Membrane Diffusion And Confocal Microscopy. J Pharm Pharmaceut Sci (https://www.cspscanada.org/) 2(3):99-107, 1999.

Web link to Exorex Lotion (Gel 1%) / Linotar Gel 1% trans dermal carrier: https://sites.ualberta.ca/~csps/JPPS2(3)/J.Saunders/microscopy.htm

(2) Tzaneva S, Hönigsmann H, Tanew A. Observer-blind, randomized, intrapatient comparison of a novel 1% coal tar preparation (Exorex®) and Calcipotriol cream in the treatment of plaque type psoriasis. British Journal of Dermatoly 2003 Aug;149(2):350-3.

Web link to Exorex Lotion (Gel 1%) 40-patient clinical study: https://pubmed.ncbi.nlm.nih.gov/12932242/

(3) Veronikis, Irini E, Malabanan, Alan O, Holick Michael F. Comparison of Calcipotriene cream (Dovonex®) with a coal tar emulsion (Exorex®) in treating psoriasis in adults: a pilot study. Arch Dermatol 1999 Apr;135(4):474-5.

Web link to Exorex Lotion (Gel 1%) 18-patient pilot study: https://pubmed.ncbi.nlm.nih.gov/10206065/

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