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Goeckerman Therapy and Ingram Regimen for Psoriasis
Goeckerman [GEK-er-man] therapy or the
Ingram regimen may be prescribed to treat severe psoriasis. While
neither is widely available, a few hospitals and psoriasis treatment
centers in the United States offer this type of treatment.
Number of treatments: Goeckerman and Ingram are effective at
clearing psoriasis, but both require intensive treatment for several
hours a day in a psoriasis clinic or hospital. Treatment is usually
given Monday through Friday. Patients must undergo daily treatment
for several weeks. Most patients receive treatment for 3, 4, or 5
weeks.
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Goeckerman therapy
typically involves receiving ultraviolet (UV) light
treatment and applying a prescription coal tar mixture
to the psoriasis. The coal tar mixture usually remains
on the skin for several hours.
Ingram regimen involves a similar process. Instead of
coal tar, a psoriasis medicine called anthralin (which
comes from coal tar) is applied to the skin. After
receiving a UVB or UVA light treatment, the anthralin is
applied. Sometimes, the body is wrapped in a plastic
dressing. The anthralin usually remains on the skin for
2 to 4 hours.
Goeckerman therapy may be combined with Ingram regimen
or another light treatment. When Goeckerman is combined
with Ingram, the patient receives UVB phototherapy and
both coal tar and anthralin are applied to the skin.
These usually remain on the skin for a few hours or
longer. This treatment is repeated Monday through Friday
for several weeks. Some claim that no treatment for
severe psoriasis works faster, has fewer side effects,
and offers longer periods of clearing than the
Goeckerman/Ingram combination. |
How long clearing lasts:
Goeckerman therapy tends to offer the longest remission time for
moderate to severe psoriasis. The average remission time for
treatment with Goeckerman therapy is 6 to 12 months. For the
Ingram regimen, the average remission time is about 6 months.
Side effects: Red and tender skin that often looks like a
sunburn, burning skin, freckling, and premature skin aging (age
spots, wrinkles, sagging skin) can develop. This intensive
treatment also may increase a person’s risk of developing skin
cancer.
With the Ingram regimen, the pores in the skin can clog and
cause a breakout that looks like acne.
References:
Koo J, Lebwohl M. “Duration of remission of psoriasis
therapies.” Journal of the American Academy of Dermatology
July 1999; 41: 51-9.
Lebwohl M, Ali S. “Treatment of psoriasis. Part 1. Topical
therapy and phototherapy.” Journal of the American Academy of
Dermatology October 2001; 45: 487-98; quiz 99-502.
Menter A, Korman NJ,
Elmets CA et al. “Guidelines of care for the management
of psoriasis and psoriatic arthritis: Section 5. Guidelines of
care for the treatment of psoriasis with phototherapy and
photochemotherapy.” Journal of the American Academy of
Dermatology January 2010; 62: 114-35.
Serrao R, Davis MD. “Goeckerman treatment for remission of
psoriasis refractory to biologic therapy.” Journal of the
American Academy of Dermatology February 2009; 60: 348-9.
Zanolli MD,
Feldman SR, Clark AR, et al. 2000. “Phototherapy
Treatment Protocols.” New York, NY: Parthenon Publishing
Group.
All content solely
developed by the American Academy of Dermatology
For an overview, visit
the AAD pamphlet
Psoriasis and Psoriatic Arthritis.
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A recent study found that
Goeckerman therapy can be effective when psoriasis does
not respond to one or more of the biologics. |
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