Although occlusive therapy have great potential in the management of some skin conditions like lichen simplex chronicus, psoriasis vulgaris, hand eczema, atopic dermatitis, lupus erythematosus and many other chronic skin lesions, the therapeutic mechanism of this therapy is not completely understood. But occlusion artificially restores and corrects the defective barrier between the skin.
Prolonged and continuous occlusion and hydration of affected skin areas with a suitable barrier increases the efficacy. This therapy is useful for treating many chronic skin disorder as faciliates the penetration of topical medicines easily. But you should be aware that occlusive therapy with class one corticosteriods are not recommended. These preparations includes – Betamethasone dipropionate creams,ointment 0.05% ( Diprolene ), Clobetasol propionate cream, ointment 0.05% ( Clobex,Temovate ), Diflorasone diacetate ointment 0.05% ( Apexicon, Psorcon ), Halobetasol propionate cream, ointment 0.05% ( Ultravate).
Instructions for Occlusive Therapy
- Soak the area in water for around 15-20 minutes
- After soaking the area apply the medication into the lesion while the skin is still moist.
- Cover the area with a plastic wrap,plastic gloves for hands,plastic bags for feet, bathing cap for scalp and vinyl exercise suit for large body areas.
- Seal the edges with tape or cover plastic with an ace bandage, a long stocking or any dressing that will ensure close adherence to skin. Paper tapes are better and less irritating.
- Use for atleast 6 hours. Overnight application is usually sufficient to induce clinical remission. But this can also be done at day time. Occlusion for even few hours may be beneficial.
I wore a full plastic suit at night for years while I slept as treatment for full body eczema. It was miserable but it worked. I was in remission for years and will use the plastic wrao method as needed.