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Review Article

The Use of Naltrexone in Dermatology. Current Evidence and Future Directions

Author(s): Mariusz Sikora*, Adriana Rakowska, Małgorzata Olszewska and Lidia Rudnicka

Volume 20, Issue 10, 2019

Page: [1058 - 1067] Pages: 10

DOI: 10.2174/1389450120666190318121122

Price: $65

Abstract

Naltrexone is a competitive opioid receptor antagonist approved as supportive treatment in alcohol dependence and opioid addiction. At a dose of 50-100 mg daily, naltrexone is used off-label in dermatology for the treatment of trichotillomania and different types of pruritus. At a dose as low as 1- 5 mg per day, naltrexone demonstrates immunomodulatory action i.e. modulates Toll-like receptors signaling, decreases release of proinflammatory cytokines (tumor necrosis factor, interleukin-6, interleukin- 12), inhibits T lymphocyte proliferation, down-regulates the expression of chemokine receptors and adhesion molecules. The efficacy of standard and low doses of naltrexone in a variety of dermatological disorders has been reported. These include diseases such as familial benign chronic pemphigus (Hailey-Hailey disease), dermatomyositis, systemic sclerosis, psoriasis and lichen planopilaris. Optimistic preliminary findings, low cost of therapy and good tolerance make naltrexone a promising alternative therapy or adjunct drug in dermatology.

Keywords: Alopecia, low dose naltrexone, opioid growth factor, pruritus, psoriasis, toll-like receptor.

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