Dapsone Offers Short-Term Relief for Dermatitis Herpetiformis

If you have dermatitis herpetiformis, you know how uncomfortable this skin manifestation of celiac disease can be. People with dermatitis herpetiformis often scratch their skin until it bleeds in a futile effort to make the itching and burning stop.

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About 15 to 25% of celiac disease patients also suffer from dermatitis herpetiformis, which appears as clusters of water-filled blisters and itchy red bumps. The skin rash most commonly erupts on the elbows, knees, lower back, buttocks, and on the back of the head, but it can appear anywhere on the body.

Although the only lifelong treatment for dermatitis herpetiformis is the gluten-free diet, it can take several weeks to several months of eating gluten-free until your rash subsides completely. Until then, your healthcare provider can prescribe the medication Dapsone to control the itch and subdue the rash.

Dapsone for Dermatitis Herpetiformis Sufferers

Dapsone, which was developed to treat leprosy and other skin infections, is a sulfur-based antibiotic that you'll take orally. It works quickly –- often within days –- to begin clearing up your dermatitis herpetiformis.

Because dapsone can cause some serious side effects, your healthcare provider may start you on a small dose and ramp that dosage up over time if needed as your symptoms begin to subside and as you get the hang of the gluten-free diet.

When taking dapsone, you might experience nausea and an upset stomach. To avoid these, take the medication with food or milk. In addition, the drug can make your skin more sensitive to sunlight, so be careful outdoors, especially in direct, strong sun.

Dapsone Risks: Rare, Serious Side Effects

All patients on dapsone see some reduction in their hemoglobin, the part of red blood cells that carries oxygen. This small drop in your hemoglobin won't hurt you. However, a few patients will experience a rapid decrease in their hemoglobin, which can cause symptoms including a sore throat, dizziness or feelings of faint. A very few patients also develop liver problems while taking dapsone.

If your healthcare provider prescribes dapsone to treat your dermatitis herpetiformis, you'll probably need to have weekly or bi-weekly blood tests for the first three months in order to make sure you're not developing these blood or liver problems related to the medication.

In addition, rare cases have been reported in which dapsone was associated with serious and potentially fatal skin reactions. If you develop any unusual rash while taking dapsone, talk to your practitioner immediately.

Dapsone also can cause headaches in some people. Medical research hasn't determined if you can take it safely when you're pregnant, but it is known to pass into breast milk, so you should talk to your healthcare provider if you are pregnant or nursing.

Options Available If Dapsone Fails to Clear Your Dermatitis Herpetiformis

If you can't tolerate dapsone or if it doesn't work for you, there are very few effective drug alternatives that might offer some relief while you're waiting for your gluten-free diet to take effect.

Dermatologists have used the medications sulfapyridine and tetracycline to treat dermatitis herpetiformis, although not as successfully as with dapsone. In addition, a report from Australia noted that sulfasalazine worked in three patients who couldn't tolerate dapsone, although one patient had to discontinue the drug due to side effects.

If you've been diagnosed with dermatitis herpetiformis, dapsone offers a short-term solution to intense discomfort. But the gluten-free diet represents your best long-term treatment.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bashir A. Dermatitis herpetiformis (DH) in association with H. pylori infection: Description of a case reportBritish Journal of Medicine and Medical Research. 2011;1(3):163-169. doi:10.9734/bjmmr/2011/364

  2. National Organization for Rare Disorders. Dermatitis herpetiformis.

  3. Wozel G, Blasum C. Dapsone in dermatology and beyond. Arch Dermatol Res. 2014;306(2):103-24. doi:10.1007/s00403-013-1409-7

  4. Wang Y, Yang B, Zhou G, Zhang F. Two cases of dermatitis herpetiformis successfully treated with tetracycline and niacinamide. Acta Dermatovenerol Croat. 2018;26(3):273-275.

Additional Reading
  • Dermatitis Herpetiformis. American Osteopathic College of Dermatology.
  • Dapsone. Drugs.com.
  • Dapsone. PubMed Health

  • E. Willsteed et al. Sulfasalazine and Dermatitis Herpetiformis. Australasian Journal of Dermatology. 2005 May;46(2):101-3.
  • M. Caproni et al. Guidelines for the Diagnosis and Treatment of Dermatitis Herpetiformis. Journal of the European Academy of Dermatology and Venereology. 2009 Jun;23(6):633-8. Epub 2009 Mar 10.
  • R. Wolf et al. Dapsone: Unapproved Uses or Indications. Clinics in Dermatology. 2000 January/February;18: 37-53.