Effectiveness Outweighs Side-Effects

Arbiser is campaigning for the compound’s expanded use in the Atlanta VAMC. “When a primary-care provider sees a patient with an itchy rash, they should try gentian violet. And if that doesn’t work, then send them to us. I think a lot would respond to gentian violet and wouldn’t need further supervision by dermatologists,” Arbiser said. “I also recommend it for emergency room personnel. If someone comes in with a bad case of poison ivy, gen violet works great for that.”

Despite being a versatile and inexpensive treatment, there are still a few barriers keeping physicians and patients from embracing gentian violet. The first is that few physicians who went through medical school in the last 40 years know about it.

 “It has a reputation as being an old-time medicine,  something that’s fallen by the wayside,” Arbiser said. “But, now that we find out how it works and how we can scientifically apply it, I think it’s time for it to make a comeback. Especially when we’re talking about containing healthcare costs.”

The other barrier is its color; gentian violet stains whatever it touches purple. Mothers who have used the drug to treat thrush complain of how it stains the baby’s mouth and saliva purple, which in turn will stain clothes purple. The purple will eventually wash off but could be a deterrent to its use.

“One of the side-effects that is listed with gentian violet is that the violet color will sometimes persist like a tattoo, but this is very rare and we haven’t seen it,” Arbiser said.

Compared with the side-effects of drugs like topical steroids, which thin out the skin after years of use, purple staining seems mild, Arbiser noted. Also, gentian violet has been found to work instantly. For people who experience severe rashes or eczema, instant relief from the painful itching can trump any side-effect.

“If you’re really itchy, you’re grateful to have something that works and works so quickly,” Arbiser said.

Currently, there are no ongoing studies with gentian violet, Arbiser said, but he hopes that will change. “I hope to do a nationwide study of gentian violet, comparing it against these other treatments. Then we can really see how effective and affordable it is.”

Editor’s note: Not all good ideas come from the highest levels of the VA. At VA medical centers around the country, clinicians in the trenches have developed novel ways to improve patient care, often cost-effectively. This is the first in a periodic series of articles about some of those concepts and the clinicians who have championed them. Do you know about an InnoVAtion we should cover? If so, please email me at mooney@usmedicine.com and let me know about it.

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