Scientific research has greatly expanded the therapeutic options for patients with cutaneous disease. This expansion, however, has not been without its drawbacks. While newer medications and procedures not only typically offer better disease control but they are also often associated with increased expense and problematic toxicities. Older medications often relegated to the dustbin of history may provide effective treatment of common dermatologic maladies and deserves reconsideration. Ichthammol, derived from shale oil, has been employed in the therapy of psoriasis, eczematous dermatitis, leg ulcers, seborrheic dermatitis, and furuncles for over a century and remains a useful topical medicament.