Coal Tar Treatment: Uses, Benefits, and Safety for Skin Conditions

Summary of Key Points

Coal tar is a topical treatment frequently used for managing skin conditions such as psoriasis, eczema, seborrheic dermatitis, and dandruff. It works by reducing itching, scaling, and inflammation. Available in various forms, including shampoos, creams, and ointments, coal tar is effective but may cause side effects like skin irritation. Always consult a healthcare provider before starting or adjusting treatment. You may also consider scheduling a telemedicine appointment with our providers for personalized care.

Names of Medication

US Brand Names: Scytera, Psoriasin, T/Gel, DHS Tar, Ionil T, Neutrogena T/Gel

Generic Name: Coal tar

The generic name refers to the chemical name of the active ingredient. In this case, “coal tar” is the generic name, meaning it is not associated with a specific brand.

Pharmacologic Category

Topical Antipsoriatics

Keratolytics

Anti-inflammatory Agents

Coal Tar Dosing for Skin Conditions

Coal tar is used to treat a variety of skin conditions, with dosing tailored to the specific condition. Always follow your healthcare provider’s instructions and consult them before making any changes. You can also schedule a telemedicine appointment with one of our providers for further guidance.

1. Psoriasis: Apply coal tar 1-2 times daily to affected areas. The duration of treatment varies depending on the severity of the condition.
2. Eczema: Apply coal tar 1-2 times daily to affected areas. Continue treatment until symptoms improve.
3. Seborrheic Dermatitis: Use coal tar shampoo 1-3 times per week. The length of treatment depends on how well symptoms are controlled.
4. Dandruff: Use coal tar shampoo 1-2 times per week. Continue as needed to manage symptoms.
5. Lichen Planus: Apply coal tar 1-2 times daily to affected areas. Treatment duration may vary.
6. Vitiligo: Apply coal tar 1-2 times daily to affected areas. The duration of use depends on the response to treatment.
7. Ichthyosis: Apply coal tar 1-2 times daily to affected areas. Continue as needed.
8. Psoriasis Vulgaris: Apply coal tar 1-2 times daily to affected areas. The length of treatment depends on the severity of the condition.
9. Atopic Dermatitis: Apply coal tar 1-2 times daily to affected areas. Continue until symptoms improve.
10. Scalp Psoriasis: Use coal tar shampoo 1-3 times per week. Continue as needed to manage symptoms.

Dosage Forms and Strengths of Coal Tar

Coal tar is available in various forms and strengths, allowing flexibility in treatment based on the specific skin condition being addressed.

1. Shampoo: 0.5% to 5% coal tar
2. Cream: 0.5% to 5% coal tar
3. Ointment: 0.5% to 5% coal tar
4. Lotion: 0.5% to 5% coal tar
5. Soap: 0.5% to 5% coal tar

Administration Instructions for Coal Tar Treatment

Coal tar should be applied directly to the skin or scalp, depending on the form prescribed. For shampoos, wet your hair, apply the shampoo, and leave it on for 5-10 minutes before rinsing thoroughly. For creams, ointments, or lotions, apply a thin layer to the affected area and gently rub it in. Avoid contact with the eyes, mouth, or open wounds. Be sure to wash your hands after application. Always follow your healthcare provider’s instructions, and contact our telemedicine team if you have any questions about using this medication.

Coal Tar Side Effects and Adverse Reactions

Like all medications, coal tar can cause side effects. While not everyone will experience them, it’s important to be aware of potential reactions. If you experience any severe side effects, contact your healthcare provider immediately.

Common Side Effects (may affect up to 1 in 10 people):

1. Skin irritation: Redness, itching, or burning at the application site.
2. Dry skin: Coal tar may cause dryness in the treated area.

Less Common Side Effects (may affect up to 1 in 100 people):

1. Photosensitivity: Increased sensitivity to sunlight, which can lead to sunburn.
2. Staining: Coal tar may stain skin, hair, or clothing.

Rare Side Effects (may affect up to 1 in 1,000 people):

1. Allergic reactions: Symptoms may include rash, swelling, or difficulty breathing. Seek medical attention if these occur.

Contraindications for Coal Tar Use

A contraindication is a specific situation where a medication should not be used due to potential harm. Understanding these situations is essential to avoid risks when using coal tar.

1. Allergy to Coal Tar: If you have a known allergy to coal tar or any of its components, avoid using this medication. Allergic reactions can include rash, itching, swelling, or more severe symptoms like difficulty breathing.
2. Sunburned or Irritated Skin: Coal tar can increase skin sensitivity to sunlight. If you have sunburn or other skin irritations, using coal tar may worsen the condition.
3. Open Wounds or Infected Skin: Do not apply coal tar to open wounds or infected skin, as it may delay healing or increase the risk of infection.
4. Photosensitivity Disorders: If you have a condition that makes your skin more sensitive to light (e.g., lupus), coal tar may increase the risk of severe sunburn or skin damage.

Drug to Drug Interactions

Coal tar can interact with other medications, potentially leading to side effects or reducing the effectiveness of either treatment. It’s important to inform your healthcare provider about all the medications you are currently taking before starting coal tar therapy.

Topical Corticosteroids

(e.g., hydrocortisone, triamcinolone) Using coal tar alongside corticosteroids may increase skin irritation or diminish the effectiveness of either treatment. Always consult your healthcare provider before combining these therapies.

Photosensitizing Agents

(e.g., methotrexate, doxycycline) These medications can make your skin more sensitive to light. When used with coal tar, they may heighten the risk of sunburn or skin damage. Exercise caution when using coal tar in combination with photosensitizing agents.

Retinoids

(e.g., tretinoin, adapalene) Retinoids can also increase skin sensitivity. Combining them with coal tar may result in excessive irritation or peeling. Be sure to discuss with your healthcare provider if you are using retinoids and considering coal tar treatment.

Coal Tar in Pregnancy

Is it safe to use coal tar during pregnancy?

There is limited research on the safety of coal tar during pregnancy. While some studies suggest it may be safe in small amounts and for short durations, it is generally advised to avoid coal tar during pregnancy, particularly in the first trimester. Always consult your healthcare provider before using coal tar if you are pregnant. If you need guidance, our telemedicine providers are available to help you make an informed decision.

Coal Tar while Breastfeeding

Is it safe to use coal tar while breastfeeding?

Coal tar is generally not recommended while breastfeeding, especially if applied to large areas of the skin or near the breast. There is a risk that the medication could be absorbed into the bloodstream and passed to the baby through breast milk. If you are breastfeeding and considering coal tar treatment, consult your healthcare provider to explore safer alternatives. Our telemedicine team can provide personalized advice based on your specific situation.

Estimated Cost of Coal Tar Products

The cost of a 30-day supply of coal tar products can vary depending on the brand and formulation. With a GoodRX coupon, the estimated cost of coal tar shampoo or topical solution ranges from $10 to $30 without insurance. Prices may also vary based on your location and the specific product you choose.

Possible Alternatives to Coal Tar Treatment

If coal tar is not suitable for you, there are other treatment options and lifestyle changes that may help manage your condition. Always discuss these alternatives with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to help you explore the best options for your health.

Psoriasis

Alternatives include topical corticosteroids, vitamin D analogs (e.g., calcipotriene), or biologics (e.g., adalimumab). Light therapy (phototherapy) may also be an option for managing psoriasis.

Eczema

Moisturizers, topical corticosteroids, and calcineurin inhibitors (e.g., tacrolimus) are common alternatives to coal tar for eczema. Avoiding triggers such as harsh soaps or allergens can also help manage symptoms.

Seborrheic Dermatitis

Antifungal shampoos (e.g., ketoconazole) or corticosteroid creams may be used as alternatives to coal tar for seborrheic dermatitis.

Dandruff

Zinc pyrithione or selenium sulfide shampoos can be effective alternatives to coal tar for managing dandruff.

Lichen Planus

Topical corticosteroids or oral antihistamines may help reduce symptoms. In some cases, light therapy may be recommended for lichen planus.

Vitiligo

Topical corticosteroids, calcineurin inhibitors, or light therapy may be used to manage vitiligo. In some cases, depigmentation therapy may be considered.

Ichthyosis

Regular use of moisturizers and keratolytic agents (e.g., salicylic acid) can help manage symptoms. In severe cases, retinoids may be prescribed for ichthyosis.

Psoriasis Vulgaris

Topical treatments like corticosteroids, vitamin D analogs, or biologics may be considered. Lifestyle changes, such as reducing stress and avoiding triggers, can also help manage psoriasis vulgaris.

Atopic Dermatitis

Moisturizers, topical corticosteroids, and avoiding triggers like allergens or irritants are common alternatives to coal tar for atopic dermatitis.

Scalp Psoriasis

Medicated shampoos containing salicylic acid or corticosteroids may be used as alternatives to coal tar for scalp psoriasis. Light therapy may also be an option.

Recent Updates on Coal Tar Research

Recent studies have focused on the long-term safety of coal tar, particularly its potential link to cancer. While older research raised concerns about the carcinogenic potential of coal tar, more recent studies suggest that the risk is minimal when used in low concentrations and for short periods. However, it is still recommended to use coal tar under the guidance of a healthcare provider, especially for long-term treatment.

Ongoing research is also exploring the combination of coal tar with other treatments, such as biologics or light therapy, to enhance its effectiveness while minimizing side effects. If you are interested in learning more about the latest treatment options, our telemedicine providers can help you stay informed about the best choices for your condition.

James Kingsley

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