Coal Tar

Generic Name: Coal Tar

Coal tar topicals are prescribed or recommended to relieve itchiness, dryness, and scaling caused by various skin conditions, including psoriasis, eczema, dermatitis, and others. This medication contains actual tar derived from coal and belongs to a class of drugs called keratoplastics or keratolytics.

It works by slowing the growth of skin cells (keratolytic) to help your skin shed dead cells from its top layer (keratoplastic). Coal tar topicals are available in over-the-counter and prescription forms, and sold under various brand names.

According to the National Psoriasis Foundation, coal tar has been used as a treatment for skin conditions for centuries. The Goeckerman regimen, which enhances the skin-shedding properties of coal tar topicals by combining them with controlled phototherapy treatments, was developed in the 1920s and is still used insome dermatology practices.

No health feed found.

The exact mechanism of action is unknown. Coal tar is a complex mixture of phenols, polycyclic aromatic hydrocarbons (PAHs), and heterocyclic compounds.

It is a keratolytic agent, which reduces the growth rate of skin cells and softens the skin's keratin.

Coal tar is used in medicated shampoo, soap and ointment. It demonstrates antifungal, anti-inflammatory, anti-itch, and antiparasitic properties. It may be applied topically as a treatment for dandruff and psoriasis, and to kill and repel head lice. It may be used in combination with ultraviolet light therapy.

Coal tar is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Coal tar is generally available as a generic medication and over the counter. In the United Kingdom 125 ml of 5% shampoo costs the NHS about £1.89. In the United States a month of treatment costs less than $25 USD.

Pine tar has historically also been used for this purpose. Though it is frequently cited online as having been banned as a medical product by the FDA due to a "lack of evidence having been submitted for proof of effectiveness", pine tar is included in the Code of Federal Regulations, subchapter D: Drugs for Human Use, as an OTC treatment for "Dandruff/seborrheic dermatitis/psoriasis".

Coal tar may be used in two forms: crude coal tar (Latin: pix carbonis) or a coal tar solution (Latin: liquor picis carbonis, LPC) also known as liquor carbonis detergens (LCD). Named brands include Denorex, Balnetar, Psoriasin, Tegrin, T/Gel, and Neutar. When used in the extemporaneous preparation of topical medications, it is supplied in the form of coal tar topical solution USP, which consists of a 20% w/v solution of coal tar in alcohol, with an additional 5% w/v of polysorbate 80 USP; this must then be diluted in an ointment base such as petrolatum.

In animal studies, coal tar has been shown to increase the chance of skin cancer.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Rare

  • Skin irritation not present before use of this medicine
  • skin rash

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Stinging (mild)—especially for gel and solution dosage forms

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For eczema, psoriasis, seborrheic dermatitis, and other skin disorders:
    • For cleansing bar dosage form:
      • Adults—Use one or two times a day, or as directed by your doctor.
      • Children—Use and dose must be determined by your doctor.
    • For cream dosage form:
      • Adults—Apply to the affected area(s) of the skin up to four times a day.
      • Children—Use and dose must be determined by your doctor.
    • For gel dosage form:
      • Adults—Apply to the affected area(s) of the skin one or two times a day.
      • Children—Use and dose must be determined by your doctor.
    • For lotion dosage form:
      • Adults—Apply directly to the affected area(s) of the skin or use as a bath, hand or foot soak, or as a hair rinse, depending on the product.
      • Children—Use and dose must be determined by your doctor.
    • For ointment dosage form:
      • Adults—Apply to the affected area(s) of the skin two or three times a day.
      • Children—Use and dose must be determined by your doctor.
    • For shampoo dosage form:
      • Adults—Use once a day to once a week or as directed by your doctor.
      • Children—Use and dose must be determined by your doctor.
    • For topical solution dosage form:
      • Adults—Apply to wet the skin or scalp, or use as a bath, depending on the product.
      • Children—Use and dose must be determined by your doctor.
    • For topical suspension dosage form:
      • Adults—Use as a bath.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Use this medicine only as directed. Do not use more of it and do not use it more often than recommended on the label, unless otherwise directed by your doctor. To do so may increase the chance of side effects.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Coal tar products should not be used on infants, unless otherwise directed by your doctor. Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of this medicine in children with use in other age groups.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of this medicine in the elderly with use in other age groups.

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