Coal Tar

What is Coal Tar?

Coal tar is a viscous, dark-brown to black liquid with a characteristic odor, derived as a byproduct during the production of coke and coal gas from coal. For centuries, it has been recognized for its medicinal properties, particularly in dermatology. It is a complex mixture of thousands of different compounds, including polycyclic aromatic hydrocarbons (PAHs), phenols, and heterocyclic compounds, which collectively contribute to its therapeutic effects.

Historically, crude coal tar was used, but modern pharmaceutical preparations utilize refined and standardized forms to ensure safety and efficacy. It is available in various topical formulations, including shampoos, creams, ointments, lotions, and bath solutions, making it a versatile option for treating a range of skin conditions. Its primary actions are thought to be keratolytic (helping to shed dead skin cells), antipruritic (relieving itching), and anti-inflammatory.

How Does it Work?

The exact mechanism of action of coal tar is not fully understood due to its complex composition, but it is believed to exert its effects through multiple pathways. One of its primary roles is to slow down the excessive growth of skin cells, a process known as hyperproliferation, which is characteristic of conditions like psoriasis. By inhibiting DNA synthesis in epidermal cells, coal tar helps to normalize skin cell turnover.

Furthermore, coal tar possesses anti-inflammatory properties, reducing redness and swelling associated with inflammatory skin disorders. It also has antiseptic qualities, which can help prevent secondary infections in compromised skin. Its antipruritic effect provides significant relief from the intense itching often experienced by individuals with conditions such as eczema and psoriasis, thereby improving quality of life. The components in coal tar are absorbed by skin cells and interact with various cellular processes, leading to its therapeutic benefits.

Medical Uses

Coal tar is a well-established and effective treatment for several chronic skin conditions. Its most prominent use is in psoriasis treatment, particularly for plaque psoriasis, scalp psoriasis, and chronic localized psoriasis. It helps to reduce scaling, itching, and inflammation, often leading to significant improvement in symptoms.

Beyond psoriasis, coal tar is also highly effective for eczema relief, especially chronic forms of atopic dermatitis, where it helps to soothe irritated skin and reduce itching. It is also widely used for seborrheic dermatitis, a common condition causing red, flaky, itchy skin, particularly on the scalp, face, and chest. For scalp conditions, coal tar shampoos are a popular choice for managing severe dandruff and scalp psoriasis, helping to control flaking and itching.

• Psoriasis: Reduces scaling, inflammation, and itching.
• Eczema (Atopic Dermatitis): Alleviates dryness, itching, and inflammation.
• Seborrheic Dermatitis: Controls flaking and redness on the scalp and face.
• Dandruff: Effective in reducing scalp flaking and itching.

Dosage

The appropriate dosage and application frequency of coal tar products vary significantly depending on the concentration of the active ingredient, the specific formulation (shampoo, cream, ointment), and the severity and location of the skin condition being treated. Concentrations typically range from 0.5% to 5% for over-the-counter products, with higher concentrations available by prescription.

For creams and ointments, it is generally applied thinly to the affected areas once or twice daily, or as directed by a healthcare professional. For shampoos, it is typically used 2-3 times per week, lathered onto wet hair and left on for several minutes before rinsing thoroughly. It is crucial to always follow the specific instructions on the product label or the guidance provided by your doctor or pharmacist. Avoid applying to broken or acutely inflamed skin unless specifically advised by a medical professional.

Side Effects

While generally well-tolerated, coal tar can cause some side effects, primarily localized to the application site. Common side effects include:

• Skin irritation: Redness, burning, stinging, or itching, especially when first starting treatment or on sensitive skin.
• Dryness: Can sometimes exacerbate skin dryness.
• Photosensitivity: Increased sensitivity to sunlight, making the skin more prone to sunburn. It is advisable to use sunscreen and protective clothing when exposed to the sun after application.
• Folliculitis: Inflammation of hair follicles, particularly with prolonged use or on hairy areas.
• Staining: Coal tar can stain skin, hair, and clothing a yellowish-brown color. This is usually temporary on skin and hair but can be permanent on fabrics.
• Unpleasant odor: Some individuals find the characteristic odor of coal tar products objectionable.

Rarely, allergic reactions may occur. The long-standing concern about the carcinogenicity of coal tar, particularly due to the presence of PAHs, has largely been mitigated for modern topical formulations when used as directed. Studies have not shown a significant increase in skin cancer risk with therapeutic use of refined coal tar products.

Drug Interactions

Due to its topical application and minimal systemic absorption, coal tar generally has few significant drug interactions. However, it's important to be aware of potential interactions or additive effects, especially with other topical treatments or medications that increase photosensitivity.

• Photosensitizing medications: Concurrent use with other drugs known to cause photosensitivity (e.g., certain antibiotics like tetracyclines, diuretics, or retinoids) may increase the risk of sunburn or phototoxic reactions.
• Other topical treatments: Avoid applying other strong topical medications, especially those containing salicylic acid or corticosteroids, to the same area simultaneously unless advised by a healthcare professional. This can sometimes lead to increased irritation or altered absorption.
• UV light therapy: If undergoing phototherapy (e.g., UVB or PUVA), discuss the use of coal tar with your dermatologist, as it can enhance the skin's sensitivity to UV light.

Always inform your doctor or pharmacist about all medications, supplements, and herbal products you are currently using before starting coal tar treatment.

FAQ

Is coal tar safe to use?

Yes, refined and standardized coal tar formulations are generally considered safe for topical use when used as directed. Concerns about carcinogenicity are largely unfounded for modern pharmaceutical preparations.

How long does it take for coal tar to work?

Improvement can often be seen within a few days to a few weeks of consistent use, depending on the severity of the condition and the product's concentration. Chronic conditions may require longer-term treatment.

Can I use coal tar on my face?

While some formulations are designed for facial use (e.g., for seborrheic dermatitis), it should be used with caution on sensitive facial skin. Avoid contact with eyes, mouth, and mucous membranes. Consult your doctor.

Does coal tar cause cancer?

Based on extensive research and clinical experience, there is no evidence that the topical use of modern, refined coal tar cream or other formulations, when used as directed, increases the risk of skin cancer in humans.

Can children use coal tar?

Coal tar can be used in children, but it's crucial to consult a pediatrician or dermatologist first, especially for infants and very young children, to ensure appropriate concentration and application.

Products containing Coal Tar are available through trusted online pharmacies. You can browse Coal Tar-based medications at ShipperVIP or Medicenter.

Summary

Coal tar remains a valuable and effective topical treatment for a variety of chronic skin conditions, including psoriasis, eczema, seborrheic dermatitis, and dandruff. Its multi-faceted action helps to reduce inflammation, itching, and excessive skin cell growth, providing significant relief for many patients. While potential side effects such as skin irritation and photosensitivity should be noted, these are generally manageable. Proper application, adherence to dosage instructions, and consultation with a healthcare professional are key to maximizing its therapeutic benefits and ensuring safe use. Despite its ancient origins, coal tar continues to be a relevant and accessible option in dermatological care.