Table of ContentsView AllTable of ContentsHow It WorksTreatment TypesHow to UseSide EffectsEffectivenessOther Considerations
Table of ContentsView All
View All
Table of Contents
How It Works
Treatment Types
How to Use
Side Effects
Effectiveness
Other Considerations
In the United States, coal tar is available over the counter in creams, gels, lotions, oil, and shampoos, typically at concentrations of between 0.5% and 5%.
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How Does Coal Tar Work?
Coal tar can treat all types of psoriasis and is especially useful withscalp psoriasisand hard-to-treatpalmoplantar psoriasis(psoriasis of the palms and soles).
Coal tar can be used to treat other inflammatory skin conditions, such as:
Types of Skin and Scalp Treatments
Coal tar is found in many over-the-counter (OTC) products, including creams, gels, lotions, oils, and bath additives. Coal tar shampoos are also available to treat scalp psoriasis.
Compound pharmacists who customize medications can mix crude coal tar or an alcohol-based coal tar solution with all sorts of bases, includingsteroid creams and ointments.
OTC coal tar products include:
Unlike products of the past that were universally black and tarry, many newer formulations are non-staining and washable.
How to Choose
To ensure safety and purity, opt for products that have undergone independent testing with a certifying body like the U.S. Pharmacopeia (USP), NSF International, or ConsumerLab. That way, you’ll know whether the product is void of contaminants and contains the ingredients listed on the product label at the described potency.
How to Use Coal Tar
Coal tar is intended for external use only. To ensure safety and effectiveness, follow the manufacturer’s instructions. You should also speak with your healthcare provider ordermatologistto ensure that it is a safe and appropriate option.
Coal tar can be used on its own or in combination with other psoriasis treatments, includingtopical corticosteroids(steroids) orphototherapy(ultraviolet light therapy).
Coal Tar With Phototherapy
Coal tar is sometimes used with phototherapy to make the skin more receptive to the effects of ultraviolet (UV) radiation.
Side Effects and Interactions
OTC coal tar products are considered safe when used in concentrations between 0.5% and 5%.Even so, the products can still cause side effects, particularly on delicate skin and at higher concentrations.
Common side effects of coal tar include:
Allergic reactions are rare but can occur. If you are prone to allergies, test the product on a small patch of skin and wait 24 hours to see if a rash develops.
There are no known drug interactions associated with coal tar.
Can Coal Tar Make Psoriasis Worse?As effective as coal tar can be in treating psoriasis, it can also make psoriasis worse in some people, according to the American Academy of Dermatology. You should stop treatment immediately if you develop severe burning or stinging, swelling, or worsening psoriasis.
Can Coal Tar Make Psoriasis Worse?
As effective as coal tar can be in treating psoriasis, it can also make psoriasis worse in some people, according to the American Academy of Dermatology. You should stop treatment immediately if you develop severe burning or stinging, swelling, or worsening psoriasis.
How Effective Is It?
Many people turn to coal tar for psoriasis because it is relatively inexpensive, is natural, does not require a doctor’s prescription, and has few side effects. Even so, it is not as effective as other forms of therapy and is most beneficial when used to support an overall treatment plan.
A 2016 review from theCochrane Database of Systemic Reviewsreported that 33% of people treated with coal tar shampoo experienced an improvement in scalp psoriasis symptoms, albeit without a significant reduction in plaque size.
A 2019 review published in theJournal of the American Academy of Dermatologyreported that coal tar may be as effective as topicalcalcipotrienein controlling mild to moderate psoriasis but not as effective as high-potency topical steroids. For moderate to severe cases, oral drugs likeHumira (adalimumab)are far more effective.
Results can vary, but adults will usually see a visible response to coal tar treatment within four weeks. In children, the response tends to be quicker, more along the lines of two weeks.
The effectiveness can vary from one person to the next. For some people, coal tar can completely clear psoriasis and achieve long-term remission. Others may not respond as well.
Are Stronger Formulations Better?The potency of coal tar in a product does not influence how well it works. Studies have shown that a 1% coal tar solution may work just as well as a 5% solution, while a 5% solution may end up causing more side effects.
Are Stronger Formulations Better?
The potency of coal tar in a product does not influence how well it works. Studies have shown that a 1% coal tar solution may work just as well as a 5% solution, while a 5% solution may end up causing more side effects.
Coal tar preparations should never be applied to inflamed, broken, or infected skin. Doing so can cause pain and trigger a flare-up of psoriasis symptoms.
Coal tar photosensitivity can persist for up to 24 hours after use.To avoid sunburn, wash your skin thoroughly after treatment and apply ahigh-SPF sunscreenif you plan to be outdoors. Do not use tanning beds.
Some coal tar preparations can stain clothes, towels, bedding, and even light-colored hair. To avoid this, apply the preparation in the shower and wash and rinse thoroughly afterward. Any hair discoloration will usually return to normal after a few shampoos.
Coal tar products made with liquor carbonis distillate (LCD) are less likely to cause staining.
For safety, coal tar should only be used in children under the direction of a dermatologist.
Summary
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Psoriasis Foundation.Over-the-counter topicals.U.S. Food and Drug Administration.Part 358 Miscellaneous external drug products for over-the-counter human use.Ahmed A, Danish M.Coal tar burn in emergency room.Int J Advances Med Sci.2(1):1-5.World Health Organization.Coal tar.American Academy of Dermatology Association.Psoriasis: causes.Sekhon S, Jeon C, Nakamura M, et al.Review of the mechanism of action of coal tar in psoriasis.J Dermatolog Treat.2018;29(3):230-2. doi:10.1080/09546634.2017.1369494Elmets CA, Lim HW, Stoff B, et al.Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy.J Am Acad Dermatol. 2019;81(3):775-804. doi:10.1016/j.jaad.2019.04.042National Health Service (UK).About coal tar.Schlager JG, Rosumeck S, Werner RK, et al.Topical treatments for scalp psoriasis.Cochrane Database Syst Rev.2016 Feb 26;2(2):CD009687. doi:10.1002/14651858.CD009687.pub2Lax SJ, Harvey J, Axon E, et al.Strategies for using topical corticosteroids in children and adults with eczema.Cochrane Database Syst Rev.2022;2022(3):CD013356. doi:10.1002/14651858.CD013356.pub2National Psoriasis Foundation.Tanning beds no substitute for phototherapy for psoriasis.U.S. Food and Drug Administration.Code of Federal Regulations, Title 21, Volume 5, Subchapter D – drugs for human use. Part 358, miscellaneous external drug products for over-the-counter human use. Subpart H–drug products for the control of dandruff, seborrheic dermatitis, and psoriasis.American Academy of Dermatology Association.Psoriasis treatment: coal tar.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Psoriasis Foundation.Over-the-counter topicals.U.S. Food and Drug Administration.Part 358 Miscellaneous external drug products for over-the-counter human use.Ahmed A, Danish M.Coal tar burn in emergency room.Int J Advances Med Sci.2(1):1-5.World Health Organization.Coal tar.American Academy of Dermatology Association.Psoriasis: causes.Sekhon S, Jeon C, Nakamura M, et al.Review of the mechanism of action of coal tar in psoriasis.J Dermatolog Treat.2018;29(3):230-2. doi:10.1080/09546634.2017.1369494Elmets CA, Lim HW, Stoff B, et al.Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy.J Am Acad Dermatol. 2019;81(3):775-804. doi:10.1016/j.jaad.2019.04.042National Health Service (UK).About coal tar.Schlager JG, Rosumeck S, Werner RK, et al.Topical treatments for scalp psoriasis.Cochrane Database Syst Rev.2016 Feb 26;2(2):CD009687. doi:10.1002/14651858.CD009687.pub2Lax SJ, Harvey J, Axon E, et al.Strategies for using topical corticosteroids in children and adults with eczema.Cochrane Database Syst Rev.2022;2022(3):CD013356. doi:10.1002/14651858.CD013356.pub2National Psoriasis Foundation.Tanning beds no substitute for phototherapy for psoriasis.U.S. Food and Drug Administration.Code of Federal Regulations, Title 21, Volume 5, Subchapter D – drugs for human use. Part 358, miscellaneous external drug products for over-the-counter human use. Subpart H–drug products for the control of dandruff, seborrheic dermatitis, and psoriasis.American Academy of Dermatology Association.Psoriasis treatment: coal tar.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Psoriasis Foundation.Over-the-counter topicals.U.S. Food and Drug Administration.Part 358 Miscellaneous external drug products for over-the-counter human use.Ahmed A, Danish M.Coal tar burn in emergency room.Int J Advances Med Sci.2(1):1-5.World Health Organization.Coal tar.American Academy of Dermatology Association.Psoriasis: causes.Sekhon S, Jeon C, Nakamura M, et al.Review of the mechanism of action of coal tar in psoriasis.J Dermatolog Treat.2018;29(3):230-2. doi:10.1080/09546634.2017.1369494Elmets CA, Lim HW, Stoff B, et al.Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy.J Am Acad Dermatol. 2019;81(3):775-804. doi:10.1016/j.jaad.2019.04.042National Health Service (UK).About coal tar.Schlager JG, Rosumeck S, Werner RK, et al.Topical treatments for scalp psoriasis.Cochrane Database Syst Rev.2016 Feb 26;2(2):CD009687. doi:10.1002/14651858.CD009687.pub2Lax SJ, Harvey J, Axon E, et al.Strategies for using topical corticosteroids in children and adults with eczema.Cochrane Database Syst Rev.2022;2022(3):CD013356. doi:10.1002/14651858.CD013356.pub2National Psoriasis Foundation.Tanning beds no substitute for phototherapy for psoriasis.U.S. Food and Drug Administration.Code of Federal Regulations, Title 21, Volume 5, Subchapter D – drugs for human use. Part 358, miscellaneous external drug products for over-the-counter human use. Subpart H–drug products for the control of dandruff, seborrheic dermatitis, and psoriasis.American Academy of Dermatology Association.Psoriasis treatment: coal tar.
National Psoriasis Foundation.Over-the-counter topicals.
U.S. Food and Drug Administration.Part 358 Miscellaneous external drug products for over-the-counter human use.
Ahmed A, Danish M.Coal tar burn in emergency room.Int J Advances Med Sci.2(1):1-5.
World Health Organization.Coal tar.
American Academy of Dermatology Association.Psoriasis: causes.
Sekhon S, Jeon C, Nakamura M, et al.Review of the mechanism of action of coal tar in psoriasis.J Dermatolog Treat.2018;29(3):230-2. doi:10.1080/09546634.2017.1369494
Elmets CA, Lim HW, Stoff B, et al.Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy.J Am Acad Dermatol. 2019;81(3):775-804. doi:10.1016/j.jaad.2019.04.042
National Health Service (UK).About coal tar.
Schlager JG, Rosumeck S, Werner RK, et al.Topical treatments for scalp psoriasis.Cochrane Database Syst Rev.2016 Feb 26;2(2):CD009687. doi:10.1002/14651858.CD009687.pub2
Lax SJ, Harvey J, Axon E, et al.Strategies for using topical corticosteroids in children and adults with eczema.Cochrane Database Syst Rev.2022;2022(3):CD013356. doi:10.1002/14651858.CD013356.pub2
National Psoriasis Foundation.Tanning beds no substitute for phototherapy for psoriasis.
U.S. Food and Drug Administration.Code of Federal Regulations, Title 21, Volume 5, Subchapter D – drugs for human use. Part 358, miscellaneous external drug products for over-the-counter human use. Subpart H–drug products for the control of dandruff, seborrheic dermatitis, and psoriasis.
American Academy of Dermatology Association.Psoriasis treatment: coal tar.
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