Note: Indications vary by product; see specific product labeling.
Atopic dermatitis: Note: Guidelines do not include recommendations for use of coal tar (Eichenfeld 2014); limited data available: Children and Adolescents: Topical: 2% to 5% coal tar cream may be applied once daily or every other day to reduce inflammation (Hanifin 1991)
Seborrhea, dermatitis: Shampoo: Adolescents: Topical: Apply twice weekly (Clark 2015)
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Coal tar: Drug information")
Seborrhea, dermatitis: Topical:
Skin: Apply to the affected area 1 to 4 times/day; decrease frequency to 2 to 3 times/week once condition has been controlled
Bath: Add appropriate amount to bath water, for adults usually 60-90 mL of a 5% to 20% solution or 15 to 25 mL of 30% lotion; soak 5 to 20 minutes, then pat dry; use once daily to every 3 days
Dandruff: Shampoo: Rub shampoo onto wet hair and scalp, rinse thoroughly; repeat; leave on 5 minutes; rinse thoroughly; apply twice weekly for the first 2 weeks then once weekly or more often if needed
Psoriasis: Topical:
Scalp psoriasis: Tar oil bath or coal tar solution may be painted sparingly to the lesions 3 to 12 hours before each shampoo
Psoriasis of the body, arms, legs: Apply at bedtime; if thick scales are present, use product with salicylic acid and apply several times during the day
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Foam, External:
Scytera: 2% (100 g) [contains disodium edta]
Ointment, External:
Psoriasin: 2% (113 g) [contains alcohol, usp, polysorbate 80]
Shampoo, External:
Beta Care Betatar Gel: 2.5% (480 mL) [contains trolamine (triethanolamine)]
DHS Tar: 0.5% (120 mL, 240 mL)
DHS Tar: 0.5% (120 mL, 240 mL) [fragrance free]
DHS Tar Gel: 0.5% (240 mL)
Ionil-T: 1% (473 mL) [contains alcohol, usp, benzalkonium chloride, edetate (edta) sodium (tetrasodium), isopropyl alcohol]
PC-Tar: 1% (177 mL [DSC])
Pentrax Gold: 4% (168 mL)
Tera-Gel Tar: 0.5% (118 mL [DSC], 237 mL [DSC]) [contains edetate (edta) sodium (tetrasodium), methylparaben, polysorbate 80, propylparaben]
Therapeutic: 0.5% (251 mL)
Theraplex T: 1% (240 mL)
X-Seb T Pearl: 10% (236 mL) [contains brilliant blue fcf (fd&c blue #1), edetate (edta) disodium]
X-Seb T Plus: 10% (236 mL) [contains brilliant blue fcf (fd&c blue #1), edetate (edta) disodium]
Solution, External:
Generic: 20% (100 mL, 500 mL, 4000 mL)
May be product dependent
Topical: For external use only; avoid contact with eyes. Do not apply in or near anogenital areas unless directed by a physician. Wash hands before and after application.
Cream, gel, ointment: Wash affected area and dry thoroughly; rub small amount of coal tar onto affected area
Foam: Shake well prior to use; invert can to dispense. Product may stain clothing, contact lenses, and hair; to minimize staining allow product to dry before contact.
Oil (Cutar Emulsion): May be used as a lotion or add appropriate amount of coal tar to bath or water for hand/foot soak
Shampoo: Rub shampoo onto wet hair and scalp and lather, leave on hair and scalp for several minutes; rinse thoroughly and repeat
Oil (Cutar Emulsion): Controls itching, flaking, and redness due to psoriasis and seborrheic dermatitis (OTC product: FDA approved in adults)
Foam (Scytera): Relief of symptoms of psoriasis (OTC product: FDA approved in adults)
Shampoo: Prevention of recurrence of scalp itching and flaking associated with psoriasis, seborrheic dermatitis, and dandruff (OTC products: FDA approved in adults)
Cream, gel, ointment: Relief of symptoms associated with psoriasis and/or seborrheic dermatitis including itching, scaling, flaking, redness, and irritation of the skin and helps prevent recurrence (OTC products: FDA approved in adults)
Has also been used to treat atopic dermatitis
Pentrax [US, Canada, Great Britain, Ireland] may be confused with Permax brand name for pergolide [multiple international markets]
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Dermatologic: Dermatitis, folliculitis. skin irritation, skin photosensitivity
Hypersensitivity to coal tar or any component of the formulation
Concerns related to adverse effects:
• Photosensitivity: May increase photosensitivity; avoid exposure to direct sunlight for 24 hours following application.
• Hair color changes: Shampoo may cause discoloration of gray, blond, tinted or bleached hair
Other warnings/precautions:
• Appropriate use: For external use only; avoid contact with eyes, genital/rectal areas.
• Polysorbate 80: Some dosage forms may contain polysorbate 80 (also known as Tweens). Hypersensitivity reactions, usually a delayed reaction, have been reported following exposure to pharmaceutical products containing polysorbate 80 in certain individuals (Isaksson 2002; Lucente 2000; Shelley 1995). See manufacturer’s labeling.
Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).
None known.
There are no known significant interactions.
Limited application of coal tar during pregnancy for the treatment of psoriasis appears to be safe in pregnant women (Gelmetti, 2009; Landau, 2011).
Tar derivatives have antiseptic, antibacterial, and antiseborrheic properties, and loosen and soften scales and crusts.
Foam (Scytera External)
2% (per gram): $0.32
Shampoo (Beta Care Betatar Gel External)
2.5% (per mL): $0.02
Shampoo (DHS Tar External)
0.5% (per mL): $0.05
Shampoo (DHS Tar Gel External)
0.5% (per mL): $0.04
Shampoo (Ionil-T External)
1% (per mL): $0.06
Shampoo (X-Seb T Pearl External)
10% (per mL): $0.08
Shampoo (X-Seb T Plus External)
10% (per mL): $0.08
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