OTC Coal Tar Forms and Usage

Use Coal Tar medicines as stated on the label or as prescribed by your doctor.

Following is general advice:

Do not leave a Tar medicine on the skin for longer than it is prescribed.

I have once left a Tar shampoo on my scalp for 1 hour instead of 10 minutes
and had a severe scalp irritation and worsening of psoriasis as a consequence.

Below you will find the most common information on the Coal Tar psoriasis medicines usage.

Coal Tar psoriasis medicines are available in the following main OTC forms:

Coal Tar Ointments, Lotions and Creams

Coal Tar Ointments, Lotions and Creams are used for the body for skin psoriasis treatment.

Crude Coal Tar in a soft paraffin base is the most effective form, which was used in psoriasis treatment for hundreds of years. However, it is pretty messy and smelly; therefore not too many people tolerate it. It is less commonly used nowadays.

Modern creams that contain Coal Tar are more pleasant, for example:

• Psorigel Coal Tar Gel: 7.5% Coal Tar solution (= 1.75% crude Coal Tar).
• Oxipor Coal Tar Lotion: 25% Coal Tar solution (= 5% crude Coal Tar).

There are many Coal Tar medications brands and types.

Usage: Apply the medication directly onto the psoriasis lesions and leave on the skin for at least 2 hours, unless otherwise stated on the label or prescribed by your doctor.

Apply the medication to the affected by psoriasis areas 2 times a day.

Tar is sometimes used in increasing concentrations (2%-5%-10% crude Coal Tar).

In order to prevent the staining, after applying the Tar medicine into the affected skin you may want to take a warm bath for 30-60 min.

For gradual increase of the Tar psoriasis medicine action, sometimes the following scheme is used:

• 1st week: the Tar medication is simply applied onto the affected skin;
• 2nd week: the Tar medication is rubbed into the affected skin;
• 3rd week: the Tar medication is applied under the dressing on the affected skin.

Coal Tar under a Dressing

One of the Tar usage methods consists of applying the Coal Tar psoriasis medication under an occlusive dressing (i.e. a plastic kitchen warp) with Tar ointment at night.

The time required to get rid of the psoriatic scales in this case is usually 3-5 days, while for the complete disappearance or the reaching of the maximum improvement in this case it takes 2-3 weeks.

This approach gives a person a greater freedom during the day.

Coal Tar under a "breathing" Dressing

Cotton socks can also help you in covering arm or leg lesions. You can cut off the toe of the sock, and pull the sock onto the limb to cover the medication. This is the so-called "breathing" dressing.

Coal Tar Shampoos

Coal Tar Shampoos are used for the Scalp Psoriasis treatment.

Usage: Wet the scalp. Work up a generous lather and rub it well into the scalp for 5 minutes, then rinse. Repeat the procedure and thoroughly rinse your scalp.

The above procedure is usually done 2 times a week, after 3-4 days each. The course of treatment with Scalp Psoriasis is usually 8-12 weeks.

If you have a strong scaling on the scalp, a pretreatment with a scale remover (i.e. the Salicylic Acid) may help to improve the effectiveness of a Tar shampoo.

Medicated Tar shampoo may be followed by any cosmetic shampoo or conditioner in order to reduce the odor left after the Tar shampoo.

Tar is reported to be capable of staining bleached, light blond and gray hair. In this case instead of a Tar shampoo you may want to use a Tar gel, as it is usually less staining.

An Intensive Coal Tar Scalp Psoriasis Treatment Study

In one study there were observed 20 patients with psoriasis who undertook an intensive Tar scalp psoriasis treatment course. The course of treatment consisted of 20 days with applying a Tar shampoo every other day (3-4 times a week), i.e. the total of 10 procedures.

During the process of treatment, 3 people with psoriasis had complications in the form of allergic reactions, and therefore the shampoo was discontinued.

Effect from the treatment with Tar Shampoo was fast to come - already by the end of the 1st week of the Tar Shampoo application all patients noted the disappearance of itch.

The skin cleared from the crusts:

• by the 4th day - in 3 patients;
• by the 7th day - in 3 patients;
• by the 10th day - in 10 patients;
• by the 17th day - in 1 patient.

The inflammation considerably regressed:

• by the 3rd day - in 1 patient;
• by the 6th day - in 5 patients;
• by the 9th day - in 7 patients;
• by the 13th day - in 2 patients;
• in 2 patients some inflammation was still present even at the end of the treatment course.

The peeling considerably reduced:

• by the 3rd day - in 5 patients;
• by the 5th day - in 6 patients;
• by the 7th day - in 6 patients;
• by the 9th day - in 1 patient.

However, in 11 patients, infrequent dry scales at the places of the lesions remained even after the 20 day treatment course.

The Conclusion of an Intensive 20-day Coal Tar Scalp Psoriasis Treatment Study:

• substantial improvement was achieved in 12 people with psoriasis;
• improvement - in 5 people with psoriasis;
• complications were observed in 3 patients: in 2 people after 2-3 procedures they developed an allergic reaction in the form of redness and itch, the 3rd person developed a complicated condition caused by tar allergy. The shampoo was discontinued in all three cases.

In one person the shampoo caused an unpleasant strong tightening of the skin on the scalp.

Please Note: Occlusion of tar preparations on the scalp may be recommended to enhance the treatment's effectiveness. However, airtight occlusion of tar (i.e. with plastic wrap) should be avoided, because it increases the risk of infection and folliculitis. Occlusion with cotton clothing etc. may not cause infection or folliculitis.

Tar Bath Solutions

You may add a Coal Tar bath solution to bath water and soak in the bath for 15-30 minutes. Tar bath solutions are usually ineffective at getting rid of psoriasis, but they may help to reduce itching and scaling.