Coal Tar Solution

• Psoriasis: Treatment of mild to moderate chronic plaque psoriasis to reduce scaling, inflammation, and itching.
• Seborrheic Dermatitis: Relief of symptoms including scaling, itching, and redness of the scalp and skin.
• Atopic Dermatitis (Eczema): Adjunct therapy to manage itching and scaling.
• Other hyperkeratotic skin conditions: Such as lichen simplex chronicus and chronic eczema with prominent scaling and thickening.

• Formulation: Typically available as an alcoholic or aqueous solution containing 0.5% to 5% coal tar.
• Adults: Apply topically once or twice daily to affected skin areas. For scalp involvement, apply solution and leave on as directed before washing.
• Pediatrics: Use with caution; lower concentrations or less frequent application recommended.
• Elderly: Same as adults; monitor for skin irritation.
• Duration: Use until clinical improvement; maintenance therapy may be required for chronic conditions.
• Special populations: Avoid application on broken, infected, or irritated skin.
• Instructions: Shake well before use; avoid contact with eyes and mucous membranes. Wash hands after application.

Coal tar solution contains a complex mixture of hydrocarbons that exert keratoplastic, antipruritic, anti-inflammatory, and mild antimicrobial effects. It slows epidermal cell proliferation by inhibiting DNA synthesis in hyperproliferative keratinocytes, thereby reducing scaling and thickening of plaques. Its anti-inflammatory action decreases erythema and itching, contributing to symptomatic relief in dermatoses such as psoriasis and seborrheic dermatitis.

• Absorption: Minimal systemic absorption through intact skin; absorption increases if skin barrier is compromised.
• Distribution: Primarily localized within the epidermis and stratum corneum.
• Metabolism: Locally metabolized in the skin; systemic metabolism is minimal due to limited absorption.
• Excretion: Any absorbed components undergo hepatic metabolism and renal excretion.
• Onset: Symptom improvement generally seen after several days to weeks of consistent use.

• Pregnancy: No formal FDA category; insufficient human data. Use only if benefits outweigh potential risks.
• Lactation: Minimal systemic absorption suggests low risk; caution recommended with extensive application.

• Primary class: Dermatologic Agent
• Subclass: Keratoplastic and Antipsoriatic Agent

• Known hypersensitivity to coal tar or any formulation components.
• Application on open wounds, ulcers, or severely inflamed or broken skin.
• History of photosensitivity or photodermatitis linked to coal tar.

• Avoid excessive sun exposure or UV light during and shortly after treatment due to photosensitivity risk.
• Use lowest effective concentration and shortest duration necessary to minimize irritation and sensitization.
• Avoid application near eyes, mucous membranes, and genitals.
• Discontinue use if severe irritation or allergic reaction occurs.
• Use with caution in children under 2 years.

Common:

• Local skin irritation, burning, stinging, redness.
• Dryness or peeling.

Rare/Serious:

• Allergic contact dermatitis.
• Photosensitivity reactions (rash, blistering).
• Possible carcinogenic risk with long-term, high-concentration use (primarily from animal studies).

• May increase irritation if used concomitantly with other topical irritants.
• Avoid use with other photosensitizing agents.
• No significant systemic drug interactions due to minimal absorption.

• Dermatology guidelines support coal tar solution as a cost-effective adjunctive treatment for psoriasis and seborrheic dermatitis.
• Recommendations stress careful monitoring for photosensitivity and skin irritation.
• Emphasis on patient education to improve adherence and minimize side effects.

• Store at 20°C to 25°C (68°F to 77°F) in a tightly closed container.
• Protect from light and heat.
• Keep away from flames or sparks; flammable solvents may be present.
• Do not freeze.
• Keep out of reach of children.