How Do You Use Coal Tar For Psoriasis
You should always test a tar product on a small area of your skin or scalp first. If it turns red, use a moisturizer first â choose a heavy cream or ointments to lock water into your skin â before you apply it.
If you have scalp psoriasis, your doctor may recommend that you use coal tar shampoo. Itâs very important to make sure the shampoo gets on your scalp. Leave it in place for 5 to 10 minutes before you rinse it out.
It can also be applied as a lotion or ointment. You massage the coal tar into the psoriasis once or twice a day. You can use an OTC product, but your doctor can also prescribe a compounded or specially made cream that also contains a corticosteroid. A commonly used one is 2% or 3% crude coal tar in triamcinolone cream 0.1% applied twice daily to individual spots of psoriasis. You can apply it to most areas where you have psoriasis, although you shouldnât apply it to very sensitive areas like your genitals or buttocks unless your doctor tells you itâs OK to do so.
Sometimes, your doctor may also have you wrap the spots where you have psoriasis after you apply coal tar to them. This increases the productâs effectiveness. Donât do it unless your doctor tells you to, since it makes the product much stronger.
Since coal tar can stain your hair, skin, and clothes, itâs best to use them at night and wear old clothes, like pajamas.
4.5 out of 5 stars
How We Chose The Winners
All our reviewers are experts in product formulation, haircare, qualified pharmacists or haircare experts.
They assess the formulation of the shampoo, deconstructing the shampoos to their constituent parts and describe the key ones in detail. In addition, they highlight the presence of any one of over 100 ingredients that can potentially itch, irritate and exasperate your condition.
Unlike most review sites, our reviewers personally try every shampoo they review and they also assess how the shampoo washes, how it smells and look at the price point in their market. These may be medicated shampoos, but that doesnt mean we want to compromise on a little bit of luxury!
We applied these same principles when choosing our best coal tar shampoo. For example, the winner is one of the gentlest dandruff shampoos weve reviewed. Its not perfect, but compared with the others it washed slightly better and the fact that it was fragrance-free gave it another edge. Thats not to say its the best coal tar shampoo for you. For example, Scalp 18 shampoo contains slightly more coal tar but is fragrance heavy. Theyre both outstanding shampoos, so we eventually chose the gentlest formulation.
How We Chose The Best Shampoos For Scalp Psoriasis
To create this list, we looked mainly for products that contain salicylic acid and coal tar to target scalp psoriasis. These are two ingredients recommended by the American Academy of Dermatology Association .
Salicylic acid is a beta hydroxy acid thats often used as an exfoliant. It helps soften and break down plaques and scales for easier removal. Removing the plaques should help ease symptoms, like itching, burning, and irritation.
Coal tar is derived from black coal, and, according to the AAD, has been used to treat psoriasis for over 100 years. It helps pump the brakes to make sure the skin cells on your scalp arent growing too fast and building up. Still, coal tar can be drying and can stain.
We also included shampoos with other research-backed ingredients, like selenium sulfide.
Finally, we looked at reviews from customers with scalp psoriasis to determine the effectiveness of each one.
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Is There A Cancer Risk
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There is no scientific evidence that coal tar causes cancer when the concentration ranges between 0.5 and 5.0%.
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Some studies suggest that ingredients in coal tar can cause cancer when a person is exposed to very high concentrations, such as in roofing and road paving.
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Further research is needed to know whether using coal tar on the skin can cause skin cancer.
Otc Medicines For Eczema
Over-the-counter eczema remedies are topical and oral medications you can buy without a prescription. You can find a range of OTC treatments that help with eczema symptoms such as itch, redness, irritation or rash. Other OTC treatments can help prevent flares and assist with sleep when night-time itch is keeping you awake.
Many OTC products are available in both brand-name or generic forms.
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What Are The Side Effects Of Coal Tar Topical
Get emergency medical help if you have signs of an allergic reaction: hives difficult breathing swelling of your face, lips, tongue, or throat.
Stop using this medicine and call your doctor at once if you have:
- severe stinging, burning, swelling, or other irritation of the treated skin.
Common side effects may include mild skin irritation or skin rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How To Use Coal Tar
Coal tar products come in a variety of topical forms. A person may use them in lotion, ointment, cream, gel, bath soaks, and shampoo.
If an individual is using a coal tar treatment on their body, they should apply and massage it into their skin. A dermatologist will advise on how often a person needs to do this.
Wrapping the area after applying the treatment increases the strength of coal tar, but a person will find optimal results from following their dermatologists instructions. When using a coal tar shampoo, individuals should make sure it gets on to their scalp.
Dermatologists may use tar and extracts of crude coal tar in the treatment of chronic eczema.
Dermatologists generally regard coal tar as safe, but it may cause:
- skin irritation
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Antihistamines And Pain Relievers
Atopic dermatitis , the most common form of eczema is part of whats known as the atopic triad . In fact, people with AD have a greater chance of developing comorbidities or related health conditions, namely asthma, hay fever and food allergies.
To help combat itch and curb inflammation if you have allergies, a healthcare provider may suggest antihistamines. Some antihistamines also contain sedatives that can help people sleep.
Examples of OTC oral antihistamines include:
- Diphenhydramine
- Chlorpheniramine
- Cetirizine
- Loratadine
- Fexofenadine
- Doxylamine
To address common eczema symptoms such as burning, pain and inflammation, a healthcare provider may also suggest OTC pain relievers such as:
- Acetaminophen
- Nonsteroidal anti-inflammatory drugs including ibuprofen
or naproxen
Tips To Find For The Best Coal Tar Shampoo For Your Scalp Psoriasis
Coal tar shampoos are formulated to treat the symptoms of scalp psoriasis, dermatitis, and dandruff. Brands extensively advertise their percentage of coal tar, the primary active ingredient in these shampoos. It might be tempting to grab whichever bottle claims the highest percentage of coal tar printed the biggest on the front label. Unfortunately, its not that simple. Here are five tips to put you in the know about coal tar, advertising claims, and concentrated USP.
1. Understand how coal tar is used.
When talking about active ingredients for psoriasis shampoos, coal tar is the active ingredient in many scalp shampoos. Its been used for more than 100 years to safely mitigate itching and flaking caused by scalp psoriasis and dermatitis. You will see product labels advertising an ingredient make up anywhere from 0.5 to 5 percent.
2. Interpret the concentrated USP.
MG217 Senior R& D Chemist, John Buteyn, Ph.D. explains it simply as: Coal tar topical solution is available only as a 20 percent solution. So, our coal tar shampoo uses 15 percent of USP Coal Tar Topical Solution to produce a three percent coal tar shampoo. In other words, you need to pay attention to a percentage of a percentage.
3. Know how much active ingredient you need.
Dr. Buteyn advises, A stronger dose is better. This is particularly true since coal tar shampoos are a wash-off product, so the coal tar has only a short time to be in contact with the scalp to impact the psoriatic skin.
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How Are People Exposed To Coal Tar And Coal
The primary routes of human exposure to coal tars and coal-tar products are inhalation, ingestion, and absorption through the skin. Exposure to coal tars and coal-tar pitches may occur at foundries and during coke production, coal gasification, and aluminum production. Other workers who may be exposed to coal-tar pitches include those who produce or use pavement tar, roofing tar, coal-tar paints, coal-tar enamels, other coal-tar coatings, or refractory bricks.
The general population may be exposed to coal tars in environmental contaminants and through the use of coal tar preparations to treat skin disorders such as eczema, psoriasis, and dandruff.
How Does Coal Tar Help Seborrheic Dermatitis
Although the root cause of Seborrheic Dermatitis is still unknown, recent research suggests seb derm to be associated with a type of fungus called Malassezia furfur. Symptoms include itching, scaling, rash and ring-shaped patches of dry, pink skin. The antifungal properties of coal tar are believed to be the primary reason that it reduces symptoms of the common skin condition. In a clinical study , coal tar demonstrated its ability to inhibit the growth of 52 Malassezia strains.
However, there are other more modern treatments for seb derm which seem to be more precise and more effective at combatting the symptoms associated with seb derm. Piroctone Olamine, Ketoconazole and Selenium Sulfide are three active ingredients that tend to be more widely used in recent years.
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What You Can Do
- read product labels and follow all safety warnings and directions
- dispose of products containing the chemical properly
- choose products, like driveway sealants, that don’t contain coal tar
- contact the manufacturer if you are unsure if the product contains coal tars
If you’re exposed to coal tars at work, talk to your employer and occupational health and safety representative about:
- relevant laws
- safe handling and storage practices
- applicable laws and requirements under the OHS legislation and the Workplace Hazardous Materials Information System
Things To Consider With Otc Products
The U.S. Food and Drug Administration decides whether a medicine is safe enough to sell over the counter. However, using OTC medicines still has potential risks. Some interact with other prescription or OTC medicines, supplements, foods or beverages. Others cause problems for people with certain medical conditions. Be sure to talk to your healthcare provider before taking any OTC medicines for eczema.
Its important to correctly follow directions for OTC medicines and be careful when administering them to children. You should never take OTC eczema drugs for longer durations or in higher doses than the product label recommends.
Some common OTC treatments for eczema include:
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Ivonne Mjj Van Vlijmen
1Department of Dermatology, Nijmegen Centre for Molecular Life Sciences, 2Laboratory of Medical Immunology, Nijmegen Institute for Infection, Inflammation and Immunity, and 3Department of Tumor Immunology, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. 4Department of Dermatology, University Hospital of Schleswig-Holstein, Kiel, Germany.
What Drugs And Food Should I Avoid While Taking Coal Tar Topical
Do not use coal tar together with other psoriasis medications unless your doctor tells you to.
Avoid getting coal tar topical in your eyes. If this does occur, rinse with water.
Do not use coal tar to treat the skin of your groin or rectal area.
Avoid exposure to sunlight or artificial UV rays . Coal tar can make your skin more sensitive to sunlight and sunburn may result.
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How Often Should I Wash Using A Coal Tar Shampoo
To use a coal tar shampoo, you should always follow the guidance provided on the label.
For example, DHS recommends using their tar shampoo, at least twice a week or as directed by a physician for best results. Whereas Psoriatrax recommends that you, use daily until symptoms disappear. Usually 3-5 days.
We asked Dr. Ben Barankin, a Toronto based board-certified dermatologist at the Toronto Dermatology Centre, for his advice, and he told us, For mild-moderate dandruff, I recommend daily shampooing, and ideally alternating 3 shampoos, each with active anti-dandruff ingredients.
Dr. Matthew Zirwas, board-certified dermatologist and founder of Bexley Dermatology in Bexley, Ohio, recommended trying a shampoo for, at least a month because if your old shampoo had ingredients that were causing a dandruff-like rash of their own, it will take 4-8 weeks for that ingredient to work its way out of your body after you start the new stuff.
How Is This Medicine Best Taken
Use coal tar shampoo as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- Do not take coal tar shampoo by mouth. Use on your scalp and hair only. Keep out of your mouth, nose, ears, and eyes .
- Wash your hands before and after use.
- Wet hair and scalp.
- Put on enough shampoo to make a lather.
- Lather well and leave on as you have been told.
- Rinse and put on again.
What do I do if I miss a dose?
- Put on a missed dose as soon as you think about it.
- If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
- Do not put on 2 doses or extra doses.
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Production And Chemical Properties
Four sources of tar have been used for therapeutic treatments wood , bitumen , petroleum and coal .3 There are two kinds of wood tars made either from trees with a high content of resin , or from hardwood trees .3 Pine tar , wood tar, brea de pino, brea vegetal, goudron végétal, nadelholzteer, pix abietinarum, pix pini and pyroleum pini),2, 7 is obtained by high temperature carbonisation of pine wood from various trees of the family Pinaceae in anoxic conditions .2 This process causes tar and pitch to drip away from the pine wood leaving behind charcoal.2 Pine tar is a dark brown or nearly black viscous semiliquid, which is denser than water and has a characteristic empyreumatic odour and a sharp taste.2, 7 Pine tar is slightly soluble in water and soluble in alcohol, chloroform, ether, acetone, glacial acetic acid, in fixed and volatile oils and in solutions of caustic alkali.2, 7 The aqueous liquid produced by shaking pine tar with water is acidic, distinguishing it from coal tar, which is alkaline.7
The components of pine tar vary according to the pyrolytic process and origin of the wood .2 It is extremely complex, containing several thousand chemical components, primarily aromatic hydrocarbons, tar acids and tar bases.8 The principal constituents of pine tar include turpentine, resin, guaiacol, creosol, methylcreosol, phenol, phlorol, toluene, xylene and other hydrocarbons.2
Is It Safe To Use Coal Tar For Psoriasis
Yes. Coal tar has been linked to skin, lung, bladder, kidney, and GI cancer. However, this was in either animal studies, where the animals were exposed to very high levels of coal tar, and in occupational studies, where people work with industrial coal tar. Thereâs no research to suggest that people who use coal tar to treat their psoriasis are at a greater risk for cancer.
California requires OTC coal tar products that contain more than 0.5% coal tar to be labeled with cancer warnings. However, the FDA says that OTC products with coal tar concentrations between 0.5% and 5% are safe, and thereâs no evidence it causes cancer.
You should avoid coal tar if:
- You’re pregnant or breastfeeding.
- You’re sensitive to UV light or take drugs that make you more sensitive to UV light.
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Coal Tar Interferes With The Th2 Cytokinemediated Stat6 Signaling Cascade
Figure 6Model of the molecular mechanism of coal tar therapy in AD.
Th2 cytokines IL-4 and IL-13 activate the STAT6 signaling cascade, leading to downregulated expression of epidermal differentiation proteins, induction of the eosinophilic chemoattractant CCL26, and histopathological features such as spongiosis and apoptosis. Under normal conditions, PTPN1 dephosphorylates STAT6, resulting in a regulatory feedback loop. However, oxidative stress caused by Th2 cytokines inactivates PTPN1, leading to sustained STAT6 signaling. Coal tarmediated activation of the AHR signaling pathway leads to enhanced epidermal differentiation and possible improvement of epidermal barrier function, thereby attenuating allergen exposure and reducing inflammatory cues. Importantly, coal tar activates the AHR/NRF2 signaling pathway, enabling detoxification of reactive oxygen species. This may prevent the oxidative inactivation of PTPN1 and lead to decreased STAT6 signaling, normalization of skin barrier protein expression, and downregulation of CCL26 expression.
Is It Dandruff Or Seborrheic Dermatitis
W. Steven Pray, PhD, DPhBernhardt Professor, Nonprescription Products and DevicesCollege of Pharmacy
Gabriel E. Pray, PharmD CandidateCollege of PharmacyWeatherford, Oklahoma
US Pharm
Patients approach pharmacists with a host of questionsabout relatively minor health conditions, and many involve the skin.Dermatologic questions concern allergic dermatitis, dry skin, minorwounds, and numerous other problems.1 Dandruff and seborrheicdermatitis are two closely related dermatologic conditions thatmay be successfully self-treated. However, the pharmacist should beaware of the various means by which both are recognized and the possibleinterventions.
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