Experiences with

Coal tar

Coal tar is a medicine that's used on the skin and scalp to treat itching, irritation and dry patches (scaling and flaking). It also has some antibacterial properties.

It comes as a cream, ointment, scalp lotion, shampoo or a liquid you add to your bath (emulsion additive).

Coal tar can help with problems such as:

• eczema
• psoriasis
• seborrheic dermatitis
• dandruff

Most coal tar products are mild. You can buy them from a pharmacy or shop, or get them on prescription.

Coal tar is sometimes combined with other ingredients such as calamine, coconut oil, salicylic acid, dithranol, precipitated sulfur or zinc oxide. These combined products are available as brands called Capasal, Cocois and Sebco.

Who can use coal tar

Most adults and children can use coal tar. However, do not use it on children under 12 years unless your pharmacist or doctor recommends it.

Who may not be able to use coal tar

Coal tar is not suitable for some people. To make sure it's safe for you, tell your pharmacist or doctor before using it if you:

• have ever had an allergic reaction to coal tar or any other medicine
• have swollen, broken or infected skin
• have skin redness and pus-filled blisters on top
• have skin that reacts badly to sunlight (photosensitive)
• have lupus, an autoimmune inflammatory condition
• are trying to get pregnant, are already pregnant or you're breastfeeding

Dosage and strength

Coal tar comes in different strengths:

• shampoo and scalp lotions contain 1% to 5% coal tar
• cream and ointments contain 1% to 12% coal tar
• bath liquid (emulsion additive) contains up to 40% coal tar

To find out how much coal tar to use and how often, follow the instructions from your pharmacist or doctor, or check the product label.

How to use it

Always use the recommended amount of coal tar. Do not use it for longer than recommended.

Do not use coal tar together with other skin treatments unless your doctor tells you to.

If you get coal tar in your eyes or mouth, wash it out immediately with plenty of cold water. If your eyes become irritated, talk to your doctor or pharmacist.

Coal tar is available as a cream and ointment.

Cream is better for skin that is moist or weepy. Ointment is thicker and greasier, and is better for dry or flaky areas of skin.

Sometimes, the amount of coal tar cream or ointment you need to use is given in fingertip units. This is the amount you can squeeze onto the end of your finger.

A fingertip unit is generally enough to treat both sides of your hand.

For children, the right amount of cream or ointment depends on their age. A doctor or pharmacist can advise you.

1. Wash your hands.
2. Squeeze out a fingertip unit of cream or ointment.
3. Carefully smooth the cream or ointment in a thin layer over the affected area.
4. Be careful not to get the cream or ointment onto broken skin or cuts.
5. Wash your hands afterwards.

If you need to use a dressing, like a bandage or plaster, wait at least 10 minutes after putting on coal tar cream or ointment.

Use once or twice a day or as recommended by a doctor.

Some creams, like Psoriderm, should only be used on the particular type of skin condition that they're recommended for. Check the packet or ask your doctor or pharmacist.

Skin creams and ointments can dry onto your clothes and bedding. This makes them more likely to catch fire. Avoid naked flames.

1. Wet your hair thoroughly.
2. Use enough shampoo to lather your hair, scalp and immediately surrounding areas if they're also affected.
3. Using your fingertips, massage your scalp and affected areas well.
4. Rinse off the shampoo thoroughly with water.
5. Repeat steps 2 to 4.
6. Wash and rinse your hands.

Coal tar shampoo should be in contact with your scalp for between 3 and 5 minutes.

Use once or twice a week or as recommended by a doctor.

How to use scalp lotion

1. Shake the bottle thoroughly before each use.
2. Wash your hands.
3. Unscrew the bottle cap and place the nozzle directly on your scalp.
4. Gently squeeze the bottle to cover the scalp area with a thin and even layer of liquid.
5. Do not use more than the recommended amount and try not to get it into your eyes.
6. Massage the area gently with your fingertips.
7. Leave the treatment to dry for 1 hour. Your scalp will feel cool while the liquid is drying.
8. Wash the scalp lotion out with warm water.
9. Wash your hands straight after use.

For children and older people, the liquid can be diluted. Boil and cool some water. Pour the recommended amount of scalp treatment into the palm of your hand and add a few drops of the cooled water. Apply the mixture to the scalp and massage. Continue with steps 7, 8 and 9.

How often you use the scalp lotion depends on your symptoms. If they are mild, use it once a week. If your symptoms are more severe, use it daily for the first 3 to 7 days then reduce to once a week.

How to use bath liquid (emulsion additive)

1. Add 30ml of the liquid to a bath of warm water.
2. Get into the bath and soak for 5 to 20 minutes. Check your medicine instructions for information on how long to soak for.
3. The bathtub may be slippery, so take care when getting out.
4. Pat your skin dry with a soft towel. Avoid rubbing with the towel as this can make your skin condition worse.

Use this as your doctor tells you and always follow the instructions that come with your medicine. This will help to prevent your symptoms coming back.

If you forget to use it

If you forget to use coal tar, use it as soon as you remember, unless you do not remember until it's nearly time to use it again. In this case, just wait and use it at the usual time.

Do not use double the amount to make up for a missed use.

If you use too much

Using more than the recommended amount of coal tar is unlikely to harm you but it may increase the risk of skin irritation. Speak to your pharmacist if you're worried.

If you put on too much cream or ointment, wipe off the extra with a tissue.

If you use too much scalp lotion, rinse your hair with water.

Common side effects

If you get any of these side effects of coal tar, there are things you can do to help cope with them:

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or lasts more than a few days.

Serious side effects

Call your doctor or call 111 if you get:

• a severe stinging or burning feeling on your skin
• swelling
• worsening psoriasis

Serious allergic reaction

Coal tar products may contain lanolin, mineral oil, or other emulsifiers. Check the label and speak to a pharmacist or doctor before using coal tar if you are allergic to any of the ingredients.

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to coal tar.

These are not all the side effects of coal tar. For a full list, see the leaflet inside your medicine packet.

Coal tar and pregnancy

Coal tar products are sometimes used in pregnancy. There is no evidence that they cause harm to the baby.

However, only use coal tar products after talking to your doctor or pharmacist. They may recommend other treatments that may be more suitable during pregnancy.

Coal tar and breastfeeding

If your doctor says you need to, you can use coal tar products while you're breastfeeding. It is not known how much passes into breast milk, but it's likely to be a tiny amount.

Use it on as small an area as possible and take care that your baby does not touch any areas of your body where you've used a coal tar product.

If you're using coal tar on your chest, avoid putting it on your nipples. If you put it on your breasts, wash it off, then wash your hands before feeding your baby.

It's usually better to use cream rather than ointment when breastfeeding as it's easier to wash off.

Coal tar and fertility

There's no evidence to suggest that using coal tar reduces fertility in either men or women.

Cautions with other medicines

It's very unlikely that other medicines, either prescribed or ones you buy from a pharmacy or shop, will affect the way coal tar works.

Tell your doctor or pharmacist if you're using any other medicines or products on the affected area of your skin or scalp. This includes medicines bought from a shop or pharmacy.

Mixing coal tar with herbal remedies and supplements

There's not enough information to say that herbal remedies and supplements are safe to use with coal tar. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Related links

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