Coal Tar

South African indications:

• Psoriasis
• Eczema
• Cold sores

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Infected open lesions
• Sore or acute pustular psoriasis

Cautions 

• Pregnancy
• Breastfeeding
• Excessive exposure to sunlight

Forms avail. in SA and covered in this monograph: cre, lot, liq, sha

Psoriasis
Eczematous conditions of the skin and scalp
Cold sores

• Topical (cre, lot, liq): Apply small quantity to affected area, 8-12hrly

Do not use this product in or around the rectum or genital area or groin

Avoid contact with eyes

Dandruff
Psoriasis
Greasy hair
Atopic eczema of the scalp
Seborrheic hair conditions

• Topical (sha): Initial: Apply small quantity to wet hair, every alternate day for 10 days; Maintenance: Apply 2-3 times/week

For severe scalp problems apply daily

Not established for use in children below 12 years

Pregnancy 

• Caution
• There are limited data from the use of coal tar preparations in pregnant women
• Coal tar has been shown to be foetotoxic and teratogenic to the offspring of laboratory animals when administered topically, orally or by inhalation at high and maternally toxic doses
• Use of coal tar during pregnancy should only be considered if the expected benefit to the mother outweighs the potential risk to the foetus
• The use of coal tar should be avoided in the first trimester of pregnancy

Breastfeeding 

• Caution
• The safe use of topical coal tar preparations during breastfeeding has not been established
• It is not known whether the topical application of coal tar preparations could result in sufficient systemic absorption to produce detectable amounts in breast milk. Use of coal tar preparations during breastfeeding should only be considered if the expected benefit to the mother outweighs the potential risk to the infant
• If used during breastfeeding, patients should be advised to ensure that any residual product is fully washed off the breast prior to breastfeeding in order to avoid accidental ingestion by the infant

Renal Impairment

• No dose adjustment recommended 

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Skin and Subcutaneous Tissue Disorders

• Alopecia
• Dermatitis
• Hair colour changes
• Abnormal hair texture
• Photosensitivity reaction
• Skin irritation
• Acne-like eruptions

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity

Sensory Disorders

• Eye irritation

Others

• Application site reactions
• Localised oedema

• Photosensitising agents

None routine

The exact mechanism of action of coal tar is not known. It is thought to suppress DNA synthesis in hyperplasic skin, inhibiting mitotic activity and protein synthesis. It decreases epidermal proliferation and dermal infiltration and thus promotes a return to normal keratinisation. Coal tar has anti-inflammatory, antibacterial, antipruritic, keratolytic, keratoplastic and vasoconstrictive effects, which is of significance in the management of psoriasis and other dermatoses associated with increased cell replication, such as dandruff. The use of coal tar preparations in products for scalp disorders is well established and such treatments have generally been shown to be safe and effective.

Coal tar is available in several formulations. Please note the list below gives examples of products which are available and is not necessarily comprehensive. The listing of a product does not constitute endorsement of the product by EMGuidance; likewise, failure to list a product does not imply that EMGuidance disapproves of the product. This information is put together on the basis of the National Government's Medicines Price Registry at the time of publication

Solution (per 100ml) 20g

• Coal tar solution (Medico Lab)

Lotion (per 100g) 1g

• Exorex lotion (Sandoz)

Liquid 5%

• Liquor Picis Carbonis (LPC) 

Gel (per 100g) 1g

• Linotar gel 1 (Glenmark)

Gel (per 100g) 2g

• Linotar gel 2 (Glenmark)

Gel (per 100g) 3g

• Linotar gel 3 (Glenmark)

Shampoo 7.5%

• Denorex anti-dandruff shampoo (Denorex)