Coal tar with coconut oil and salicylic acid

How it works

Coal tar provides anti-inflammatory, antiscaling and antipruritic action, salicylic acid is a keratolytic that softens and lifts adherent scale, and coconut oil acts as an emollient base that loosens crusts and aids removal of scale.

Prescribing in practice

• Coal tar increases photosensitivity, so the scalp and any treated skin should be protected from strong sunlight, with extra care if phototherapy is used.
• Keep the preparation away from the eyes and broken or inflamed skin, as both tar and salicylic acid can cause irritation.
• Salicylic acid is absorbed percutaneously, so avoid widespread application especially in young children to limit the risk of salicylate toxicity.

Monitoring

No laboratory monitoring is generally required; review the scalp for irritation and response to treatment.

Counselling the patient

• Massage into the scalp as directed and rinse out; take care to avoid the eyes.
• Expect a tar smell and possible staining of light or bleached hair.
• Stop and seek advice if the scalp becomes sore or irritated.

Evidence & guidelines

Combined coal tar and salicylic acid scalp preparations are well-established for scaling scalp disorders and feature in stepped topical care for scalp psoriasis.