Coal tar with salicylic acid and precipitated sulfur

How it works

Coal tar provides anti-inflammatory and antiscaling action, salicylic acid is keratolytic and softens scale, and precipitated sulfur contributes mild keratolytic, antiseptic and antiseborrhoeic effects.

Prescribing in practice

• Coal tar increases photosensitivity, so treated skin should be protected from sunlight and care taken if phototherapy is used concurrently.
• Keep away from the eyes and avoid broken, infected or acutely inflamed skin, as the combination can cause irritation.
• Salicylic acid is percutaneously absorbed, so avoid extensive or prolonged application, especially in children, to limit salicylate toxicity risk.

Monitoring

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

Counselling the patient

• Apply as directed and avoid contact with the eyes and healthy surrounding skin.
• Expect a characteristic odour and possible staining of fabrics and light hair.
• Protect treated areas from strong sunlight and stop if the skin becomes irritated.

Evidence & guidelines

Multi-ingredient coal tar, salicylic acid and sulfur preparations are long-established keratolytic-antiscaling treatments for scaling dermatoses such as psoriasis and seborrhoeic dermatitis.