Coal tar with salicylic acid

How it works

Coal tar provides anti-inflammatory, antiscaling and antipruritic effects while salicylic acid acts as a keratolytic, softening and removing scale and improving penetration of the coal tar.

Prescribing in practice

• Coal tar increases sensitivity to ultraviolet light, so treated areas should be protected from strong sunlight and care taken if phototherapy is also used.
• Avoid application to broken, infected or acutely inflamed skin, and keep away from the eyes, as both components can irritate.
• Salicylic acid is absorbed through the skin, so avoid extensive or prolonged use, particularly in children, to reduce the risk of salicylate toxicity.

Monitoring

No routine laboratory monitoring is required; review the treated area for irritation and clinical response.

Counselling the patient

• Apply as directed, avoid the eyes and surrounding healthy skin, and wash your hands afterwards.
• Expect a tar odour and possible staining of fabrics and light hair.
• Protect treated skin from strong sunlight and stop if irritation develops.

Evidence & guidelines

Coal tar with salicylic acid is an established keratolytic-antiscaling option for scaling psoriasis and is used within NICE-supported stepped topical therapy.