Coal Tar: Complete Medication Guide
Key Takeaways
Coal tar is a thick, dark substance used to treat skin conditions like psoriasis, eczema, and dandruff
It works by slowing down skin cell growth and reducing inflammation, itching, and scaling
Common side effects include skin irritation, staining, and sensitivity to sunlight
Coal tar products come in many forms: shampoos, creams, ointments, and bath solutions
Always apply as directed and avoid sun exposure after use, as coal tar can make skin more sensitive to UV rays
Coal Tar Overview
Coal tar is a thick, oily substance created when coal is heated to very high temperatures. It's been used in medicine for over 100 years to treat various skin problems. Coal tar works by slowing down how fast your skin cells grow and divide. This helps reduce the red, itchy, scaly patches that appear with conditions like psoriasis and eczema.
The way coal tar helps is by reducing inflammation—the body's swelling response—and calming irritation on the skin's surface. It also has mild antibacterial properties, which can help prevent infection when you scratch itchy areas. Coal tar comes in many different forms, from shampoos you use on your scalp to creams and ointments you apply directly to affected areas. You can find it in over-the-counter products and prescription-strength versions. This flexibility makes it a popular choice for people dealing with stubborn skin conditions that don't respond well to other treatments.
Side Effects
Coal tar is generally well-tolerated when used as directed, but like any medication, it can cause some unwanted effects. Most side effects are mild and go away once you stop using the product or your skin adjusts to it.
Common Side Effects
Skin irritation or burning sensation – Your skin may feel irritated, red, or like it's burning when you first apply coal tar. This usually improves with continued use.
Staining of skin and clothing – Coal tar is dark brown or black and can stain your skin, nails, and clothes. Wear old clothing when applying and wash your hands afterward.
Unpleasant odor – Coal tar has a strong, distinctive smell that some people find unpleasant. This fades once the product dries.
Excessive dryness – Your skin may become very dry while using coal tar. Using a moisturizer can help manage this side effect.
Increased sensitivity to sunlight – Coal tar can make your skin more sensitive to UV rays. You may burn more easily in the sun.
Photosensitivity reactions – Some people experience unusual reactions to sun exposure when using coal tar, such as severe redness or rash in exposed areas.
Serious Side Effects
Severe allergic reaction – Though rare, some people may develop hives, swelling of the face or throat, or difficulty breathing after using coal tar products.
Worsening skin condition – In unusual cases, coal tar may cause your skin problem to get worse instead of better, or trigger a new rash.
Chemical burn or severe irritation – If coal tar is left on your skin too long or applied to sensitive areas like the face without direction, it can cause severe burning or damage.
Systemic absorption concerns – Very rarely, when coal tar is used over large areas of the body for extended periods, small amounts may be absorbed into the bloodstream and cause side effects.
When to Seek Medical Attention
Contact your healthcare provider if you experience severe burning, swelling, or blistering that doesn't improve within a few days. If you develop signs of an allergic reaction—such as hives, itching all over your body, or difficulty breathing—seek immediate medical help. You should also reach out if your skin condition gets worse or if you notice new, unexplained rashes appear while using coal tar. If you're uncertain whether a side effect is normal or need guidance on how to use the product safely, don't hesitate to call your doctor or dermatologist.
Dosage
Product Form |
Typical Application |
Frequency |
Key Details |
Shampoo |
Work into wet scalp, lather, leave on 5 minutes |
2–3 times per week |
Rinse thoroughly; start with once weekly if new to coal tar |
Cream or ointment |
Apply thin layer to affected area |
1–3 times daily |
Rub in gently; cover with bandage if directed |
Bath solution |
Add to bathwater as directed on package |
Once or twice daily |
Soak 15–20 minutes; pat skin dry gently |
Gel or lotion |
Apply to affected area, massage gently |
1–2 times daily |
Allow to dry before dressing; avoid sensitive areas |
Medicated oil |
Apply sparingly to scalp or skin lesions |
Once daily or as directed |
May be used overnight under a shower cap for scalp treatment |
Important: Never use coal tar products more often or in larger amounts than directed on the label or by your doctor. Do not stop using coal tar suddenly without talking to your healthcare provider, especially if it's helping your condition. If you miss a dose, simply apply it when you remember, but skip the missed dose if it's almost time for the next one. Always wash your hands thoroughly after applying coal tar unless you're treating your hands. Keep the product away from your eyes, mouth, and other sensitive areas.
Drug Interactions
Coal tar is applied to the skin and is not typically absorbed into your body in significant amounts, so it has fewer drug interactions than oral medications. However, some interactions are still possible, especially if you use other topical products at the same time.
Other Topical Medications
Using coal tar with other creams, ointments, or lotions on the same area can reduce how well both products work or increase skin irritation. Wait at least 15 minutes between applying different topical products, or apply them to different areas of your skin.
Retinoids or Vitamin A Derivatives
Retinoids (like tretinoin or adapalene) used on the same skin area as coal tar may cause excessive irritation, redness, and peeling. It's best to use these products on different days or different areas of your body.
Benzoyl Peroxide
Combining coal tar with benzoyl peroxide on the same area can cause significant skin irritation and may reduce the effectiveness of both products. Apply these treatments to separate areas or at different times of day.
Photosensitizing Medications
If you take medications that make your skin sensitive to sunlight (such as certain antibiotics or NSAIDs), using coal tar may increase your risk of severe sunburn or unusual skin reactions. Talk to your doctor about sun protection strategies.
Salicylic Acid or Sulfur Products
Using coal tar alongside salicylic acid or sulfur-based treatments may cause excessive drying and irritation. These products can usually be used one at a time on an alternating schedule rather than together.
Continue Learning
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Pros and Cons
Pros
Proven long track record – Coal tar has been used safely for over a century to treat skin conditions, with established effectiveness for psoriasis and eczema
Available over the counter – Most coal tar products are sold without a prescription, making them accessible and affordable
Multiple application forms – You can choose shampoos, creams, ointments, bath solutions, or gels depending on where your skin problem is located
Mild side effect profile – When used as directed, coal tar causes fewer serious side effects than some prescription skin medications
Combination therapy compatible – Coal tar can often be used alongside other treatments like light therapy to improve results
Cons
Strong unpleasant odor – The distinctive smell of coal tar can be bothersome and may linger on your skin and clothing
Staining and discoloration – Coal tar's dark color can permanently stain clothes, bedding, and sometimes skin, requiring careful handling
Sun sensitivity requirement – You must avoid sunlight for extended periods after application and use strict sun protection, which limits outdoor activities
Slow results – Coal tar typically takes 2–4 weeks or longer to show noticeable improvement, requiring patience and consistency
Messy application – The thick, oily texture can be difficult to apply evenly and may feel uncomfortable on skin until it fully dries
Frequently Asked Questions
Get answers to common questions about coal tar.
Most people begin noticing improvement in their skin condition within 2 to 4 weeks of regular use. However, more significant results may take 6 to 8 weeks or longer, depending on how severe your condition is and how consistently you use the product. Patience and consistent application are key to getting the best results from coal tar treatment.
Coal tar is generally not recommended for facial skin unless specifically directed by a dermatologist, as facial skin is thinner and more sensitive than skin on other parts of your body. If you have psoriasis or eczema on your face, ask your doctor about gentler alternatives or lower-strength coal tar products designed for facial use. Never apply regular coal tar products near your eyes or mouth.
While topical coal tar applied to the skin is not believed to cause significant harm during pregnancy, research is limited. Always discuss any topical medications with your healthcare provider during pregnancy so they can assess the specific risks and benefits for your situation and recommend the safest option for you and your baby.
Coal tar stains can be difficult to remove but will eventually fade as your skin naturally sheds dead cells, usually within 1 to 2 weeks. To prevent staining, wear old clothing that you don't mind getting discolored, and wash your hands immediately after application. For clothing stains, treat them promptly with stain remover before washing, as older stains are harder to remove.
The frequency of coal tar use depends on the specific product and your skin condition. Most coal tar shampoos are used 2 to 3 times per week, while creams or ointments may be applied daily. Always follow the instructions on your product label or your doctor's directions. Using coal tar more often than recommended can increase side effects like dryness and irritation without improving results.
The Bottom Line
Coal tar is a time-tested, over-the-counter treatment for stubborn skin conditions like psoriasis, eczema, and seborrheic dermatitis. Its ability to slow skin cell growth and reduce inflammation makes it effective for many people, especially when other treatments haven't worked. While it has drawbacks like an unpleasant odor and sun sensitivity requirements, the mild side effect profile and proven track record make it worth trying under medical guidance. Results typically appear after 2 to 4 weeks of consistent use. If you're dealing with a persistent skin condition, talking with your healthcare provider about whether coal tar is right for you is a smart first step.
Ready to take control of your health? Doctronic offers 24/7 access to healthcare guidance with free AI consultations and affordable video or text visits starting at $19—all with a 4-minute wait time. Get personalized advice about whether coal tar or other treatments are right for your skin condition.
This information is educational and does not replace advice from your healthcare provider.
