coal tar, distilled: clinical use

Prescribing considerations

• Select the cream for sub-acute or chronic psoriasis affecting skin, scalp or flexures, and the shampoo for scalp psoriasis.
• Avoid eyes and mucous membranes; keep the cream away from genital or rectal areas, cuts and grazes.
• Counsel about staining, possible photosensitivity and the cream's fabric fire hazard.
• Review treatment if the condition worsens or does not respond.

Contraindications and cautions

• Hypersensitivity to the active substance or formulation ingredients.
• Acute, sore or pustular psoriasis.
• Infected treatment sites.

Monitoring

• Clinical response and evidence of infection.
• Local irritation or acne-like eruptions.
• Photosensitivity reactions.
• Safe handling of fabrics exposed to the cream.

Clinical pharmacology

A topical tar antipsoriatic with incompletely defined pharmacology; reducing excessive epidermal mitosis is considered an important effect. Systemic pharmacokinetic data are not specified in the selected product information.

Formulation and product differences

• The cream is licensed for sub-acute and chronic psoriasis of the skin, scalp and flexures. It contains lecithin and propylene glycol, which may irritate susceptible skin.
• The foaming shampoo is licensed specifically for scalp psoriasis. It contains lecithin and a methylchloroisothiazolinone/methylisothiazolinone-preserved surfactant.
• The cream carries a specific warning that contaminated clothing, bedding and dressings can burn more easily.