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Coal tar

Long-established medicine for scaling in dandruff, seborrhoeic dermatitis and mild scalp psoriasis Also on labels as: tar, coal tar solution

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What it does

Coal tar has been used on skin for a very long time. It's one of the three ingredients the NHS suggests looking for in an anti-dandruff shampoo, and the NHS lists it among treatments for psoriasis of the skin and scalp. Coal tar shampoos are sold over the counter; NICE notes that newer branded products are preferred to crude coal tar, which is smellier and messier.

Dermatologists say medicated shampoos containing coal tar can help scaling in mild scalp psoriasis. Some coal tar shampoos can be used daily; others only once or twice a week — follow the pack.

Cautions

  • Smell and staining: it has a distinctive smell, and can stain skin, hair and fabric (NICE, BAD).
  • Sun sensitivity: NICE advises minimising sun exposure after use.
  • Can cause irritation, acne-like spots or inflamed hair follicles.
  • Don't use on broken, infected or acutely inflamed skin, or in the first three months of pregnancy; take care later in pregnancy and when breastfeeding (NICE).
  • On its own it isn't enough for severe scalp psoriasis — see a GP.

How strong is the evidence?

Evidence: Limited

Small or early studies only — promising at best.

Coal tar is recommended in NICE guidance for GPs as an option for scalp psoriasis and as an alternative medicated shampoo for seborrhoeic dermatitis, and the British Association of Dermatologists describes tar products as safe. NICE says coal tar shampoo shouldn't be used on its own for severe scalp psoriasis, and many people dislike the smell and mess. For dandruff, a 2015 BMJ Clinical Evidence review found tar shampoo may reduce flaking and redness compared with placebo, but rated the evidence low quality. On safety, a large Dutch study of more than 13,000 people treated with coal tar (mostly ointments for psoriasis or eczema) found no increased risk of cancer.

UK rules and availability

Coal tar is not allowed in cosmetics in Great Britain, so coal tar shampoos are licensed medicines; many can be bought over the counter (NICE). Some well-known tar shampoos have been discontinued, so check what your pharmacy stocks. Read the leaflet and ask a pharmacist if unsure.

Products on this site that list it

Not medical advice. This guide is general information from the sources listed, not a diagnosis or a substitute for a pharmacist, GP or dermatologist. If you are worried, or symptoms are severe or not improving, get advice. Read our health information policy.

Sources

  1. NHS – Dandruff nhs.uk
  2. NHS – Psoriasis nhs.uk
  3. NICE CKS – Coal tar products cks.nice.org.uk
  4. NICE CKS – Scalp psoriasis cks.nice.org.uk
  5. British Association of Dermatologists – Psoriasis: topical treatments bad.org.uk
  6. Naldi L, Diphoorn J. Seborrhoeic dermatitis of the scalp. BMJ Clin Evid 2015 pmc.ncbi.nlm.nih.gov
  7. Roelofzen JH et al. No increased risk of cancer after coal tar treatment in patients with psoriasis or eczema. J Invest Dermatol 2010 pubmed.ncbi.nlm.nih.gov
  8. legislation.gov.uk – Cosmetics Regulation Annex II (prohibited substances) legislation.gov.uk