Monday, March 28, 2016

Coal Tar: Safety in Children

Availability:
  • Coal tar 1-9% oinment
  • Coal Tar 20% Solution
  • Coal Tar and salicyclic acid (various concentration)
  • Polytar Shampoo
General
  • Crude coal tar has antipsoriatic, antiseborrheic, antipruritic and keratolytic effects.
  • It can be compounded in an ointment, cream or solution vehicle in concentrations from 0.5% to 20%.
  • Safe, effective treatment for childhood psoriasis and is supplied in a variety of topical formulations and shampoos.
  • Can be used alone or compounded with corticosteroids, lactic and salicylic acid. 
  • Its safety, efficacy, and relatively low cost, compared with other topical agents are advantages in the long-term treatment of psoriasis.
  • Side-effects of tar include folliculitis, irritation, and photosensitivity.
  • It should not be used on acutely inflamed skin, or on pustular or erythrodermic psoriasis
  • Education regarding the favorable safety profile and place in therapy as a steroid-sparing adjunct may increase tolerance and compliance of this excellent and underutilized topical therapy.
Safety
  • Preparations containing 6% coal tar : children 1 month to 2 years
  • Preparations containing 10% coal tar : children above 2 years
  • Shampoos containing coal tar 1-4% has been used for at least twice weekly
Dosing
  • Bath:
    • 60-90 mL of a 5% to 20% solution or 15-25 mL of 30% lotion is added to bath water; soak 5-20 minutes, then pat dry; use once daily to once every 3 days
  • Shampoo:
    • Apply twice weekly for the first 2 weeks then once weekly or more often if needed
  • Skin:
    • Apply to the affected area 1-4 times/day; decrease frequency to 2-3 times/week once condition has been controlled
  • Atopic dermatitis:
    • 2% to 5% coal tar cream may be applied once daily or every other day to reduce inflammation
  • Scalp psoriasis:
    • Tar oil bath or coal tar solution may be painted sparingly to the lesions 3-12 hours before each shampoo
  • Psoriasis of the body, arms, legs:
    • Apply at bedtime; if thick scales are present, use product with salicylic acid and apply several times during the day
References:
  1. BNF Children 2009
  2. Lexicomp

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.