Coal tar shampoo can provide symptom relief for some people with scalp psoriasis, a type of plaque psoriasis. The National Psoriasis Foundation (NPF) has given two over-the-counter (OTC) coal tar shampoos its NPF Seal of Recommendation — MG217 Medicated Conditioning Coal Tar Formula Shampoo and Neutrogena T/Gel Therapeutic Shampoo-Stubborn Itch. The foundation also recommends coal tar shampoos in general as a topical treatment for mild scalp psoriasis. Used properly, coal tar shampoo may reduce skin dryness, itching, and flaking, and it may help soften and remove thick scales and dead skin.

Members of MyPsoriasisTeam often discuss coal tar shampoos, and many have shared how these treatments have improved their symptoms.

“I used Alphosyl shampoo and it has worked great,” a member wrote. “My head feels great and not one sign of psoriasis on my head anymore, as it contains coal tar, which is great for psoriasis.”

Another member wrote about their experience with coal tar shampoo. “I haven’t found anything in three decades that works as well.”

What Is Coal Tar Shampoo?

Coal tar shampoos are medicated shampoos designed to be used as scalp treatments rather than hair care. Coal tar shampoo can be an effective treatment for symptoms of dandruff, seborrheic dermatitis (a type of eczema), and scalp psoriasis. Coal tar can also be found in many other skin care products and topical treatments — such as creams, lotions, foams, and ointments — for relieving itching, dry skin, and flaking.

A byproduct of coal, coal tar is a thick black liquid with a long history of use as a topical treatment of psoriasis and other skin conditions. Sometimes, it’s combined with ultraviolet (UV) light therapy in a clinical setting. Although studies of coal tar are limited, its effectiveness in treating psoriasis symptoms in some people is well-documented. Research has shown that carbazole, a type of hydrocarbon found in coal tar, is likely the active ingredient that inhibits inflammation in psoriasis. Inflammation causes the rapid growth of skin cells in psoriasis.

How To Use Coal Tar Shampoos

Before trying a coal tar shampoo, talk to your dermatologist about how to properly use it to help prevent side effects. Getting medical advice is always a good idea when using a new product for psoriasis. Your doctor may recommend that you first try a coal tar shampoo on a small area of your scalp.

Coal tar shampoos shouldn’t be used in larger quantities nor more often than recommended, and they’re not appropriate for infants. Coal tar shampoo is not considered a risk for breastfeeding. However, health experts recommend that you clear coal tar products from your skin before breastfeeding.

Coal tar products can increase sensitivity to the sun, so doctors recommend people wear sunscreen and/or protective headwear when using a coal tar shampoo.

The Mayo Clinic recommends these steps when using coal tar shampoo:

• Wet your hair and scalp with lukewarm water.
• Gently rub the shampoo into your scalp and rinse.
• Apply once more and massage into the scalp with a rich lather.
• Wait five minutes.
• Rinse well.

In addition, be sure to follow these precautions when using coal tar shampoo:

• Avoid direct sun or tanning lamp exposure for 72 hours after treatment.
• Avoid use during a flare-up or if you have raw, infected, or blistered areas on your scalp.
• Avoid contact with eyes and flush eyes immediately with water if exposed.

Side Effects and Risks

Coal tar shampoo is considered safe, but there is a risk of side effects. Common side effects include:

• Mild skin irritation or rash
• Sunburn due to sensitivity from coal tar
• Dark stains on skin or hair
• Dry or brittle hair

To avoid damaging hair, use coal tar shampoos primarily on your scalp. Some people combine a coal tar shampoo for scalp treatment with a moisturizer or a regular shampoo for cleaning their hair.

MyPsoriaisisTeam members have offered tips to help protect their hair and scalp when using a coal tar shampoo. “I soak my scalp overnight in coconut oil and wash it out in the morning with your usual shampoo,” one member shared. “Or I use a coal tar shampoo then my normal shampoo, and I find that helps me a lot.”

Stop using coal tar shampoo and contact your dermatologist if you have an allergic reaction or experience any of these more serious side effects:

• Worsened psoriasis symptoms
• Intense burning or stinging sensation
• Swelling in the face, throat, or tongue

The Smell of Coal Tar Shampoo

Some people with scalp psoriasis find the smell of coal tar shampoo difficult to tolerate. The unpleasant odor causes some people to avoid using coal tar products. Many MyPsoriasisTeam members have commented on the smell of coal tar. “Ah, the sexy smell of … COAL TAR! 😖,” wrote a member.

But many members have found ways to overcome the odor and enjoy the benefits of coal tar shampoo.

“I use a shampoo called Tarsum, manufactured by Summers Laboratories,” a member said. “It’s a coal tar shampoo, but it doesn’t stink horribly like most of them and it has a nice lather to it when shampooing. I used to put it on my skin as well, let it sit then jump in the shower after ten minutes and wash with a cloth. It was a total relief when it came to my pain and itch. It helped clear my scalp psoriasis.”

Another member offered this guidance. “Neutrogena T/Gel shampoo cleared my scalp in three weeks. It has coal tar in it and does not smell very good, but my conditioner afterwards took care of the smell.”

Coal Tar and Cancer Risks

Coal tar is also used industrially in applications such as paints, roofing, and paving. Exposure to large quantities of coal tar has been linked to cancer in the lungs, kidneys, bladder, and skin. The risk of cancer from coal tar has raised concerns among people who might use it as a treatment for skin or scalp conditions.

However, according to the American Academy of Dermatology, research has shown that coal tar is safe and effective for long-term use and, when used as advised for treating psoriasis symptoms, doesn’t cause cancer. Studies on animals and in occupational studies have linked coal tar to increased cancer risks. However, in these studies, subjects were exposed to much higher concentrations of coal tar than the amount found in coal tar shampoos and skin care products.

The U.S. Food and Drug Administration (FDA) has also determined that products such as coal tar shampoo with concentrations of coal tar up to 5 percent are safe for people with psoriasis. Nonetheless, in California, OTC coal tar shampoos and skin care products have a cancer warning label.

Talk With Others Who Understand

On MyPsoriasisTeam, the social network for people with psoriasis and their loved ones, more than 110,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Do you have experience with coal tar shampoos? Share your perspectives in the comments below, or start a conversation by posting on your Activities page.