Coal tar CT has been used for many years as a topical preparation in the treatment of psoriasis.
However, in recent years the use of CT has been discouraged because it contains possible carcinogens.
I will look at the evidence and consider whether CT is as an effective psoriasis cure and whether it's a safe treatment option.
Firstly, let's look at what CT is and how it is derived.
CT is a by-product of the coal industry and is a thick brown or black liquid that is used to tarmac roads.
However, the chemicals contained in CT were found to be effective in treating psoriasis over 150 years ago, both on its own and mixed with other ingredients.
Even though it is not fully understood how it works as a therapeutic treatment, it's thought to reduce inflammation and the turn-over of skin cells.
CT preparations are found in many over-the-counter and prescription-only creams, lotions, ointments, bath oils and shampoos and are usually not harmful.
However, some people have experienced minor skin irritations and more seriously an allergic reaction such as hives, swelling, stinging and burning.
CT can also discolor fair skin and hair as well stain clothes and other fabrics.
It's always wise to wear your oldest clothes and use old bedding when you first start using these products in case they stain.
Very few people seem to experience any serious side effects.
At first crude CT was used in a 1 to 10% concentration in soft paraffin to treat psoriasis.
However, it is less commonly used these days because it is extremely smelly and messy to use and few people can put up with it.
These days, however, the creams containing between 0.
4 - 2% concentrations are more pleasant and easier to use at home.
However, two studies have shown that a 1% concentration used twice daily has significantly less therapeutic effect than a 5% concentration.
The studies concluded that there were no benefits in exceeding a 5% CT concentration.
Preparations like Psorin ointment which contains dithranol, salicyclic acid and 1% CT are commonly prescribed for treating psoriasis because the active ingredients slow down the process of skin cell production and shedding old skin cells.
They also reduce inflammation.
A recent study compared the efficacy of a new CT preparation called exorex (containing 1% concentration) with calcipotriol cream (containing Vitamin D), and found that even though exorex was as effective as calcipotriol, people could tolerate calcipotriol better.
However, the study concluded that CT preparations are considerably less expensive than taking calcipotriol and are a useful and effective topical medication for chronic psoriasis.
Even though it has been found that using 5% CT concentration is more effective than a 1% concentration, the World Health Organization's International Cancer Research Agency has classified 5% or greater concentration as a carcinogen.
Some studies have shown that using very high concentrations may cause cancer and, consequently, doctors and dermatologists are concerned about any use of coal tar products.
Californian law regards even a 0.
5% concentration dangerous, whilst the FDA still maintains that using 0.
5% to 5% preparations is safe.
So, with this confusing information, the question that remains is whether coal tar products cause cancer? In the 1950s 280 patients were treated with crude coal tar and UV lights (known as the Goeckerman regimen).
Following up 25 years later, they found that the incidence of skin cancer had not increased above the expected incidence of the general population.
They concluded that there was a minimal risk for skin cancer using coal tar preparations.
Despite the cautiousness of the medical profession, there is no firm evidence that using over-the-counter coal tar preparations causes skin cancer or other cancers.
In the end, it seems that it is still an effective and safe psoriasis cure.
However, in recent years the use of CT has been discouraged because it contains possible carcinogens.
I will look at the evidence and consider whether CT is as an effective psoriasis cure and whether it's a safe treatment option.
Firstly, let's look at what CT is and how it is derived.
CT is a by-product of the coal industry and is a thick brown or black liquid that is used to tarmac roads.
However, the chemicals contained in CT were found to be effective in treating psoriasis over 150 years ago, both on its own and mixed with other ingredients.
Even though it is not fully understood how it works as a therapeutic treatment, it's thought to reduce inflammation and the turn-over of skin cells.
CT preparations are found in many over-the-counter and prescription-only creams, lotions, ointments, bath oils and shampoos and are usually not harmful.
However, some people have experienced minor skin irritations and more seriously an allergic reaction such as hives, swelling, stinging and burning.
CT can also discolor fair skin and hair as well stain clothes and other fabrics.
It's always wise to wear your oldest clothes and use old bedding when you first start using these products in case they stain.
Very few people seem to experience any serious side effects.
At first crude CT was used in a 1 to 10% concentration in soft paraffin to treat psoriasis.
However, it is less commonly used these days because it is extremely smelly and messy to use and few people can put up with it.
These days, however, the creams containing between 0.
4 - 2% concentrations are more pleasant and easier to use at home.
However, two studies have shown that a 1% concentration used twice daily has significantly less therapeutic effect than a 5% concentration.
The studies concluded that there were no benefits in exceeding a 5% CT concentration.
Preparations like Psorin ointment which contains dithranol, salicyclic acid and 1% CT are commonly prescribed for treating psoriasis because the active ingredients slow down the process of skin cell production and shedding old skin cells.
They also reduce inflammation.
A recent study compared the efficacy of a new CT preparation called exorex (containing 1% concentration) with calcipotriol cream (containing Vitamin D), and found that even though exorex was as effective as calcipotriol, people could tolerate calcipotriol better.
However, the study concluded that CT preparations are considerably less expensive than taking calcipotriol and are a useful and effective topical medication for chronic psoriasis.
Even though it has been found that using 5% CT concentration is more effective than a 1% concentration, the World Health Organization's International Cancer Research Agency has classified 5% or greater concentration as a carcinogen.
Some studies have shown that using very high concentrations may cause cancer and, consequently, doctors and dermatologists are concerned about any use of coal tar products.
Californian law regards even a 0.
5% concentration dangerous, whilst the FDA still maintains that using 0.
5% to 5% preparations is safe.
So, with this confusing information, the question that remains is whether coal tar products cause cancer? In the 1950s 280 patients were treated with crude coal tar and UV lights (known as the Goeckerman regimen).
Following up 25 years later, they found that the incidence of skin cancer had not increased above the expected incidence of the general population.
They concluded that there was a minimal risk for skin cancer using coal tar preparations.
Despite the cautiousness of the medical profession, there is no firm evidence that using over-the-counter coal tar preparations causes skin cancer or other cancers.
In the end, it seems that it is still an effective and safe psoriasis cure.
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