Usage
This topical medication is primarily prescribed for the treatment of chronic plaque psoriasis, a skin condition characterized by red, itchy, scaly patches. It can also be used for eczema. It falls under the pharmacological classification of dermatological preparations, specifically keratolytics and antipsoriatics. The combination of ingredients works synergistically to remove dead skin cells, reduce inflammation, and slow down the excessive production of skin cells.
Alternate Names
No widely recognized alternate names exist for this specific combination. Brand names may vary depending on the manufacturer and region. Derobin is one such brand.
How It Works
Pharmacodynamics:
- Coal Tar: Exerts anti-inflammatory, antipruritic, and antiproliferative actions.
- Dithranol (Anthralin): Inhibits DNA replication in skin cells, slowing down cell growth and reducing scaling and thickening of the skin.
- Salicylic Acid: Acts as a keratolytic agent, breaking down keratin, softening the skin, and promoting the shedding of dead skin cells. It also has mild anti-inflammatory properties.
Pharmacokinetics:
Primarily topical application. Absorption is minimal with topical use. Small amounts of salicylic acid can be absorbed systemically. Metabolism and elimination pathways for this combination are not well-defined.
Mode of Action:
The drugs work together to target various aspects of psoriasis. Dithranol slows skin cell production, while salicylic acid and coal tar break down keratin and promote exfoliation of dead skin cells. Coal tar also has anti-inflammatory and anti-itch effects.
Dosage
Standard Dosage
Adults:
Apply a thin layer to affected areas once or twice daily. The specific concentration and duration of treatment should be determined by a physician based on the severity of the condition and patient response.
Children:
Use with caution in children. Lower concentrations may be necessary. Consult a pediatrician for appropriate dosing guidelines and safety considerations.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically required.
- Patients with Renal Impairment: Use with caution. Monitor for systemic side effects of salicylic acid.
- Patients with Hepatic Dysfunction: Use with caution. Monitor for systemic side effects.
- Patients with Comorbid Conditions: Patients with diabetes, acute or pustular psoriasis, unstable psoriasis, or blood circulation problems should use with caution and under close medical supervision.
Clinical Use Cases
This medication is specifically intended for topical dermatological use. It is not indicated for intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
Adjustments may be necessary based on individual patient response and tolerance. Start with a low concentration and gradually increase as tolerated. Reduce dosage or discontinue if irritation occurs.
Side Effects
Common Side Effects
Skin irritation, burning sensation, staining of skin, hair, and clothing, dryness of the skin.
Rare but Serious Side Effects
Allergic reactions, severe skin irritation, worsening of psoriasis, folliculitis (tar acne).
Long-Term Effects
Prolonged use may increase the risk of skin cancer.
Adverse Drug Reactions (ADR)
Severe skin irritation, allergic reactions.
Contraindications
Hypersensitivity to any of the ingredients (coal tar, dithranol, salicylic acid, or any other components of the formulation). Acutely inflamed or broken skin, infected lesions, exacerbation of psoriasis, pre-existing skin infections.
Drug Interactions
Limited information available. Potential interactions with other topical medications, phototherapy, or systemic medications are not well-established. It is essential to inform the physician about all other medications, including OTC drugs and supplements.
Pregnancy and Breastfeeding
Consult a physician before using during pregnancy or breastfeeding. Safety during pregnancy and breastfeeding has not been definitively established. Minimize infant’s exposure to treated areas.
Drug Profile Summary
- Mechanism of Action: Keratolytic, anti-inflammatory, antiproliferative, reduces scaling and thickness of psoriatic plaques.
- Side Effects: Skin irritation, staining, burning sensation.
- Contraindications: Hypersensitivity, broken skin, acute inflammation.
- Drug Interactions: Limited data available. Inform physician of all medications.
- Pregnancy & Breastfeeding: Consult physician before use.
- Dosage: Apply thinly to affected area once or twice daily as directed by physician.
- Monitoring Parameters: Monitor for skin irritation, treatment response, and signs of systemic absorption (especially in children and patients with renal or hepatic impairment).
Popular Combinations
This combination itself contains three active ingredients. Combining with other topical medications is usually not recommended unless specifically directed by a physician.
Precautions
Perform a skin test before applying to larger areas, especially in patients with sensitive skin. Avoid contact with eyes, mucous membranes, and genitals. Wash hands thoroughly after application. Avoid sun exposure after application. Monitor for skin irritation and signs of allergic reaction. Use with caution in children, pregnant or breastfeeding women, and patients with renal or hepatic impairment.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Coal Tar + Dithranol + Salicylic Acid?
A: The recommended dosage varies depending on the individual and the severity of the condition. Typically, a thin layer is applied once or twice daily to affected areas. A physician should determine the exact dosage and duration of treatment.
Q2: Can I use this combination on my face?
A: Use with extreme caution on the face due to increased risk of irritation. Lower concentrations might be necessary. Consult a physician before applying to the face.
Q3: How long does it take to see improvement?
A: Improvement is usually observed within 4-6 weeks of consistent use. However, individual responses may vary.
Q4: What should I do if I experience skin irritation?
A: Discontinue use and consult a physician. Reducing the frequency of application or using a lower concentration might be helpful.
Q5: Can I use this medication during pregnancy or breastfeeding?
A: Consult a physician before use during pregnancy or breastfeeding. Safety has not been definitively established.
Q6: Does this medication stain?
A: Yes, this combination can stain skin, hair, and clothing. Take precautions to protect clothing and linens.
Q7: How should I apply this medication?
A: Apply a thin film to the affected areas. Avoid contact with eyes, mucous membranes, and normal skin. Wash hands thoroughly after application.
Q8: Can I combine this medication with other topical treatments?
A: Generally, combining with other topical treatments is not recommended unless specifically directed by a physician. Combining with other topical treatments can increase the risk of skin irritation or other adverse effects.
Q9: Are there any long-term risks associated with this medication?
A: Prolonged use of coal tar may increase the risk of skin cancer. Regular skin checks are recommended, especially with long-term use.
Q10: What are the signs of an allergic reaction to this medication?
A: Signs of an allergic reaction can include itching, redness, swelling, hives, difficulty breathing, or dizziness. Seek immediate medical attention if any of these symptoms occur.
