Coal tar is the one over-the-counter psoriasis active that actually treats the disease, rather than just removing scale. It is recommended in guidelines from the AAD and the National Psoriasis Foundation, and it stands up to a prescription vitamin D cream by about 12 weeks.
This is a simple 2% preparation in a petrolatum base. That base is occlusive, which drives the tar in and keeps water from escaping — useful on dry, scaly plaques. The short ingredient list means fewer extras to react to.
One label note stands out: this product is written for healthy adults, and it is more restrictive about age than most. Read the box and patch test before regular use.
| Key active | Coal tar 2% |
| Texture | Greasy ointment |
| Best for | Plaque psoriasis on the body |
| Approximate price | $11–$15 |
| Fragrance | Fragrance free |
Coal tar is the only over-the-counter psoriasis active that actually treats the disease rather than just removing scale — and this is a proper 2% preparation in the format that works best.
It is guideline-recommended. The AAD and National Psoriasis Foundation include coal tar for mild-to-moderate psoriasis, and it stands up against prescription calcipotriol by the twelve-week mark.
The petrolatum base is occlusive, which both drives the tar in and stops water escaping — genuinely useful on a dry, scaly plaque.
The cancer fear around coal tar is largely misplaced — see below.
Psoriasin's own label says it is "for use by normally healthy adults only," and that people under 18 should use it only as directed by a doctor. That is more restrictive than most, and worth knowing.
It can lighten light-coloured hair. The label tells you to patch test.
Some sources say Psoriasin is 1.25% coal tar. The current FDA label says 2%. The lower figure appears to belong to an older or different product in the line. Check your box.
It is greasy and it stains.
The real problems with coal tar are not cancer — they are why people quit it.
It smells. Strongly, medicinally, and it lingers. This is the number one reason people stop.
It stains clothes, sheets, towels and baths.
It makes you sun-sensitive for up to 24 hours after you apply it. Cover the area or stay out of the sun.
It can cause folliculitis — "tar acne" — and irritant rashes.
About the Prop 65 cancer warning on the box: that is a California labelling law, triggered by the presence of the chemical — not a finding about the risk of using it as medicine. The cancer classification people cite applies to industrial exposure — coke ovens, roofing, gasworks — at doses vastly higher than a tube of cream. The largest study followed 13,200 patients for a median of 21 years and found no increase in cancer.
When to stop self-treating and see a doctor — this matters more than which cream you buy.
Psoriasis is not a skin problem. It is a systemic inflammatory disease.
Psoriatic arthritis develops in roughly 20–30% of people with psoriasis, and the joint damage it causes can be permanent if it is not treated. Psoriasis also carries a raised risk of cardiovascular disease, driven by long-term inflammation.
See a doctor if: You have any joint pain or stiffness — especially morning stiffness lasting over 30 minutes — or swollen fingers or toes Your plaques cover more than about 3–5% of your body (your palm is roughly 1%) It affects your face, scalp, genitals, palms, soles or nails It is not improving after a few weeks It is affecting your sleep or your mental health
Every one of these products says "ask a doctor if your condition does not improve." This is why.
Active ingredients: Coal Tar 2% (from Coal Tar Topical Solution, USP 20%)
Inactive ingredients: Ethanol, Petrolatum, Polysorbate 80
1. Psoriasis treatment: Coal tar (https://www.aad.org/public/diseases/psoriasis/treatment/medications/coal-tar) — American Academy of Dermatology patient guidance stating coal tar effectively treats plaque psoriasis, itch and scale, supporting that coal tar is an OTC active that actually treats the disease. 2. Psoriasis: Update on Topical Therapy From the American Academy of Dermatology (https://www.aafp.org/pubs/afp/issues/2022/0500/p558.html) — AAFP summary of the AAD-NPF topical guideline confirming coal tar is effective for mild-to-moderate psoriasis and appears even more effective than calcipotriene (calcipotriol). 3. Efficacy and Tolerability of a Cosmetically Acceptable Coal Tar Solution in the Treatment of Moderate Plaque Psoriasis (https://link.springer.com/article/10.2165/11530380-000000000-00000) — 12-week controlled comparison in American Journal of Clinical Dermatology showing coal tar gave greater PASI reduction (58% vs 37%) than calcipotriene cream, supporting that coal tar stands up against calcipotriol by the twelve-week mark. 4. No increased risk of cancer after coal tar treatment in patients with psoriasis or eczema (https://pubmed.ncbi.nlm.nih.gov/20016499/) — Journal of Investigative Dermatology cohort of 13,200 patients finding coal tar treatment did not increase skin or non-skin cancer risk, supporting that the cancer fear around coal tar is largely misplaced.