Other Topical Therapies (Dyes, Tanning Agents, Tars, CO2)

  • Claudia Schröder-KraftEmail author
Living reference work entry


  • Dyes can be used as antiseptic agents in superinfected dermatoses but their relevance in clinical dermatology is declining. The adjuvant use in occupational eczema maybe helpful.

  • Tanning agents enhance therapeutic options of eczema.

  • Tars and shale oils are useful for therapy of dermatitis especially in order to spare local corticoids and to avoid their side effects.

  • CO2 –enriched water is able to invigorate the skin barrier and can possibly support the prevention and therapy of occupational dermatoses

  • For most of these therapeutic options, no randomized, double-blind, placebo-controlled studies exist and only limited evidence-based findings on their therapeutic effects and modes of action do exist. This is surprising as they are widely used in a number of countries.


Dyes Tanning agents Tars Shale oils CO2 


  1. Arnold WP (1997) Tar. Clin Dermatol 15:739–744CrossRefPubMedGoogle Scholar
  2. Balabanova M, Popova L, Tchipeva R (2003) Dyes in dermatology. Clin Dermatol 21:2–6CrossRefPubMedGoogle Scholar
  3. Barnes TM, Greive KA (2017) Topical pine tar: history, properties and use as a treatment for common skin conditions. Australas J Dermatol 58:80–85CrossRefPubMedGoogle Scholar
  4. Bock M, Schürer N, Schwanitz HJ (2004) Effects of CO2-enriched water on barrier recovery. Arch Dermatol Res 296:163–168PubMedGoogle Scholar
  5. Borska L, Andrys C, Krejsek J, Hamakova K, Kremlacek J, Palicka V, Ranna D, Fiala Z (2010) Genotoxic and apoptotic effects of Goeckerman therapy for psoriasis. Int J Dermatol 49(3):289–294CrossRefPubMedGoogle Scholar
  6. Boyd AS (2010) Ichthammol revisited. Int J Dermatol 49(7):757–760CrossRefPubMedGoogle Scholar
  7. Brockow K, Grabenhorst P, Abeck D, Traupe B, Ring J, Hoppe U, Wolf F (1999) Effect of gentian vilot, corticosteroid and tar preparations in Staphylococcus-aureus-colonized atopic eczema. Dermatology 199(3):231–236CrossRefPubMedGoogle Scholar
  8. Coevorden AM, Coenraads PJ, Svensson A, Bouwes Bavinck JN, Diepgen TL, Naldi L, Elsner P, Williams CH (2005) Overview of studies of treatments for hand eczema-the EDEN hand eczema survey. Br J Dermatol 151:446–451CrossRefGoogle Scholar
  9. Czarnetzki BM (1986) Inhibitory effects of shale oils (Ichthyols) on the secretion of chemotactic leukotrienes from human leukocytes and on leukocyte migration. J Invest Dermatol 87(6):694–697CrossRefPubMedGoogle Scholar
  10. Di Nardo A, Sugino K, Wertz P, Ademola J, Maibach H (1996) Sodium lauryl sulfate (SLS) induced irritant contact dermatitis: a correlation study between ceramides and in vivo parameters of irritation. Contact Dermatitis 35(2):86–91CrossRefPubMedGoogle Scholar
  11. Diepgen T, Elsner P, Schliemann S, Fartasch M, Köllner A, Skudlik C, John SM, Worm M (2009) Guideline on the management of hand eczema ICD-10 Code: L20. L23. L24. L25. L30. J Dtsch Dermatol Ges 7(Suppl 3):S1–S16PubMedGoogle Scholar
  12. Diezel W, Schewe T, Rohde E, Rosenbach T, Czarnetzki BM (1992) Ammonium bituminosulfonate (Ichthyol). Anti-inflammatory effect and inhibition of the 5-lipoxygenase enzyme. Hautarzt 43(12):772–774PubMedGoogle Scholar
  13. Docampo R, Moreno S (1990) The metabolism and mode of action of gentian vilot. Drug Metab Rev 22:161–178CrossRefPubMedGoogle Scholar
  14. Frosch P (1985) Humane models for quantification of corticosteroid adverse effects. In: Maibach H, Lowe N (eds) Models in dermatology, vol 2. Karger, Basel, pp 5–15Google Scholar
  15. Frosch PJ, Aberer W, Agner T, August PJ, Conde-Salazar L, Constandt L, Engasser P, Heras F, John SM, Lauerma A, Le Coz C, Lindberg M, Maibach HI, Muston HL, Nixon RL, Rast H, van Tichelen WI, Williams J (2011) International comparison of legal aspects of worker’s compensation for occupational contact dermatitis. In: Duus Johansen J, Frosch PJ, Lepoittevin JP (eds) Contact dermatitis, 5th edn. Springer, Berlin/Heidelberg, pp 1029–1051CrossRefGoogle Scholar
  16. Götz H, Deichmann B, Zabel M (1978) Zur Frage der iatrogenen Karzinomprovokation durch Teeranwendung in der Dermatologie. Z Hautkr 53:751–755PubMedGoogle Scholar
  17. Hachem J, Crumrine D, Fluhr J (2003) pH directly regulates epidermal permeability barrier homeostasis, and stratum corneum integrity/cohesion. J Invest Dermatol 121(2):345–353CrossRefPubMedGoogle Scholar
  18. Hjort N, Nørgaard M (1991) Tars. In: Maibach HI, Roenigk HH Jr (eds) Psoriasis. Marcel Dekker, New York, pp 473–479Google Scholar
  19. Höger PH (1998) Topische Antibiotika und Antiseptika. Hautarzt 49:331–347CrossRefPubMedGoogle Scholar
  20. Hornstein OP, Nürnberg E (1985) Externe Therapie von Hautkrankheiten. Georg Thieme Verlag, Stuttgart/New YorkGoogle Scholar
  21. Korting H, Schöllmann C, Cholcha W, Wolff L (2010) Efiicacy and tolerability of pale sulfonated shale oil cream 4% in the treatment of mild to moderate atopic eczma in children: a multicentre, randomized vehicle-controlled trial. J Eur Acad Dermatol Venereol 24(10):1–7CrossRefGoogle Scholar
  22. Lebwohl M, Ali S (2001) Treatment of psoriasis, part 1: topical therapy and phototherapy. J Am Acad Dermatol 45:487–498CrossRefPubMedGoogle Scholar
  23. Lin A, Moses K (1985) Tar revisited. Int J Dermatol 24:216–218CrossRefPubMedGoogle Scholar
  24. Listemann H, Schölermann A, Meigel W (1993) Antifungal activity of sulfonated shale oils. Anzneimittelforschung 43(7):784–788Google Scholar
  25. Moritz O (1962) Einführung in die allgemeine Pharmakognosie. Fischer, StuttgartGoogle Scholar
  26. Nast A, Kopp IB, Augustin M, Banditt KB, Boehncke WH, Follmann M, Friedrich M, Huber M, Kahl C, Klaus J, Koza J, Kreiselmaier I, Mohr J, Mrowietz U, Ockenfels HM, Orzechowski HD, Prinz J, Reich K, Rosenbach T, Rosumeck S, Schlaeger M, Schmid-Ott G, Sebastian M, Streit V, Weberschock T, Rzany B, Germany Society for Dermatology (2006) S3-guidelines for the therapy of psoriasis vulgaris. J Dtsch Dermatol Ges 4(Suppl 2):S1–S126CrossRefPubMedGoogle Scholar
  27. Niedner R, Pfister-Wartha A (1990) Farbstoffe in der Dermatologie. Akt Dermatol 16:255–261Google Scholar
  28. Nürnberg W, Reimann H (2008) Benefit-risk analysis for prescribing triphenylmethane dyes. Hautarzt 59:833–837CrossRefPubMedGoogle Scholar
  29. Paghdal KV, Schwartz R (2008) Topical tar: back to the future. J Am Acad Dermatol 61(2):294–302CrossRefGoogle Scholar
  30. Post B, Jänner M (1971) Indication for tannin therapy in dermatology. Clinical experiences with Tannosynt. Ther Ggw 110:1477–1494PubMedGoogle Scholar
  31. Reimann H (2017) Lokaltherapie mit Farbstoff-Rezepturzubereitungen. Hautarzt 68:588–590CrossRefPubMedGoogle Scholar
  32. Roelofzen J, Aben K, Oldenhof U, Coenraads P, Alkemade H, van de Kerkhof P et al (2010) No increased risk of cancer after coal tar treatment in patients with psoriasis and eczema. J Invest Dermatol 130(4):953–961CrossRefPubMedGoogle Scholar
  33. Schmid M-H, Korting H (1996) Coal tar, pine tar and sulfonated shale oil preparations: comparative activity, efficacy and safety. Dermatology 193(1):1–5CrossRefPubMedGoogle Scholar
  34. Schneider HG (1981) Gerbstoffe sind in der Dermatologie noch zeitgemäß. Ärztl Praxis 33:2468–2470Google Scholar
  35. Schoppelrey HP, Mily H, Agathos M, Breit R (1997) Allergic contact dermatitis from pyoctanin. Contact Dermatitis 36(4):221–224CrossRefPubMedGoogle Scholar
  36. Silverman A, Menter A, Hairston JL (1995) Tars and anthralins. Dermatol Clin 13:817–833CrossRefPubMedGoogle Scholar
  37. Skudlik C (2007) Tertiäre Individualprävention (TIP) in der Berufsdermatologie. Universitätsverlag Osnabrück, OsnabrückGoogle Scholar
  38. Skudlik C, Wulfhorst B, Gediga G, Bock M, Allmers H, John S (2008) Tertiary individual prevention of occupational skin diseases: a decade’s experience with recalcitrant occupational dermatitis. Int Arch Occup Environ Health 81(8):1059–1064CrossRefPubMedGoogle Scholar
  39. Skudlik C, John SM, Weisshaar E, Scheid R, Wulfhorst B, Elsner P, Schönfeld M, Diepgen TL (2012) First results of from the multicentre study “rehabilitation of occupational diseases – optimization and quality assurance of inpatient management (ROQ)”. Contact Dermatitis 66(3):140–147CrossRefPubMedGoogle Scholar
  40. Smith CH, Jackson K, Chinn S, Angus K, Barker JN (2000) A double blind, randomized, controlled clinical trial to assess the efficacy of a new coal tar preparation (Exorex) in the treatment of chronic, plaque type psoriasis. Clin Exp Dermatol 25:580–583CrossRefPubMedGoogle Scholar
  41. Sprecher E (1990) Gerbstoffdrogen. Ärztl Kosmetol 20:178–182Google Scholar
  42. Stoughton RP, DeQuoy P, Walter JF (1978) Crude coal tar plus near ultraviolet light suppresses DNA synthesis in epidermis. Arch Dermatol 114:43–45CrossRefPubMedGoogle Scholar
  43. Thami GP, Sarkar R (2002) Coal tar: past present and future. Clin Exp Dermatol 27:99–103CrossRefPubMedGoogle Scholar
  44. Unna P (1887) Ichthyol. Br Med J 1(1371):800Google Scholar
  45. Van den Bogaard EH, Bergboer JGM, Vonk-Bergers M, van Vlijmen-Willems I, Hato SV, van der Valk P, Schröder JM, Joosten I, Zeeuwen P, Schalkwijk J (2013) Coal tar induces AHR-dependent skin barrier repair in atopic dermatitis. J Clin Investig 123:917–927PubMedGoogle Scholar
  46. Warnecke J, Wendt A (1998) Anti-inflammatory action of pale sulfonated shale oil (ICHTHYOL pale) in UVB erythema test. Inflamm Res 47(2):75–78CrossRefPubMedGoogle Scholar
  47. Werfel T, Aberer W, Augustin M, Biedermann T, Fölster-Holst R, Friedrichs F, Gieler U, Heratizadeh A, Kapp A, Przybilla B, Rietschel E, Schlaeger M, Schmid-Grendelmeier P, Sitters H, Staab D, Szczepanski R, Vieluf D, Voigtmann I, Worm M (2009) Atopic dermatitis: S2 guidelines. J Dtsch Dermatol Ges 7(Suppl 1):S1–S46PubMedGoogle Scholar
  48. Werfel T, Aberer W, Ahrens F, Augustin M, Biedermann T, Diepgen T, Fölster-Holst R, Gieler U, Heratizadeh A, Kahle J, Kapp A, Nast A, Nemat K, Ott H, Przybilla B, Roecken M, Schlaeger M, Schmid-Grendelmeier P, Schmitt J, Schwennesen T, Staab D, Worm M (2016) Leitlinie Neurodermitis (atopisches Ekzem; atopische Dermatitis). J Dtsch Dermatol Ges 14(1):e1–e75CrossRefPubMedGoogle Scholar
  49. (08.03.2017) DAC/NRF-Rezepturhinweise Steinkohlenteer, Steinkohlenteerlösung und Steinkohlenteerspriritus, Stand 08.03.2017
  50. (20.04.2017) DAC/NRF-Rezepturhinweise Holzteer
  51. Zesch A (1988) Externa – Galenik, Wirkung, Anwendung. Springer, BerlinGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck and Dermatologic Centre, Trauma HospitalHamburgGermany

Personalised recommendations