(February, 1999)

An Alternative to Tar Shampoos?
from Amy D.

Hello! I've been lurking for a little while now, gaining information, a sense of comradeship, and a few laughs. I finally have something to contribute, so I thought I would.

I've had P since I was about 13. My derm at the time had me using a coal tar shampoo. As I'm sure many have experienced, it dried out my hair and smelled awful. Part of my teenage rebellion was to refuse the torture of this and all of the other goops that didn't do anything to clear my skin. The smell of coal tar still makes me sick to my stomach.

I'm 28 now, and my P is so bad I've had to go back to the dermatologist. This past visit, he said I should go back to the T/Gel. A friend said that she had seen a non-coal tar shampoo at our local natural foods store. As it turns out, Aubrey Organics makes a scalp treatment shampoo with calaguala fern and cade tar. I've been using it for about a week and I'm getting results. It still dries my hair quite a bit, but the smell is actually pleasant.

As for other treatment... I was completely clear for about a week this fall after using Triamcinolone faithfully day and night. Then the stress of full-time work and part-time school hit and my spots became resistant to the Triamcinolone. I tried Dovonex just before the Triamcinolone and had no change. Currently I'm trying Tazorac in the morning and the Triamcinolone at night. The Tazorac is doing what NPF said it would do—it's really red and hurts some, but I think it is working. I've learned not to hold my breath on any of these, but I'm hopeful with this one. We'll see.

While I'm here, I want to thank you, Ed, for providing this space. I leave the derm's office in tears of frustration every visit. I still cry in the car all the way home, but then I click on Flake HQ and find myself smiling, nodding in agreement, and feeling not so alone. So, thanks! -Amy D.


Ed's Response: Thanks for sharing, Amy. You think T/Gel stinks? Try Pentrax some time! Pentrax is the only smelly, ugly shampoo I've tried that really works for me. Pentrax' concentration of coal tar extract is supposedly the strongest available over the counter. And, unlike Neutrogena Dermatologics' T/Gel, the Pentrax folks don't even try to mask the obnoxious smell and feel of their product. Oh well, no pain, no gain ... right? Unfortunately (or fortunately) I can usually find Pentrax here in the Blue Grass only once or twice a year and it's too expensive to really stock up. So, in the Pentrax-less periods, I use Extra Strength T/Gel every day. T/Gel can't control my scalp P alone. To really get the scalp P to quiet down I have to occlude my "scalp cocktail" under a showercap at night. (My pharmacist has informed me that the scalp cocktail, which he compounds himself, is a combination of tar extract and salicylic acid. The tar extract inhibits rapid skin growth; the salicylic acid aids in flake removal. The concoction is expensive because it is extremely difficult to get these two substances to co-exist in a common agent—the same reason Neutrogina has two separate products, T/Gel and T/Sal.)

Thanks for pointing to Aubrey Organics scalp treatment shampoo. I'd not heard of this before and am going to try it. A bit of time off from the tar sounds good to me!

Good luck with the Dovonex and Tazorac. You've probably read what those two drugs did (and didn't do) to me (see Archives). Unfortunately I appear to be in the 20% category of flakers who don't do well with either of these. (I think I'm too old and set in my ways.)

I empathize with your leaving the derm's office in "tears of frustration." Eventually I learned P-driven visits to my derm were never likely to garner any other kind of reaction, so I made a conscious decision to knock them off (or down, at least). It just got silly for me to pay $40 a pop for my derm to barely look at the same old lesions, scratch his head, and write a prescript for the next thing on his list. (It got silly after we'd been through the UVA/B, PUVA, intralesion steroid injections, dismissed systemic treatments, and fixed on topical palliatives as my best bet.) It's come to this: I contact my derm if something extraordinary is going on or when I need prescripts renewed. Twice a year he makes me visit so he won't get into trouble for dolling out prescripts without observation. Since he can't cure me, he seems happy that I'm living with it. For me, Amy, that seems to be the ticket—learning to live with it.

Stay in touch! -Ed

T/Gel Overnight

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