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Coal Tar for Psoriasis
Dr. Alan Rockoff,
I have read your response to http://www.medhelp.org/posts/Dermatology/Scytera-Coal-Tar-Foam-2/show/1005637. Which addresses a patient with coal tar for use for penile psoriasis.  I have mild glans psoriasis and had heard that coal tar may help.  I bought a small jar of psoriasin ointment with 2% coal tar.  I used this product for about 6 weeks once daily before I went to my office for 8 hours, before I stopped use due to mediocre results.  I know you are a dermatologist but knowing how medication reacts to other organs are essential.  

My question is have there been reports of male infertility after topical coal tar use? I have a 2 year old child and I have not used psoriasin for about a year.  I have been trying to concieve a second and fear the coal tar has affected my sperm production and motility.  The internet may be the cause of this fear.  Articles such as:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740921/

and

http://www.fda.gov/ohrms/dockets/dailys/00/oct00/102700/c0006.pdf

were used as source references for my concern.

I estimate I have used approximately 2 oz of ointment= approximately 1 gram of coal tar= 1% Benzo(a)pyrene 10 mg available for absorption.  I assue most of ointment will rub off on clothes.  But my concern is that if BAP is absorbed into the scrotum directly through the blood-testis barrier that my Sertoli cells may be permantly damaged.

I understand you may say that I am very paranoid, but I greatly regret ever purchasing this product.  Are my chances of birth defects increased?

Most sources say topical use up to 5% coal tar are considered safe.  But that is refering to cancer risk.  What if testicular risk was not evaluated or noted at the time of testing.  Most men who are infertile do not know why, this maybe a reaction many men are un-aware of until they find they cannot have children and wonder why.  This issue has greatly weighted down my conscience, every month that passes that we dont get pregnant increases my worry.  I am planning on scheduling a semen analysis but just want to get an opinion as to the validity of my concern.

Any opinion on this subject would be greatly appreciated.

thanks,





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