Over the counter medication: a study among dermatology outpatients

Abstract

<p class="abstract"><strong>Background:</strong> Over-the-counter (OTC) medicine or non-prescription medicine refer to medicine that you can buy without a prescription from a health care professional. The prevalence, clinical patterns and causative agents of cutaneous drug reactions vary among different populations. The most widely used over the counter medication in dermatological practice are topical steroids. The main objective is to know awareness among the people about over the counter medication and clinical analysis of effects caused by them, to find the most commonly used OTC medication.</p><p class="abstract"><strong>Methods:</strong> Prospective questionnaire based study comprising of 453 cases of cutaneous effects due to over the counter medication was carried out for a period of 1 year. Diagnosis was made mainly based on clinical features.<strong></strong></p><p class="abstract"><strong>Results:</strong> Super potent and high potent steroids were the most common OTC medication used which caused nodulocystic acne in 51.6% patients, atrophy in 3.97% patients, tinea incognito in 23.8% patients. Irritant contact dermatitis (due to hydroquinone, cotrimoxazole, neomycin) was seen in 18.5% patients. Fixed drug eruption was seen in 1.32% patients, cushingoid features in 0.66% patient.</p><p class="abstract"><strong>Conclusions:</strong> Indiscriminate abuse of steroids by people due to lack of awareness should be stopped. This misuse and damage have serious effect on the quality of life of the patients in general and the skin of the face in particular. Management is difficult and necessitates psychological counselling as well as physical soothing of the sensitive skin. For the safety of people Indian association of Dermatology, Venereology and Leprology (IADVL) also started IADVL Task force Against Topical Steriod Abuse (ITATSA).</p>

The Spectrum of Cutaneous Adverse Drug Reactions Following the Application of Topical Medications: An Observational Study at a Tertiary Care Center

“…This finding was similar to the study conducted by Varshney et al [9], which showed fungal infection (59.5%) as the most common indication. The study by Birudala et al showed that most patients used topical medications for acne (39.7%), which was different from our research [3].…”

“…The male to female ratio (M: F) was 0.9:1. Our finding was similar to that of the study conducted by Birudala et al (M: F = 0.6:1) [3]. Over-the-counter, freely available fairness creams are responsible for the raised numbers of female patients in our study.…”

“…People generally use over-the-counter (OTC) topical medications for common skin conditions like acne, hyperpigmentation, hypopigmentation, bacterial and fungal infections, eczema, pruritus, burns, etc. OTC or nonprescription medicine is the medicine that anyone can buy without a prescription from a health care professional [3]. Commonly available OTC creams or ointments for skin conditions include steroids, antibiotics, antifungals, dithranol, coal tar, salicylic acid, urea, hydroquinone, tretinoin, herbal ingredients, various fixed drug combination (FDC) creams, etc.…”

“…There are very few studies in India addressing this problem [3][4][5]. We have conducted this study to observe demographic data, various clinical presentations of cutaneous adverse drug reactions, commonly used agents, mode of misuse, and source of drug prescription.…”