Published: 2019-07-24

Over the counter medication: a study among dermatology outpatients

Ramadevi Birudala, Shruthi Hassan Nagaraj, Kousar Begum Bannala, Vijayarangam ShivaKumar


Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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).


Over the counter medication, Nodulocystic acne, Misuse, IADVL, Topical steroid dependant face

Full Text:



Panda A, Pradhan S, Mohapatra G, Mohapatra J. Drug-related problems associated with self-medication and medication guided by prescription : A pharmacy-based survey. Indian J Pharmacol. 2016;48:515-21.

Brody JE. Over-the-Counter Medicines’ Benefits and Dangers. The New York Times. 30.11.2015.

Choon S, Lai N. An epidemiological and clinical analysis of cutaneous adverse drug reactions seen in a tertiary hospital in Johor, Malaysia. Indian J Dermatol Venereol Leprol. 2012;78:734-9.

Mehta AB, Nadkarni NJ, Patil SP, Godse KV, Gautam M, Agarwal S. Topical corticosteroids in dermatology. Indian J Dermatol Venereol Leprol. 2016;82:371-8.

Mishra AK, Saraswat D. Topical corticosteroid abuse in dermatology. IOSR journal of dental and medical sciences 2016;15:110-4.

Nagesh TS, Akhilesh A. Topical steroid awareness and abuse: a prospective study among dermatology outpatients. Indian J Dermatol. 2016;61:618-21.

Kumar S, Goyal A, Gupta YK. Abuse of topical corticosteroids in India: Concerns and the way forward. J Pharmacol Pharmacother. 2016;7:1-5.

Lahiri K, Coondoo A. Topic al steroid damaged/dependent face (TSDF): An entity of cutaneous pharmacodependence. Indian J Dermatol. 2016;61:265-72.

Saraswat A, Lahiri K, Chatterjee M, Barua S, Coondoo A, Mittal A, et al. Topical corticosteroid abuse on the face: A prospective, multicenter study of dermatology outpatients. Indian J Dermatol Venereol Leprol. 2011;77:160-6.