Implications of Emulating a Dermatologist: A Study of Topical medication usage for dermatoses prescribed by Non-Dermatologists in a rural area

Abstract

Introduction: Over-the-counter (OTC) medications refer to drugs that a patient can purchase without prescription from a registered medical practitioner. Topical OTC medication usage for skin disorders is common in rural India, due to non-availability of Dermatologists. Inappropriate use of such drugs has resulted in various cutaneous adverse effects and antifungal resistance. Aims: To determine the pattern of usage of the different OTC topical medications for various Dermatological indications, their source of prescription and their cutaneous adverse effects. Materials and Methods: Patients presenting to Dermatology OPD with a history of usage of topical OTC drugs for skin disorders were recruited. Details such as type of OTC drug used, the source of its prescription, indications for which it was advised and patients knowledge regarding steroids were documented. Patients were examined for cutaneous adverse effects. Results: Out of 100 patients there were 46 males and 54 females. Dermatophytosis (29%) was the most common indication for which these drugs were used. The common side effects were itching (17.86%) and burning sensation (13.39%). Majority of the drugs were advised by pharmacists (36%) followed by friends and relatives (29%). Betamethasone was the commonest steroid and Betnovate was the commonest brand misused. Majority (97%) of the patients were unaware of topical steroids and their adverse effects. Conclusion: The growing threat of OTC drug abuse is evident from our study. Stringent drug control policies are required to regulate the sale of topical OTC drugs. Creating awareness among patients and General physicians about the adverse effects of OTC topical medications including steroids is truly the need of the hour.