Clinicians review the availability and potential misuse of prescription-strength topical steroids in the United States.
Topical steroids are used to treat inflammatory conditions of the skin, such as eczema. They are available in varying potencies. Low potency topical steroids may be available for purchase without a prescription. Topical steroids can cause systemic side effects such as growth retardation in children, high blood pressure, high blood sugar levels, abnormal hair growth and vision disturbances. Children and the elderly are more susceptible to these adverse effects. Applying the steroid to broken or diseased skin also increases the risk of developing adverse effects. The higher the strength of the steroid, the greater the risk of adverse effects.
A recent article published in JAMA Dermatology details a case of recurrent atopic dermatitis (eczema) and bacterial infection in a patient in the United States. The patient had been prescribed triamcinolone 0.1% ointment. As the medication did not resolve the condition, the patient purchased a cream without his physician’s advice. It was purchased at a store not approved to sell prescription medications.
The cream, Funbact-A, contains three active ingredients, one of which is a prescription strength topical steroid called betamethasone dipropionate. The other two ingredients in the cream are clotrimazole (antifungal) and neomycin sulfate (antibacterial). The patient used the cream for a few days before it was discontinued at the physician’s office. There were no noted adverse reactions in the short period of time the medication was used. The clinicians investigated the availability of Funbact-A. It was found to be available online, circumventing the need for a prescription prior to purchase.
Regulatory agencies like the US Food and Drug Administration (FDA) and Health Canada are responsible for promoting public safety and determine the level of accessibility of drugs to the public. In this instance, the sale of this regulated product was reported to the FDA. It is important to be aware of what medications we purchase and where we obtain them. It is recommended that medications be purchased only at designated pharmacy outlets. This ensures that products purchased are the highest quality and considered safe for general use.
Written by Anuolu Bank-Oni, Pharm.D, CDE
Burke KT, Fricke MA, Carver DeKlotz CM. Prescription-Strength Topical Steroids Sold Without Prescription. Jama Dermatology
Dhar S, Seth J, Parikh D. Systemic Side-Effects of Topical Corticosteroids. Indian J Dermatol. 2014 Sep-Oct; 59(5): 460–464.