Over the counter products could contain corticosteroids

[Fred]

People with psoriasis often start with creams to sooth the skin, I have often reported about so-called naturel products having illegal potent topical corticosteroids. So you would think going to a pharmacy for over the counter products would be a safe bet, but this US research suggest differently.

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Introduction:
Skin conditions affect approximately 85 million individuals in the US alone. Numerous over-the-counter (OTC) skin products marketed online claim benefit for conditions such as psoriasis, eczema, and hyperpigmentation despite lacking clinically proven active ingredients. We and others, including regulatory agencies such as the US Food and Drug Administration (FDA), previously identified undeclared pharmacologically active ingredients (UPAIs) in OTC skin products, including potent topical corticosteroids at pharmacologically active doses. Such ingredients may explain apparent efficacy but may also pose substantial risks when used without medical supervision. To our knowledge, no widely adopted standardized approach exists to systematically identify UPAIs in OTC skin products. We performed a targeted assessment for the presence of UPAIs in 18 OTC skin products marketed online.

Methods:
This quality improvement study did not involve human participants and therefore did not require IRB approval or informed consent. Skin products were purchased from major online retail platforms and selected using predefined criteria: efficacy claims for inflammatory or persistent skin conditions, including dermatitis, psoriasis, eczema, or hyperpigmentation; absence of listed clinically proven ingredients for these conditions; and consumer engagement, defined as 100 or more reviews on at least 1 platform. Products with prior reports of UPAIs or branding or labeling characteristics similar to those of previously identified products were included if they met at least 1 criterion. Analytical screening for 28 corticosteroids and antifungals was performed using high-resolution liquid chromatography–mass spectrometry with tandem mass spectrometry confirmation as previously described methods. Products were purchased from February through December 2025 and analyzed from April 2025 through April 2026. When a UPAI was detected, 2 additional units of the same product were purchased and analyzed, resulting in 3 samples evaluated per product. At the time of analysis, review counts were also recorded from online platforms on which products were identified.

Results:
UPAIs were identified in 6 of 18 preselected products (33.3%) and in all 3 analyzed units of each positive product. The superpotent (class I), prescription-only corticosteroid clobetasol propionate was detected in 6 products (33.3%), 2 of which additionally contained the antifungals miconazole or terbinafine. Detected concentrations of clobetasol propionate ranged from approximately 0.01% to 0.46%, with the highest concentrations exceeding those in FDA-approved topical formulations (0.05%) by 9.2 fold None of these clinically proven active ingredients were disclosed on product labels. Products that tested positive had more than 10 000 combined user reviews across online retail platforms.

Be careful, go and see a doctor.

Source: amanetwork.com