Unlabeled Active Drugs Detected in Some OTC Skin Products
Researchers analyzed 18 over-the-counter skin creams sold online and found undeclared active drugs in six of them. The detected substances included clobetasol propionate, a prescription corticosteroid, plus the antifungals miconazole and terbinafine, none of which appeared on the labels. The authors warn that repeated exposure may cause skin and systemic harms and say current regulatory oversight is insufficient.
Researchers examined 18 online OTC skin creams and found six contained pharmacologically active substances absent from their labels. Additional units of those six products also tested positive. Clobetasol propionate, a prescription-only superpotent corticosteroid, appeared in all six at roughly 0.01% to 0.46%; the strongest sample was over nine times the 0.05% level in approved topical forms. Two products also held miconazole or terbinafine.
These items had drawn more than 10,000 combined online reviews and some ranked as category bestsellers. The authors note roughly 85 million Americans have skin conditions, and nonprescription products lack the premarket review required for approved drugs. They warn repeated use could damage skin or affect the body systemically, including adrenal suppression, and that oversight remains inadequate.
People managing chronic skin conditions online may be most affected, because they could unknowingly apply potent steroids or antifungals while believing the creams are benign. Short-term improvement might delay proper diagnosis or treatment, and repeated use may bring skin thinning, discoloration, or systemic effects. Clinicians may need to ask about online purchases when symptoms worsen or appear atypical. The findings could also prompt greater scrutiny of marketplace listings and label accuracy, though the study's small sample limits broad conclusions.