Over the counter use of topical corticosteroid for skin conditions among patients before attending skin specialist clinic in Nepal

A qualitative study

Bibliographic Data

ID19592950
AuthorsYogesh Poudyal (0000-0001-6692-5688, Sai Krishna Medical College & Hospital, corresponding author), Nishika Aryal (0009-0003-7327-6948, La Trobe University, corresponding author), Anuja Rajbhandari (0009-0009-7786-9680, La Trobe University, corresponding author), Mukti Ghimire (Government of Nepal, corresponding author), Sanjaya Acharya (0000-0003-0543-2868, corresponding author), Shristi Raut (0000-0002-5599-7763, Tribhuvan University Teaching Hospital, corresponding author), Bishal Joshi (0000-0001-9096-4660, College of Medical Sciences, corresponding author), Sunil Pokharel (0000-0002-6716-7732, University of Oxford, corresponding author), Phaik Yeong Cheah (0000-0001-6327-3266, Mahidol University, corresponding author), Bipin Adhikari (0000-0001-8981-3910, Tribhuvan University, corresponding author)
EditorsJulia Robinson (0000-0003-0719-3995)
Year2025
Volume5
Issue6
Pagese0004812
Publication date2025-06-24
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0004812
PMID40554469
OpenAlexW4411585073
LanguageEN
References cited45

Access to topical corticosteroids (TCs) globally includes over the counter (OTC) sale without proper guidelines, exacerbating treatment-resistant infections and complicating outcome of skin conditions. The main aim of the study was to evaluate the reasons behind OTC use of TCs among patients with skin conditions before attending a skin specialist clinic. This study was conducted from September 2021 to March 2022. The study included in-depth interviews (IDIs) and observations, among a total of thirty-one patients with specific skin conditions using TCs, at the Sarnath Skin Centre in Siddhartha Nagar (Bhairahawa), Nepal. All interviews were conducted in the Nepali language, audio-recorded, transcribed and translated into English and were coded and analyzed in NVivo. Among the 31 individuals diagnosed with Dermatophytosis, Melasma, Eczema, common treatments included use of Sonaderm (Clobetasol, Gentamycin and Miconazole), Derma-KT (Clobetasol, Gentamicin, Ketoconazole and Iodochlorhydroxyquinoline) and steroid-infused products from non-medical sources for prolonged periods of time, exposing patients to transient recovery and perpetuating a vicious cycle of OTC treatment seeking until patients failed to recover. OTC seeking was facilitated by participants’ easy access to drug dispensers, suggestions from and practice of family and friends which often led to temporary relief for a few weeks/months. In addition, access factors (e.g., distance, cost, time), convenience factors (e.g., ease of presenting at the drug store compared to skin clinic) also influenced the choice for OTC. There was a lack of knowledge related to adverse effects of topical steroids, including proper guidance on the use of topical medications and limitations of home remedies. OTC use of topical medications poses significant challenges, often leading to complicated skin cases that present late at skin-specialist clinics. A multi-pronged public and community engagement approach is critical to curb the treatment seeking dynamics among patients developing skin conditions

Corticosteroid · Family medicine · Medical prescription · Over-the-counter · Qualitative research · Sociology · Traditional medicine · Allergic Rhinitis and Sensitization · Dermatology and Skin Diseases · Medicine · Nursing · Urticaria and Related Conditions · Dermatology · Surgery

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Open DOIOpen Access