title: Trends in the use of topical over the counter products in the management of dermatologic disease in the United States.
abstract: BACKGROUND
  Over the counter (OTC) products play an important role in treating and preventing disease in the U.S. Topical OTCs are widely used but use in dermatology is not well defined.
  
  
  OBJECTIVE
  To characterize topical OTC use in the U.S.
  
  
  METHODS
  The National Ambulatory Medical Care Survey was queried for physician visits in which topical OTCs were recorded. Physician specialty, patient demographics, and diagnoses were examined and linear regressions were performed to determine trends over time.
  
  
  RESULTS
  From 1989 to 2008, there were an estimated 320 million visits documenting topical OTC recommendations; the majority of which were visits to a dermatologist (33.5%). Dermatologists most commonly recommended hydrocortisone (16.9%), benzoyl peroxide (13.3%), and sunscreen (7.4%). Dermatologists were more likely than other providers to use moisturizers in the treatment of dermatologic disease. Overall, topical OTC recommendations by all physicians has decreased over time (p < 0.0001). However, dermatologists' recommendations for moisturizers and sunscreens has increased significantly.
  
  
  CONCLUSIONS
  Topical OTC products have an important role in the prevention and treatment of dermatologic disease. Topical OTC recommendations are decreasing over time whereas their use as complementary components (sunscreen/moisturizers) appears to be increasing. Increased awareness of the utility of these agents may help to improve patient outcomes.
authors.affiliation: Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Bridgit V
authors.initials: BV
authors.lastname: Nolan
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Levender
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.forename: Ashley N
authors.initials: AN
authors.lastname: Feneran
authors.forename: Alan B
authors.initials: AB
authors.lastname: Fleischer
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D012871:Skin Diseases / Q000188:drug therapy*; D014481:United States
chemical_list: D004366:Nonprescription Drugs