A third of tested OTC skin products had secret prescription steroids. A new study found that 6 of 18 over-the-counter skin products purchased online contained undisclosed clobetasol propionate — a prescription-only, superpotent corticosteroid — at concentrations up to 9.2 times higher than FDA-approved levels. Experts say this signals a serious gap in regulatory oversight of OTC skincare products.
One in three over-the-counter skin products tested in a new study contained a hidden, prescription-strength steroid — and consumers had no idea. Published in JAMA Network Open, the study found that 6 of 18 OTC products purchased online for conditions like eczema, psoriasis, and hyperpigmentation contained undisclosed clobetasol propionate, a class 1 prescription-only corticosteroid. These weren't obscure products either — they collectively had over 10,000 user reviews across online platforms.
The findings are raising red flags among dermatologists. Clobetasol propionate is rarely recommended even by prescription for facial use, and long-term unsupervised exposure can cause serious side effects including skin atrophy, steroid acne, and hormonal disruption — some of which may be irreversible. Three of the six flagged products were skin-lightening creams, and two also contained undisclosed antifungals.
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Why it matters: These products are widely accessible and heavily marketed, yet they carry hidden risks that even physicians wouldn't anticipate. The study highlights a critical need for stronger FDA surveillance of online OTC skincare markets — and serves as a reminder for clinicians to ask patients about products they're sourcing on their own.
