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Factors affecting treatment choices in dermatology/skin care

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What are the most important factors in choosing Rx and OTC treatments for prescribers vs. patients? Are they always aligned? How can we better understand the needs and preferences of patients to increase compliance and improve outcomes?

Lidia Pomaville, PA-C, MPAS
40 months ago

5 answers

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MOst important to me is the doctors knowledge of the known carcinogens in the products they are using on people and promoting for sale. Most dermatologists are unaware of the many dangers of the chemicals in daily used personal care and beauty cosmetics. the US Reports on Carcinogens include mineral oil, petrolatum, propylene glycol, diethanolamine, triethanolomine, parabens, formeldyhyde and many, many more. Many of these chemicals are in the very products the doctors use.There have been no new laws on any product put to market since1938, so anything goes regarding ingredients used. PublicsRight2Know.org

shelley kramer
40 months ago
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I'd agree but go further. First, regarding dermatologists, once practicing, dermatologist awareness of products and technology are in their hands - its not mandated. That's frightening as a consumer so i deeply research all of my caregivers and all of the treatments. I sense that I am the exception. A dermatologist and the patient may accordingly be alligned in wanting to cure the condition but not necessarily at all beyond that more often than one might think. The patient may want cost and fast cure and no pain and the like whereas the doctor may have many other influencers - business costs, operations costs, reimbursement rates, payment terms, a screwed up schedule. those are all things interfering and distracting the doctor from the best care.
For professionsl treatment, dermatologists as a choice by the consumer are limited to reviews if even read, referrals, professional or otherwise, or by pure circumstance. What else can they do?
Regarding product choices for OTC, the selections are as for any marketed consumer product and any limits imposed by regulation. Thats a whole different discussion.
Safety? Ethical physicians, pharmacies and here in the US our FDA.

Adam Malofsky, PhD
40 months ago
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Regarding outcomes, the biggest issue in prescription and often OTC regards compliance. its noted in many studies that 80% of clinical patients do not take their medications as prescribed with almost 30% not taking them at all or enough to have an effect. The worst part? They then lie to their doctors. Game over at that point.
A potential solution for oral medications? Tagents in the blood or other fluids peristent enough for a simple, near instant test as for glucose or in urine to test for compliance.
A similar topical test could be visual or better invisble by UV or other physiochemical property like in biological research to indicate application and its persistance. Not sure what an OTC comsumer would accept for validation or compliance beyond "healing".

Adam Malofsky, PhD
40 months ago
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Regardless of whether you are talking about cosmetic or therapeutic products, the concept of 'cosmetic elegance' is common between staff and patients. The idea that a cream, for example, is not greasy or shiny; that application is simple; that the way you use the product does not detract from its clinical value - are all important elements in a derm topical product that will impact compliance (and prescribing behaviors). As for orals, they are no different than any other category - efficacy without safety issues (eg, medication guides for some acne products), and less frequent dosing are the key drivers for compliance.

Nancy Barlow
40 months ago
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The major skin diseases (dermatological conditions) are (i) Acne, (ii) Dry Skin, (iii) Dermatitis (Eczema & Seborrheic dermatitis & Contact dermatitis), (iv) Pruritus (itching), (v) Rosacea, (vi) Psoriasis, (vii) Alopecia, (viii) Moles, (ix) Hyperhidrosis, (x) Spider Veins, and (xi) Wrinkles and other age related changes in the skin condition.

The severity level of these conditions determine the treatment options either go for OTC or Rx. Prior going for the available treatment options (OTC or Rx), a thorough examination and diagnosis with an a dermatologist is prerequisite. Prescriptions medicine are available both in topical and oral format. Best on the convenience patients can ask the required format and treatment options (OTC or Rx).

Samares B
38 months ago

Have some input?