Evidence map›Paper›PMID 40554469›Full record

ArticlePLOS global public health2025

Over the counter use of topical corticosteroid for skin conditions among patients before attending skin specialist clinic in Nepal: A qualitative study.

Yogesh Poudyal, Nishika Aryal, Anuja Rajbhandari, Mukti Ghimire, Sanjaya Acharya, Shristi Raut, Bishal Joshi, Sunil Pokharel, Phaik Yeong Cheah, Bipin Adhikari

Abstract read
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yogesh PoudyalSarnath Skin Centre, Shanti Path, Bhairahawa, Nepal.ORCID https://orcid.org/0000-0001-6692-5688
Nishika AryalDepartment of Public Health, La Trobe University, Melbourne, Australia.ORCID https://orcid.org/0009-0003-7327-6948
Anuja RajbhandariDepartment of Public Health, La Trobe University, Melbourne, Australia.ORCID https://orcid.org/0009-0009-7786-9680
Mukti GhimireDepartment of Pediatrics, Nepal Police Hospital, Krishnadhara Marg-3, Kathmandu, Nepal.
Sanjaya AcharyaAcademy for Data Science and Global Health, Kathmandu, Nepal.
Shristi RautDepartment of Microbiology, Institute of Medicine, Tribhuvan University, Maharajgunj Campus, Kathmandu, Nepal.
Bishal JoshiDepartment of Physiology, Universal College of Medical Sciences, Bhairahawa, Nepal.
Sunil PokharelCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Phaik Yeong CheahCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Bipin AdhikariCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0001-8981-3910

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Identifiers

PMID40554469
PMCPMC12186941

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.