Understanding Over-the-Counter Skin Medications

Effectively Navigate the Drugstore Aisles

Putting a bandaid on child's knee
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Even if you've outgrown the years of skinned knees and banged-up elbows, you still might get scratches and scrapes, along with the occasional itchy spot. Although these conditions probably aren't serious enough to warrant a visit to the doctor, you shouldn't completely ignore them because they could get infected.

Many over-the-counter (OTC) skin medications allow you to treat your skin yourself, but standing in the drugstore aisle staring at the hundreds of products available is overwhelming.

Here's how to choose the right products:

Topical Antiseptics

Active Ingredients: isopropyl alcohol, hydrogen peroxide, benzalkonium chloride.

Common Brand Names: BD Alcohol Swabs, pharmacy brands, generic rubbing alcohol and hydrogen peroxide, Bactine (also includes lidocaine, a pain reliever).

How They Work: Topical antiseptics slow or halt the growth of germs on the skin's surface to prevent infection in scrapes and cuts. Routine use of these products, however, is being closely scrutinized. Because isopropyl alcohol and hydrogen peroxide can also irritate wounds, rinsing the scrape with running water is equally effective, according to the American Academy of Family Physicians.

How to Use: One liquid or spray application immediately after injury.

Important Information: If the wound has not improved in one week, you need to see a doctor.

Antibiotic Ointments

Active Ingredients: bacitracin, polymyxin, neomycin.

Common Brand Names: Neosporin, Polysporin. Generics are available.

How They Work: They prevent and treat infections by killing bacteria and they keep wounds moist.

How to Use: Apply one to three times a day. Cover with bandage.

Important Information: Neosporin contains all three active ingredients. If you're allergic to neomycin, choose Polysporin, which contains larger amounts of bacitracin and polymyxin, but no neomycin.

Neomycin may result in irritation, burning, redness, rash or itching in those who are allergic. Tell your doctor if you are pregnant, breastfeeding, considering pregnancy or have had kidney disease before using neomycin.

Topical Pain Relievers

Active Ingredients: lidocaine, benzocaine, pramoxine, butamben, tetracaine, camphor.

Common Brand Names: Bactine, Xylocaine, Lanacane, Campho-Phenique. Available as generics.

How They Work: They reduce pain by blocking nerve signals, resulting in short-term numbness.

How to Use: Apply one to three times a day.

Important Information: In rare cases, using too much or applying to a large area can cause death if large quantities are absorbed into the bloodstream. Tell your doctor if you are also taking medications for heart rhythm disorders. Many products - including Bactine First Aid Antibiotic Plus and Mycitracin - combine pain relievers with antibiotic ointments. Topical pain relievers can also be used to relieve itching.

Anti-Itch Products

Active Ingredients: calamine, diphenhydramine, hydrocortisone.

Common Brand Names: Calamine Lotion, Caladryl, Aveeno, Benadryl, Cortizone, Cortaid, Gold Bond. Available as generics.

How They Work:  Calamine creates a cooling sensation as it evaporates from your skin. Topical Benadryl (diphenhydramine) is an antihistamine that works against chemicals called histamines, which cause itching after they are triggered in the body by the presence of allergens.

Cortaid (hydrocortisone) is a topical steroid that inhibits chemicals that cause inflammation, redness, and swelling. It is usually applied to treat allergic reactions, eczema or psoriasis. Anti-itch products are available in sprays, creams, and gels.

How to Use: Use three to four times a day as needed for itching.

Important Information: Side effects of calamine can include hives, difficulty breathing, and swelling of the face, lips, tongue or throat. Benadryl (diphenhydramine) may produce increased sensitivity to the sun and sunlamps. Side effects of Cortaid (hydrocortisone) may include redness, burning, itching, peeling, blistering and stretch marks or thinning of the skin. Avoid getting any anti-itch medicines in your eyes, ears or nose.

General Precautions

The U.S. Food and Drug Administration warns that the medicines in all topical creams and ointments penetrate the skin and enter the bloodstream. Therefore they should not be used in amounts or in numbers of applications that exceed package directions.

Sources:

"Bacitracin, Neomycin, and Polymyxin B (Topical)." myhealth.ucsd.edu. 31 Mar. 2008. University of California San Diego. 10 Feb. 2009: http://myhealth.ucsd.edu/library/healthguide/en-us/DrugGuide/topic.asp?hwid=d03524a1&.

"Calamine (Topical)." myhealth.ucsd.edu. 6 Mar. 2006. University of California San Diego. 10 Feb. 2009: http://myhealth.ucsd.edu/library/healthguide/en-us/DrugGuide/topic.asp?hwid=d03653a1&.

"Cuts, Scrapes and Stitches: Caring for Wounds." familydoctor.org. Dec. 2006. American Academy of Family Physicians. 10 Feb. 2009: http://familydoctor.org/online/famdocen/home/healthy/firstaid/after-injury/041.html.

"Diphenhydramine Topical." nlm.nih.gov. 1 Sep. 2008. National Institutes of Health. 10 Feb. 2009: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601044.html.

"Lidocaine Topical." myhealth.ucsd.edu. 21 Feb. 2008. University of California San Diego. 10 Feb. 2009: http://myhealth.ucsd.edu/library/healthguide/en-us/DrugGuide/topic.asp?hwid=d00683a1&.

"Neomycin Topical." nlm.nih.gov. 1 Sep. 2008. National Institutes of Health. 10 Feb. 2009: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682274.html.

"Neosporin Drug Facts." brands2liveby.com. 2009. McNeil-PPC, Inc.. 10 Feb. 2009: http://www.brands2liveby.com/product.aspx?id=363.

"Original First Aid Liquid." bactine.com. 2008. Bayer Health Care. 10 Feb. 2009: http://www.bactine.com/original.htm.

"Polysporin Drug Facts." brands2liveby.com. 2009. McNeil-PPC, Inc.. 10 Feb. 2009 <http://www.brands2liveby.com/product.aspx?id=430>.

"Skin Rashes and Other Changes." familydoctor.org. 2009. American Academy of Family Physicians. 10 Feb. 2009: http://familydoctor.org/online/famdocen/home/tools/symptom/545.html.

Smith, Robert. "A Critical Discussion of the Use of Antiseptics in Acute Traumatic Wounds." Journal of the American Podiatric Medical Association 95:2(2005):148-53. 10 Feb. 2009: http://www.japmaonline.org/cgi/content/abstract/95/2/148. (subscription)

"Use Caution With Over-the-Counter Creams, Ointment." fda.gov. 1 Apr. 2008. US Food and Drug Administration. 10 Feb. 2009: http://www.fda.gov/consumer/updates/otc_creams040108.pdf.

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