In an article published in Cutis, a peer-reviewed clinical journal for dermatologists, Sophie A. Greenberg, MD, from the Department of Dermatology, Columbia University Medical Center, New York, New York, reported that dermatologists have the highest rate of recommending OTC topical formulations compared with all medical specialists. These products are endorsed by pharmacists to treat a vast variety of ailments, including dermatitis and acne, as well as to prevent damage to the skin from the sun. 

According to Dr. Greenberg, “Over-the-counter (OTC) topical products commonly are discussed during dermatology encounters. Unsurprisingly, dermatologists recommend OTC topical formulations at the highest rate of all medical specialists. These products may aid in the treatment of skin disease and include shampoo for seborrheic dermatitis, moisturizer for atopic dermatitis, and an armamentarium of products for acne. Conversely, an incorrect selection of OTC topicals can cause or exacerbate skin conditions or result in systemic toxicity.”

In her article, Dr. Greenberg reminds healthcare professionals who make OTC recommendations that these products,  including topical steroids, antimicrobials, and sunscreens, are categorized as drugs. This makes the Australian analysis, which its authors point out is the first study to compare the cost effectiveness of primary prevention and early detection in the context of skin cancer, even more compelling.

Using Markov data modeling from population-based, randomized controlled trials carried out in Queensland, Australia, the researchers compared the long-term economic impact of melanoma prevention by sun protection with the corresponding impact of early detection to decrease melanoma deaths. 

Lead author of the Australian study, Associate Professor Dr. Louisa Gordon, a health economist and group leader of health economics at QIMR Berghofer, describes the following three strategies that were compared as primary prevention: daily sunscreen use, early detection consisting of whole-body skin examination by physician, and, no intervention, which meant no dedicated early detection or primary prevention program for melanoma. With a comprehensive description of methods used, including quality-adjusted life years and 30-year modelling based on the Markov health state transition cohort model, the researchers concluded that primary prevention through use of daily sunscreen was an effective intervention.

Results were reported per 100,000 subjects for early detection, primary prevention, and no intervention, as 2,446, 1,364 and 2,419 new melanomas; 556, 341, and 567 melanoma deaths; 64,452, 47,682, and 64,659 keratinocyte cancers; and £493.5, £386.4, and £406.1 million in economic costs, respectively.

Based on these results, the authors emphasize that primary prevention with the use of sunscreen should be prioritized as an investment to control melanoma.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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