Avoid these OTC drugs | The Health Culture

I try to resist writing about health advice, since most health news is designed to increase anxiety unnecessarily. But here’s something I found that’s quite sensible and helpful. It’s a post by Dr. Edward Pullen on over-the-counter (OTC) medications at KevinMD.

Scarring, stuffy noses, headaches, and sleep aids

You might think that products sold without a prescription would have no harmful side effects. Or at least that they’d be useful. That’s not always the case.

Topical vitamin E. The evidence that vitamin E can reduce scarring is “sketchy.” As a side effect it can cause a “severe topical skin reaction.” Simply keeping a wound moist while it’s healing will reduce scarring and promote healing.
Afrin nasal spray. The recommended time period for using Afrin is three days, but people often continue to use it for four days or more. The side effect here is that nasal passages become so congested you can no longer breathe through your nose. Relief comes only when you use the spray again. Don’t be tempted to overuse. An alternative is a nasal rinse.
Daily headache medication. The problem here is rebound headaches — a symptom of withdrawal from medication. This applies to migraine sufferers especially.
Antihistamine use in the elderly. Many OTC sleeping aids, such as Tylenol PM, contain antihistamines. The problem for older adults is that chances increase for accidentally falling or having an auto accident.

Topical antibiotics

Neosporin. Dr. Pullen discusses this one first, but I’ve saved it for last due to my interest in antibiotic resistance. Neosporin is the brand name of a Johnson& Johnson product containing three different antibiotics: bacitracin, neomycin, and polymyxin B. The problem with Neosporin is that some people are allergic to neomycin and can develop contact dermatitis. According to Dr. Pullen, most emergency rooms no longer use Neosporin. A better alternative is a topical antibacterial ointment that contains only bacitracin.
Do topical antibiotics contribute to antibiotic resistance? Undoubtedly they do, although the only studies I’ve found were on topical antibiotics for acne. With resistance in mind, however, doctors recommend that topical antibiotics be used only on “fresh” wounds (when they first happen), not on infections that have already started. (You can tell that a wound is infected if it’s red.) Also, use should be limited to only a few days.

Sources:

(Links will open in a separate window or tab.)

Edward Pullen, MD, Neosporin and other OTC drugs to avoid, KevinMD, April 12, 2010
Antibiotics, topical, Encyclopedia of Surgery
Jil K. Swanson, Antibiotic Resistance of Propionibacterium acnes in Acne: Topical Antibiotics, Medscape Today, 2003