Undeclared pharmacologically active ingredients ID'd in OTC skin products

A study published in JAMA Network Open on October 8, 2026, has identified undeclared pharmacologically active ingredients in one-third of online skin care products. Researchers from Beth Israel Deaconess Medical Center in Boston examined 18 OTC skin care products available for purchase online. They found that six of the products, or 33.3%, contained undeclared active ingredients.

These products included six units, each of which tested positive for the presence of undeclared ingredients. The superpotent corticosteroid clobetasol propionate was the most notable undeclared ingredient, found in six of the products. The concentration of clobetasol propionate ranged from about 0.01% to 0.46%, which is significantly higher than those found in FDA-approved topical formulations.

Two of the products also contained antifungals, either miconazole or terbinafine. The product labels did not disclose any of these ingredients, which are clinically proven to be effective. The vast majority of the products that tested positive for undeclared ingredients had over 10,000 user reviews on online retail platforms. Despite the FDA's health fraud database covering only a small fraction of contaminated products, the researchers warn that products containing undeclared active ingredients may still be available to consumers until detected through targeted surveillance or adverse-event reporting.

Consumers and the medical community should be aware of the potential risks associated with exposure to undeclared pharmacologically active ingredients from the use of OTC products for chronic skin conditions. The study's findings were prepared by Zaur Abilov, M.D., and colleagues.