|OPINIONS/EXPERIENCES/TIPS AND TRICKS
|Year : 2010 | Volume
| Issue : 1 | Page : 49
Cost-effective use of scalp lotions-Some points to ponder
Karthika Natarajan, CR Srinivas
Department of Dermatology, PSG Hospitals, Coimbatore, India
|Date of Web Publication||26-Nov-2010|
Department of Dermatology, F-12 Doctors Quarters, PSG Hospitals, Coimbatore - 641 004
|How to cite this article:|
Natarajan K, Srinivas C R. Cost-effective use of scalp lotions-Some points to ponder. Indian Dermatol Online J 2010;1:49
|How to cite this URL:|
Natarajan K, Srinivas C R. Cost-effective use of scalp lotions-Some points to ponder. Indian Dermatol Online J [serial online] 2010 [cited 2013 May 25];1:49. Available from: http://www.idoj.in/text.asp?2010/1/1/49/73265
Dermatologic medications are expensive and their cost is increasing each day. The cost of medicine can be compared with the cost of petrol. Just as fuel efficiency is a major selling factor with vehicles, devising means to reduce the amount of medicine or reduce the wastage of medicine due to incorrect application is a justified exercise.
Various steroid and antifungal scalp lotions are frequently advised for various scalp ailments by dermatologists. Steroid lotions are expensive and the cost for 15 ml ranges from Rs. 75 to Rs 150. Most dermatologists advise topical steroids but do not provide specific instructions for its effective and efficient use. Some patients cut the nozzle and apply the lotion directly over the scalp from the compressible container. This leads to rapid delivery of the drug and dribbling of the drug along the uninvolved areas of the scalp and this can rarely enter the eyes causing smarting of the eyes. Most patients, however, are likely to pour the steroids into the hollow of the non-dominant hand and use the finger tip of the dominant hand to apply the drug over the skin of the scalp. It is likely that more drug will adhere to the skin of the palm and this adhered medicine will be lost and intentionally or unintentionally applied to other sites of the body such as face, legs and arms. This study was undertaken to determine the amount of medicine saved by using the spoon instead of the palm.
Two milliliter of Clotrimazole lotion was taken in a measuring cylinder and then poured into a 5 ml plastic spoon used to dispense pediatric syrup. Using a micropipette the lotion from the spoon was retrieved and the amount remeasured with the measuring cylinder. Similarly the amount of drug retrieved from the hollow of the palm was also measured.
There was a loss of 0.2 ml from the spoon and 0.4 ml from the palm. The cost of 0.2 ml was calculated as 92 paise and hence 0.4 ml was double this cost i.e. Rs. 1.84. Thus an additional 0.2 ml is lost during each application from the palm as compared with the spoon, leading to a loss of 96 paise per application. Considering the fact that the topical steroid applications are used repeatedly for prolonged duration, the amount saved by using a non-adhesive surface such as spoon could result in cost-effective use of medicine. The difference will be more significant if more expensive preparations are used. Also the inadvertent application of topical lotion over undesired sites can be avoided.
We seem to have overlooked basic issues such as educating the patient in the method of application of topical drugs. Pharmaceutical companies do not write detailed instruction and most dermatologists take for granted that their patients know the correct method. In lotions such as topical steroids as well as creams and ointments containing the same, it is imperative to instruct the patient as to how much to apply. Not doing this exercise can lead to increased expenditure to the patient, excessive use leading to adverse cutaneous reactions and perhaps more serious consequences like systemic absorption. Devoting a minute or two to teaching the method of application would be helpful to the patient and the treating dermatologist.