A Third of Tested Online Skin Products Hid Potent Steroids

A cream you bought online to calm your eczema could secretly contain one of the strongest prescription steroids in dermatology. A study published online in October 2026 in JAMA Network Open found undeclared prescription-strength steroids in a third of the Online Skin Products it tested, every one of them an over-the-counter cream sold on major retail websites and marketed for conditions like eczema, psoriasis, dermatitis and hyperpigmentation.

The research team, led by Zaur Abilov, MD, of Beth Israel Deaconess Medical Center and Harvard Medical School, bought 18 products from major online retail platforms between February and December 2025. The products were selected because they promised relief for inflammatory or stubborn skin conditions, listed no ingredients with established clinical evidence, and had at least one hundred customer reviews on at least one platform. From April 2025 through April 2026, the team screened each product for 28 corticosteroids and antifungal agents using high-resolution liquid chromatography-mass spectrometry, with tandem mass spectrometry confirming every detection.

Undeclared pharmacologically active ingredients turned up in six of the 18 products, a 33.3 percent hit rate, according to the study authors. Every flagged product contained clobetasol propionate, a superpotent corticosteroid that sits at the very top of the potency ladder and is available in the United States only by prescription. Two of the six also hid an antifungal, either miconazole or terbinafine. When the researchers bought two extra units of each flagged product and tested them again, every repeat sample came back positive too.

Some samples were many times stronger than approved drugs

The concentrations were as alarming as the secrecy. Detected clobetasol levels ranged from roughly 0.01 percent to 0.46 percent, and the strongest samples carried more than nine times the 0.05 percent strength used in FDA-approved topical clobetasol formulations. None of these ingredients appeared anywhere on the product labels. The flagged listings were not obscure either: together they had collected more than ten thousand customer reviews across online retail platforms, and several ranked among the best-selling items in their categories at the time of analysis.

Medscape, reporting on the study, noted its main limitation. This was a targeted quality-improvement assessment, not a random sweep of everything sold online. The researchers deliberately picked products with bold therapeutic claims and no disclosed active ingredients, so the results cannot say how common hidden steroids are across the whole market. The screening could also have missed alternative chemical forms of the drugs, and the team had no data on how many people had actually used the products or been harmed.

Regulators have chased this problem for decades

The study authors pointed out that worries about hidden corticosteroids in over-the-counter skin products have surfaced repeatedly for decades, prompting FDA warning letters and safety alerts. One notorious case involved Skin-Cap, an imported psoriasis spray that drew a U.S. import alert in the late 1990s after testing revealed undisclosed clobetasol beneath its labeling.

Health Canada has confronted the same pattern in creams sold directly to consumers. The regulator seized unauthorized skin lotions and creams labeled to contain potent steroids such as clobetasol propionate and betamethasone dipropionate, warned the public not to use them, and pressed the sellers to recall them, according to reporting by Cosmetics Business. The scheme keeps resurfacing for a simple reason: a cream secretly spiked with a superpotent steroid appears to work dramatically well, earning rave reviews that push it higher in online rankings.

That hidden potency is exactly what makes these products risky. Doctors prescribe clobetasol only for limited periods and limited areas of skin, because unsupervised long-term use can thin the skin, trigger steroid acne and change skin pigmentation. If enough of the drug is absorbed through the skin, it can suppress the body's own stress-hormone system, the study authors noted. Stopping abruptly after months of unknowing exposure can also set off severe rebound flares of the original condition.

What online shoppers should do

For anyone who treats star ratings as a second opinion, the study is a reality check on Online Skin Products: an ingredient list reveals little when the seller has failed to declare what is inside. A Dermatology Times journal digest of the paper said the findings show why clinicians should ask patients with stubborn skin problems about online purchases, not just prescription medicines.

The same caution applies across the medicine cabinet. An Amazon acetaminophen recall recently sent shoppers digging through their own supplies, while bootleg weight-loss drugs have shown how unregulated sellers can turn dangerous. Even legitimate skin products move slowly through safety review, as the arrival of the first new sunscreen ingredient in a quarter century illustrates.

A few practical habits follow from the research. Be skeptical of creams that promise dramatic clearing of eczema or psoriasis under "natural" or "herbal" branding with no listed active ingredients, especially listings with thousands of glowing reviews. Check the FDA's health-fraud database for warnings about hidden drug ingredients, while remembering that it captures only a fraction of affected products. And if a cream you bought online works almost suspiciously well, bring the tube to a dermatologist before using it for months, since both the hidden drug and quitting it suddenly carry real risks.

The authors concluded that products with undeclared ingredients can stay on sale until targeted testing or adverse-event reports catch them, and they urged patients and the medical community to treat Online Skin Products with open eyes and steady caution.