Controversies in Off-Label Prescriptions in Dermatology: The Perspective of the Patient, the Physician, and the Pharmaceutical Companies

The document from 2018 examines the widespread practice of off-label drug prescriptions in dermatology, focusing on the ethical, legal, and safety concerns it raises. It points out that off-label prescribing is driven by the need for more therapeutic options and the slow and expensive drug approval process, which discourages pharmaceutical companies from seeking new approvals. Conditions like acne rosacea and actinic keratosis are often treated off-label, and drugs such as botulinum toxin are used for various dermatological conditions, including alopecia, despite the need for more research on their efficacy and safety. The document stresses the importance of informed consent and the ethical obligation of physicians to disclose off-label use to patients. It also notes the potential conflicts of interest for pharmaceutical companies and advises physicians to prescribe off-label medications judiciously, ensuring they are in the best interest of the patient.