Rinse-off cosmetic products, primarily shampoos, are frequently implicated in the onset of allergic contact dermatitis (ACD) caused by alkyl glucosides (AGs). AGs are increasingly popular surfactants and known contact allergens. Glucoside-induced ACD was most frequently observed with shampoos and skin-cleansing products in both consumer and occupational settings. Thereby, studies have shown that atopic individuals are the most susceptible to ACD. Also, several investigations have indicated that individuals with sensitive skin might be more prone to skin allergies. This is why the presence of AGs was investigated in shampoos and body cleansers marketed as hypoallergenic or for sensitive skin. For this purpose, the website of Amazon.com was surveyed. Four groups of cosmetics were obtained by using the following keywords: \"hypoallergenic shampoo for adults,\" \"sensitive skin shampoo for adults,\" \"hypoallergenic body cleanser for adults,\" and \"sensitive skin body cleanser for adults.\" The first 30 best-selling cosmetics in each group were investigated for the presence of AGs, by analyzing the product information pages. The results showed that as much as 56.7% of hypoallergenic shampoos contained AGs, as ingredients, whereas the percentage was somewhat lower for other product categories. Even though decyl and lauryl glucoside were nearly ubiquitously used AGs in cosmetics over the past decade, the most commonly present AG in our analysis was coco-glucoside. The results of this study indicated a necessity to include coco-glucoside in the baseline series of patch testing allergens. Industry, regulators, and healthcare providers should be made aware of the frequent presence of AGs in rinse-off cosmetic products marketed as hypoallergenic or for sensitive skin to ensure the safety and well-being of consumers and patients.

The rapid growth of technology has transformed the way the public purchases many products, including medications. Online medication purchasing has become a convenient and confidential route for patients to access healthcare without leaving their homes. Online pharmacies have many benefits but also present an increased risk for patient harm caused by unintentionally purchasing from illegal online pharmacies. Illegal online pharmacies are those that operate online without the requisite valid licenses or supply drugs not approved by the Food and Drug Administration (FDA). As obtaining certain medications has become restricted, either due to policy or drug shortages, more patients are relying on services provided by Internet pharmacies. The overturning of Roe versus Wade has caused an emerging drug restriction that may coerce the public to turn to Internet pharmacies for purchasing medications. A narrative review was conducted to analyze both the past and present effects of medications sold by illegal online pharmacies to help recognize the implications of restricting access to FDA-approved medications. Several large science and health literature databases were searched to find relevant references. Resulting resources, which referenced the connection between restricting access to FDA-approved medications and the increase in illegal online sales, were included in this review. The information evaluated in this article will help inform healthcare providers and policymakers of the inadvertent effects of restricting access to FDA-approved medications.
A Narrative Review of Illegal Online Pharmacies and Contemporary Issues with Restricting FDA-Approved Medication Access.
UNASSIGNED: Illegal online pharmacies target vulnerable patient populations such as patients affected by drug shortages or patients who require restricted access medications.Increased production of substandard or falsified medications is rampant during drug shortages or restricted access use and can lead to patient harm.The overturning of Roe versus Wade in the United States may illicit a response from the public to acquire their medications through illegal online pharmacies which may be providing substandard or falsified medications.
UNASSIGNED: A narrative review was conducted to understand the implications of restricting access to FDA-approved medications. Previous instances of drug shortages and restricted access use medications were analyzed to understand the effects the overturning of Roe versus Wade may have on patient harm.
UNASSIGNED: Illegal online pharmacies continue to threaten patient harm by supplying substandard or falsified medications to patients.Patient harm from substandard and falsified medications has been observed through previous abortion bans.
UNASSIGNED: Purchasing abortive medications from illegal online pharmacies is correlated with an increase in the number of serious or fatal events.This phenomenon can continue to impact the healthcare system as legal implications surrounding abortion develop.Education and advocacy to safe and effective abortive medications are key in ensuring patient safety in reproductive care.

This study examines how the COVID-19 pandemic has affected online purchasing behavior using data from a major online shopping platform in Japan. We focus on the effect of two measures of the pandemic, i.e., the number of positive COVID-19 cases and state declarations of emergency to mitigate the pandemic. We find that both measures promoted online purchases at the beginning of the pandemic, but in later periods, their effect faded. In addition, online purchases returned to normal after states of emergency ended, and the overall time trend in online purchases excluding the effects of the two measures was stable during the first two years of the pandemic. These results suggest that the effect of the pandemic on online purchasing behavior is temporary and will not persist after the pandemic.
UNASSIGNED: The online version contains supplementary material available at 10.1140/epjds/s13688-022-00375-1.

Alpha hydroxy acids (AHAs) are used in dermatology for topical treatment of skin disorders. Some regulatory bodies, including Food and Drug Administration (FDA), recommended labeling cosmetic products with sunburn alerts and proposed limitations regarding concentrations of AHAs in cosmetic products. In addition, The Cosmetic Ingredient Review (CIR) Expert Panel recommended 10% of AHAs in products as the maximal safe concentration. With a rapidly increasing trend of online purchasing of cosmetic products, it is important that their labels convey the necessary warnings and that they be harmonized with regulatory bodies regarding the recommended concentrations of AHAs. The aim of this report was to investigate whether or not the sunburn alert, as well as AHA recommendations mostly used for exfoliating cosmetic products, was visible to consumers during the online purchasing. The compliance with FDA and CIR Expert Panel standards was analyzed in the first 50 cosmetic products obtained after the conducted investigation on the Amazon.com e-commerce company website using the search term \"AHA anti-aging.\" It was found that exfoliating cosmetic products contained AHAs in a broad range of concentrations, from 2.5 up to 70%. Nineteen out of 50 products contained a concentration of AHAs greater than recommended. Twelve products did not contain any data at all regarding the concentration of AHAs. Sunburn alerts were present in 16 out of 50 analyzed product pages. In conclusion, more efforts should be made in providing users with information and the necessity of protection from potential complications after topical AHAs product treatments.

UNASSIGNED: Patients with hypertension often self-medicate and are increasingly purchasing their medications online. This study aimed to identify the medications and products used for hypertension offered by Indonesian online marketplaces and the availability of prescription-only antihypertensive medication on these platforms.
UNASSIGNED: This qualitative document analysis comprehensively assessed three online marketplaces in Indonesia in May 2019. Five top products in each online marketplace were identified and reviewed. An in-depth analysis was performed to obtain detailed information about the products (e.g., ingredients), indications, and customers\' comments. Selected antihypertensive medications (captopril, amlodipine, and valsartan) were searched for. The data were analyzed thematically.
UNASSIGNED: The search results showed that more than 5000 products were available in each online marketplace and that all of the top products offered in these platforms were traditional medicines. Some products specifically claimed to be effective for lowering blood pressure (e.g., \"the solution for hypertension without complications\"). Morinda citrifolia (noni) and Allium sativum (garlic) were ingredients found in all three platforms, mainly in combination with other herbal medicines. The prescription-only antihypertensive medications offered and could be purchased through online marketplaces reviewed. However, information about dosage forms, indications, side effects, and contraindications of these medications was rarely provided on these platforms.
UNASSIGNED: Indonesian online marketplaces provide a wide range of products for the treatment of hypertension, particularly traditional medicines. Given the increasing trends of online shopping, providing objective and adequate information for customers is essential. Regulations for the purchase of prescription-only medicines, such as antihypertensive medications, should be strengthened.

We use country-wide data on all electronic payments in point-of-sale (POS) and online terminals of Iran to study the change in the pattern of consumption and online-offline substitution during the COVID-19 lockdown and after the relaxation of restrictions in May and June. Using a difference-in-difference approach, we find that during the strictest lockdown month, growth in value of transactions dropped by 41% compared to the benchmark month before the pandemic. After lifting the lockdown, the growth rose by 12% above the benchmark month. We also find that the COVID-19 pandemic led to a spike in online transactions of activities with online terminals and has had a persistent effect on consumer preference for online shopping even after the reopening of the economy.

BACKGROUND: Malta has an average of 3-4 private community pharmacies per locality, providing patients with easy access to medicines yet according to general statistics gathered from European organisations, Internet is used to purchase various online products with medicines being amongst them.
OBJECTIVE: To identify patterns around internet purchasing of medicines among Maltese residents.
METHODS: The study followed a mixed methods approach, employing a cross-sectional survey followed by semi-structured interviews. A random sample of 1996 residents were selected from the Maltese electoral register to participate in a postal questionnaire designed to gather data about purchasing prescription-only-medicines (POM) as well as over-the-counter (OTC) medicines. Results were analysed using descriptive statistics and Chi-square to establish associations between responses. Five interviews investigated participants\' concerns related to sourcing of medicines. The participants were purposively chosen from the questionnaire respondents. Data were analysed using thematic analysis.
RESULTS: The survey had a 22% response rate (N = 444) (60% female; mean age 52 years ± 17). Two (0.45%) participants reported purchasing POMs online in the past, while 4.3% (n = 19) purchased OTCs including vitamins, supplements and herbal combinations. The main reasons for OTC online purchasing were lack of local availability (n = 6; 1.4%) and lower price (n = 11; 2.5%). A total of 89% (n = 395) of respondents provided a reason for not purchasing online, with safety issues being the primary reason for 41% (n = 181) of these. Interviewees expressed disregard towards internet purchasing of medicines that was evident from the themes that emerged: definition of \'medicines\', health autonomy and trust in self-care, relationships and trust in health professional, restrictions of medicine supply, influence of cost, need for options.
CONCLUSIONS: The Maltese appear to be rather cautious and do not purchase POMs online, citing the risks that may be associated with internet purchasing. With regards to OTCs, a small percentage purchase these online and exposing them to risks associated with unauthorised sites.

BACKGROUND: Sunscreens, unlike prescription medications, are purchased by consumers directly from retailers. The proportion of online sunscreen sales is increasing. It is therefore important for dermatologists to know what factors influence online sunscreen purchases to optimize appropriate recommendations.
METHODS: Data on the top 100 best-selling sunscreens from an online retailer were collected. Variables included cost, formulation, product claims, ingredients, consumer ratings, and number of reviews. Ordinal logistic regression was used to analyze the impact of collected variables on position on the best-seller list.
RESULTS: Ninety-six of the 100 search results could be defined as actual sunscreens with a total of 41 788 reviews. The median price per ounce was $3.02 (range $0.34-$309.18). The most popular formulations were lotions. The most common unregulated claim was \"non-greasy\" found in 57.3% of sunscreens. For 26 unregulated product claims analyzed, the mean number of claims per sunscreen was 5.2. Using an ordinal regression model, the following factors were found to significantly influence sunscreen sales: number of reviews, the claim \"decreases the risk of skin cancer and early aging,\" and the presence of six or more unregulated claims.
CONCLUSIONS: Multiple sunscreen options exist for consumers with varying price points, active ingredients, and formulations. Consumers who purchase online prefer sunscreens with a higher number of reviews and more unregulated marketing claims. FDA-regulated claims such as \"decreases the risk of skin cancer and early aging\" are not as impactful in this purchasing cohort. To facilitate usage, dermatologists should be cognizant of factors that influence sunscreen selection among this group.

We aimed to document the experience of buying abortion pills from online vendors that do not require a prescription and to evaluate the active ingredient content of the pills received.
We searched the internet to identify a convenience sample of websites that sold mifepristone and misoprostol to purchasers in the United States and attempted to order these products. We documented price, shipping time and other aspects of ordering. We sent the samples received to a testing laboratory that measured the amount of active ingredient in individual tablets.
We identified 18 websites and ordered 22 products: 20 mifepristone-misoprostol combination products and 2 that contained only misoprostol. We received 18 combination products and the 2 misoprostol products from 16 different sites. No site required a prescription or any relevant medical information. The time between order and receipt of the 20 products ranged from 3 to 21 business days (median 9.5 days). The price for the 18 combination products ranged from $110 to $360, including shipping and fees; the products without mifepristone cost less. Chemical assays found that the 18 tablets labeled 200 mg mifepristone contained between 184.3 mg and 204.1 mg mifepristone, while the 20 tablets labeled 200 mcg misoprostol contained between 34.1 mcg and 201.4 mcg of the active ingredient.
Obtaining abortion medications from online pharmaceutical websites is feasible in the United States. The mifepristone tablets received contained within 8% of the labeled amount of active agent. The misoprostol tablets all contained that compound but usually less than labeled.
Given our findings, we expect that some people for whom clinic-based abortion is not easily available or acceptable may consider self-sourcing pills from the internet to be a rational option.

To examine the purchasing and supply patterns of new psychoactive substance (NPS) consumers in Australia.
Data were obtained from a self-selected sample of 296 past-year NPS consumers, with comparisons made across dimethyltryptamine (n = 104), 2C-x (n = 59), NBOMe (n = 27), and synthetic cannabinoid (n = 22) users.
Most consumers (58%) nominated a friend as their main NPS source, and almost half (46%) reported that they had supplied NPS to others in the past year (predominantly \"social supply\"). However, when comparisons were made across NPS, NBOMe users were more likely to nominate a dealer (30%) or online marketplace (22%) as their main source and to report: supplying NPS to others (63%); supplying to strangers (29%) and acquaintances (24%); and supplying NPS for cash profit (29%). Similarly, NPS consumers who nominated online markets as their main NPS source (9%; n = 26) were more likely to have supplied NPS to others (risk ratio [RR] 1.57); supplied to strangers (RR 6.05) and acquaintances (RR 12.11); sold NPS for cash profit (RR 4.36); and to have exchanged NPS for something else (RR 3.27) than those who reported alternative primary sources.
NBOMe consumers and those who nominated online markets as their main NPS source reported greater engagement with for-profit supply; it is unclear if these individuals have \"drifted\" into dealing or if they were already engaged in such activities.