The products are easily available on websites such as and e and in local stores catering to immigrants and expats from other countries, the study authors write in a letter to JAMA Dermatology. requires prescriptions for topical steroids with more than a 0.5 percent concentration, much stronger and potentially harmful steroid creams are not hard to find without a prescription, doctors report. “We were alarmed when we realized how easily accessible these products were online and that there was no indication there could be serious repercussions,” said a coauthor of the letter, Dr. Cynthia De Klotz of Georgetown University School of Medicine in Washington, DC. “Patients need to know that any over-the-counter product - such as herbals, pills, vitamins, creams and supplements - could be harmful,” she told Reuters Health in a phone interview. “Use them with caution and take time to discuss them with your healthcare providers.” De Klotz and her colleagues write about their experience with a patient who had recurrent atopic dermatitis, a type of eczema that involves redness, dry skin and intense itching. 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