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Topical Therapy for the Internist: A Practical Framework for Safer Prescribing
1Adjunct Assistant Professor, Burnett School of Medicine, Texas Christian University, Fort Worth, TX.
Mayo Clinic Proceedings
|August 5, 2026
Summary
This review provides a practical framework for topical prescribing in internal medicine, addressing common errors to improve patient outcomes and reduce adverse effects from dermatologic treatments.
Area of Science:
- Dermatology
- Internal Medicine
- Pharmacology
Background:
- Cutaneous complaints are frequent reasons for adult internist visits, often treated with topical medications.
- Topical prescribing is inadequately taught, leading to common errors and poor treatment outcomes.
Purpose of the Study:
- To offer a practical prescribing framework for topical therapies in internal medicine.
- To summarize key topical drug classes, safety considerations, and common prescribing errors.
Main Methods:
- A narrative review of literature searched via PubMed/MEDLINE and Cochrane Database up to May 2026.
- Prioritization of systematic reviews, randomized trials, guidelines, and seminal studies on topical therapy, corticosteroids, and drug safety.
Main Results:
- A framework is presented where morphology guides vehicle choice, diagnosis dictates the active drug, and site/patient factors determine potency, duration, and quantity.
- Seven common prescribing errors are identified with corresponding corrective strategies.
- Point-of-care tables and an algorithm are provided for implementation.
Conclusions:
- Improved topical prescribing practices can enhance treatment efficacy and minimize adverse events.
- A structured approach to topical therapy is crucial for internists managing dermatologic conditions.
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