From acne treatments to wart removers, OTC products cover nearly every body, and nearly every new product on the market touts its natural, effective ingredients. But some pieces of the OTC puzzle are more profitable than others; according to data from Information Resources, Inc., sales of first aid treatments, the largest category within the OTC space, rose a scant 0.3% to $1.5 billion, compared to a 9.3% gain in the nearly $800 million external analgesic rubs category. At the same time, stalwart OTC segments such as acne treatments, depilatories and fade/bleach creams all suffered declining sales (see chart below).

Still, industry veterans insist that the OTC business is healthy as consumers try to avoid a costly, often confusing trip to the doctor in favor of off-the-shelf remedies. Long-time pharma executive Art Clapp is the CEO of Nuvothera, an OTC company that he founded in 2014, after a career with Galderma and others. Nuvothera is introducing Prosoria, an OTC product for psoriasis.

“A recent survey of dermatologists and patients found that nearly 90% of them aren’t happy with products available today,” he told Happi. “For example, biologics are great, but they stop working and are immunosupressants.”

According to Clapp, OTC products are safer and the category is moving in a more “natural” direction. During his pharma career and later, as an entrepreneur, Clapp discovered molecules for use in traditional pharmaceutical products, as well ingredients for Chinese and Ayurvedic medicine.

“When people rely on steroids for their psoriasis treatment, they go from flare to flare,” explained Clapp. “We use a combination therapy approach to create potent product with safe ingredients that treat inflammation with a simple, three-step system. Prosoria really helps prevent flares,” he said about his product.

The Prosoria system includes a conditioning and hydrating gel, a treatment gel, and exfoliating and moisturizing cream. There’s also a rapid repair skin exfoliating ointment to boost and accelerate exfoliation. Prosoria formulas contain turmeric, curcumin, bromelain, salicylic acid, shea butter and vitamin E to provide antioxidants plus the necessary skin exfoliation and moisturization needed to restore smoothness, softness and a healthy appearance to skin.

“Turmeric has a great affect on skin and is a super potent antioxidant and an excellent ingredient for topical formulas because it is lipid soluble,” Clapp explained.

What’s In for Skin?
At this month’s American Academy of Dermatology annual meeting in Washington, DC, multinationals such as Procter & Gamble, Unilever and Johnson & Johnson will battle for dermatologists’ attention to promote their newest OTC skin creams and ointments. But they also share the floor, and the market, with much smaller competitors such as Kamedis, Nuvothera and others.

According to Information Resources Inc. (IRI), sales of acne treatments in food, drug and mass merchandisers slipped 1.4% to $572.2 million for the 52 weeks ended Dec. 30, 2018. Neutrogena, a J&J brand, dominates the category with a 30.05% share, but there is room for innovative companies that can deliver effective treatment without the irritation often associated to benzoyl peroxide-based formulas, according to industry experts.

Kamedis Bio-Herbal Skin Care for Acne relies on the power of botanicals to help improve skin.

“There are patients who are not getting what they need from regular OTC (formulas),” explained Kelli Rodriguez, US director of sales and marketing, Kamedis.

The company’s Bio-Herbal Skin Care for Acne line contains botanical extracts that not only has probiotic activity, but also reduces the bad bacteria that is associated with acne, according to Yonit Bomstein, chief technology officer, who explained that in tests, the extracts have some ability to balance the microbiome.

“We don’t know how it works, but we do know that it is more complicated than just feeding the bacteria a steady sugar supply,” Bomstein explained. “The extract has many mechanisms.”

Kamedis researchers have proposed that their extract system has antibacterial, probiotic, anti-inflammatory and other modes of action that, together, provide an effective treatment. Now the company is taking that systemic approach with other skin ailments such as eczema and psoriasis. Dermatologists and other researchers suggest that more cases of eczema and psoriasis are on the rise as modern, stressful lives, combined with rising levels of environmental pollutants, create the perfect environment for the development of psoriasis and eczema.

“Most skin conditions are chronic; we are trying to bring skin back to its normal condition,” explained Bomstein. “Extracts have many qualities and mechanisms of action and are very effective.”

But the most effective treatments involve a combination of extracts. For example, Bomstein noted that rhubarb is known as a food source and in China it is used as a treatment for internal ailments.
“Rhubarb has many activities, but it needs assistance from other herbs; there are no magic bullets,” she said.

Oh, the Pain!
The US Centers for Disease Control estimates that 50 million Americans live with chronic pain and to cope with all those aches, consumers purchased nearly $800 million worth of analgesic rubs in food, drug and mass merchandisers, according to IRI data (see chart, p. 42). Icy Hot holds the top spot with nearly a 19% share, but there is clearly room for more players and formats as Americans get older and achier.

Last month, Village Naturals launched its Chronic Pain & Fatigue collection, which includes a bath soak as well as a body wash. The soak contains ginger to relieve soreness and D-ribose to improve skin elasticity, while the body wash contains “uplifting essential oils” to get consumers going again. Each retails for $5.27 in Walmart. 

Last year, Quest Products, Pleasant Prairie, WI, introduced two new products under its ProVent brand—a hemp patch designed for pain relief and a wart remover that includes natural botanicals. The hemp patch releases small amounts of hemp into the top layer of the skin. A user applies the ProVent patch to a painful area of the body and it begins to soothe muscle pain and stiffness through motion-activated heat technology. The product is designed to relieve pain associated with swelling, inflammation and arthritis.

The ProVent Wart Remover also works through topical application. The user applies the liquid daily and will usually see results within a few weeks, according to Quest. The formula is said to contain 100% natural ingredients and botanical extracts to gently remove warts.

Other ProVent products include remedies for motion sickness, vertigo, eczema and psoriasis and skin tags.

Sleep On It!
Aching muscles, of course, can be the source of insomnia; in recent years, sleep deprivation has become a global phenomenon, one that impacts the health and well-being of consumers whether they are physically hurting or not.

“We have been following trends and reports on global sleep patterns since 2011, during which time the impact of sleep deprivation on health, well-being, productivity, memory, aging and appearance has become a hard news story flooding the media,” explained Anna Persaud, CEO, This Works, which recently introduced Sleep Power sleep aids, which include pillow sprays, bath soaks and, most recently, nap spray, power recharge mask and a napping hood. “At the same time, Millennials, who deeply value work life balance, are finding themselves becoming the most sleep deprived generation and are actively seeking natural solutions to help improve not just their sleep but also their performance.”

But unlike standard sleep aids, Sleep Power was created to enable its user to modulate their natural circadian rhythm to compensate for any disruptions caused by lifestyle or working commitments. It is one of the first natural sleep aids to encourage and facilitate sleep outside of the traditional sleep-phase of 11pm to 6am, according to Persaud.

“It signifies a step change in how we think and talk about sleep, encouraging people to engage with their sleep routine and if sleeping at night is a challenge, to proactively plan short naps (30 or 90 minutes) during the day to top up their sleep over a 24 hour period and by doing so improve their physical and mental performance,” she said.

In a clinical trial of 100 subjects who regularly take naps during the day, compared with no product, the following results were revealed after using the product to nap: 

• 93% felt they performed better mentally;
• 93% felt they performed better physically;
• 93% felt more able to control their impulses (e.g. eating wrong food, drinking smoking); and
• 95% felt more refreshed.

Persaud noted that multiple studies demonstrate people who nap during the day experience significant physical and mental benefits, such as improved learning and memory retention, heightened senses and creativity peaks. And after a sleep-deprived night of just four hours, a 30-minute lunchtime nap increased alertness, decreased sleepiness and boosted a 20m sprint performance, according to the company.

“Knowing the impact that lack of sleep can have on performance, coupled with our work and research into circadian rhythm, we began to consider how we could help those who are not able to achieve eight hours of sleep a night either through work or lifestyle and what the incremental performance gain might be if you were able to top up your sleep during the day—not the emergency sleep on the sofa we’re all familiar with but if you were to plan in times outside of the night where you took a brief nap to recharge and recover.  And it was this thinking that led to the creation of Sleep Power,” explained Persaud.

The Sleep Power recharge mask contains skin care ingredients that do not aid sleep, but rather mimic skin’s natural overnight repair and revitalization to deliver the optimum results in minimum time. The mask’s fragrance, Deep Sleep blend, aids relaxation, too.

“Because sleep disruption takes only 24 hours to be seen on our skin, the mask is great for times when sleep is broken or in short supply—for example, if you’re travelling between time zones and struggling with jet lag, in just 20 minutes you can give your skin the same boost as around 8 hours of sleep,” noted Persaud.

Although well-known for its sleep solutions, This Works remains primarily a skin care company—but with a link to sleep that’s based on the skin’s needs following the natural circadian rhythm.
“By understanding these natural processes, we appreciate that sleep is without doubt the first step in any good skin care regime —as it’s whilst we sleep that is set to ‘repair and renew’ mode when stem cells begin to replace old cells with new fully functioning ones,” concluded Persaud. “Which is why, on the whole, you’ll notice skin tends to appear more attractive or refreshed in the morning.”
Clapp is extremely bullish on the OTC sector and is developing natural ingredient-based formulas for acne and rosacea. After working in the OTC business for decades, he is convinced the market has room to grow as more consumers self-diagnose and self-treat a variety of ailments, and at lower cost, too.

“The high price of prescription drugs is helping to create a new generation of OTC products with great ingredients and new technology.”