People’s Pharmacy: Mysterious white spots from Campho-Phenique

Q. A customer came in my store with shorts on. Her legs were bright red from sunburn except some small spots that were white with no sunburn. I asked her about those white spots.

She said she’d had chigger bites and put Campho-Phenique on each one before she went out in the sun. Have you ever heard of Campho-Phenique to prevent sunburn?

A. Campho-Phenique is an old-timey topical remedy that was introduced in 1884. At that time, the camphor and phenol were in the form of a powder designed to treat wounds and other skin lesions.

Bayer’s Campho-Phenique Pain & Itch Relief still contains camphor and phenol along with inactive ingredients: colloidal silicon dioxide, eucalyptus oil, glycerin and light mineral oil.

It is promoted as a spot treatment for insect bites, cuts, scrapes, cold sores and sunburn. So far as we can tell, none of these ingredients is approved for preventing sunburn, and no one should apply Campho-Phenique over a large area of skin.

Colloidal silicon dioxide is frequently included in sunscreen as an inactive ingredient. According to one manufacturer, some microspherical silicon dioxide products scatter UV light to make the active sunscreen ingredients more efficient.

Q. I have been on 0.5 milligrams of alprazolam for anxiety since before I turned 80. Now my doctor has retired, and my new doctor won’t prescribe the drug. At my age, it’s not as if I were using alprazolam for recreational purposes or intentionally abusing it. I need something for anxiety.

Because I could not get a new prescription, I cut the pill in half to get 0.25 milligrams. I took it on alternate days for about a week and then dropped it altogether. As of today, I’ve been off alprazolam for about five days, and I feel pretty anxious. I also have an upset stomach and difficulty sleeping. I suppose that’s due to withdrawal effects.

I would prefer to continue on the drug, but it appears I won’t be allowed to. Is there any other anxiety medicine I could use? What can I expect regarding withdrawal effects?

A. Your new doctor is probably aware that alprazolam (Xanax) is on the “Beers list” of drugs that should generally not be prescribed for older adults. Benzodiazepine drugs like alprazolam can put you at a greater risk of falling. They also have been linked to memory loss and cognitive impairment in older people.

We discuss the Beers list and other inappropriate drugs for senior citizens in much more detail in our eGuide to Drugs and Older People. You can find it in the Health eGuides section of peoplespharmacy.com.

The withdrawal symptoms you are experiencing from stopping alprazolam should start to fade fairly soon, but you might continue to have difficulties for a few weeks. Talk to your doctor about this. He or she might be able to refer you for cognitive behavioral therapy, which can help alleviate anxiety without drugs. An alternative medication would be buspirone, which is less likely to cause such troublesome side effects.

Q. I have discovered a new off-the-shelf drug, esomeprazole magnesium. I have taken Tums for years with modest results.

My wife bought me this new drug, and I take it once a day. Like magic, I have no more heartburn. I can eat food that has always bothered me, like pizza and spaghetti sauce. I have not taken Tums in months.

A. We’re not surprised you’ve found this drug helpful. It is the generic form of Nexium 24HR. It works best when taken once a day, as you describe, but you shouldn’t take it for more than two weeks. Such proton pump inhibitors may have serious side effects over the long term.

Write Joe and Teresa Graedon via their website peoplespharmacy.com.