Dr. Ruhoy isn't suggesting that you throw out your prescription topical creams and shampoos, but there are ways to minimize their impact on the environment:
• Pre-bathe. "One first step people can take is to remove excess residue from skin with a cotton swab before hopping in the shower," she says. Add a little rubbing alcohol if the creams are thick.
• Don't assume more is more. A major difficulty with topical products is that they don't come in pills. With pills, it's easy to take the exact specified dose, Ruhoy says. "But when it comes to topically applied drugs, people just get a tube of cream, and while there are directions, it's more subjective in its application. People lather on more than they need to, or apply it more frequently than they should." So, she says, don't assume more is better. Try as best you can to stick to the directions, and ask your pharmacist to show you what a proper dose should be. This is particularly important with prescription shampoos—drugs that essentially get washed down the drain full-strength.
• Stay healthy. "If we reduce the use of pharmaceuticals, we'll reduce healthcare costs, while also protecting the environment," says Dr. Ruhoy. Eating right, exercising, and other good habits that help you live longer will reduce your reliance on medications—and leave the fish a little happier, too.