Tetmosol soap, marketed by Piramal Pharma Limited as a treatment for scabies and lice, contains the outdated active ingredient Monosulfiram (5% w/w). While effective for its intended use, Tetmosol’s widespread over-the-counter (OTC) availability in India and other developing regions, coupled with vague marketing claims, has led to rampant misuse for undiagnosed dermatological conditions. This misuse risks ineffective treatment, skin irritation, and delayed diagnoses, raising serious concerns about consumer safety and Piramal’s ethical responsibility. The article critically examines Tetmosol’s composition, safety, regulatory status, consumer misuse, and Piramal’s marketing practices, alongside broader enforcement challenges and Piramal’s product portfolio. It argues for a temporary suspension of Tetmosol’s sales until clearer labeling, robust consumer education, and stricter regulations are implemented to protect public health.