Abstract
Introduction: Topical Corticosteroids (TC), introduced in 1952, are used in a number of dermatological conditions. This very usefulness along with misconception regarding TCs as magical fairness and anti-acne cream and free availability over the counter has made it a double edged sword leading to rising instances of abuse and misuse.
Aim: To evaluate the misuse of TCs on face and the adverse effects due to their application.
Materials and Methods: A questionnaire‑based analysis was done among patients presenting with various facial dermatoses in the dermatology outpatient department of a tertiary care hospital in Jharkhand. Patients were asked about their current use of topical preparations and on further follow-up questioning, those who revealed the use of TCs for a minimum duration of four weeks were included in the study and observed for local adverse effects.
Results: A total of 743 patients were observed, 506 were females (68.1%) and 237 were males (31.9%). Majority (36.9%) were of age group 20-29 years.156 patients (21%) used creams containing combination of TC, antibiotic and antifungal, 139 patients (18.7%) used creams containing combination of TC and salicylic acid whereas only 67 patients (9%) used TC alone.156 patients were advised to use TC by their friends, family members, or neighbors. Steroid used erythema (25.9%) was the most common adverse effect observed followed by steroid induced acne. (23.6%)
Conclusions: TC misuse in patients with facial dermatoses is quite common, and most of this use is unwarranted.Use as a fairness cream is the most common indication in this study.
Keywords: Misuse, combination cream, topical steroids, rosacea.
References
- Sulzberger MB, Witten VH. The effect of topically applied compound F in selected dermatoses. J Invest Dermatol 1952;19:101-2.
- Coondoo A, Phiske M, Verma S, Lahiri K. Side-effects of topical steroids: A long overdue revisit. Indian Dermatol Online J 2014;5:416-25.
- Saraswat A, Lahiri K, Chatterjee M, Barua S, Coondoo A, Mittal A, et al. Topical corticosteroid abuse on the face: A prospective, multicenter study of dermatology outpatients. Indian J Dermatol Venereol Leprol 2011;77:160-6.
- Mahe A, Ly F, Aymard G, Dangou JM. Skin diseases associated with the cosmetic use of bleaching products in women from Dakar, Senegal. Br J Dermatol 2003;148:493-500.
- Lu H, Xiao T, Lu B, Dong D, Yu D, Wei H, et al. Facial corticosteroid addictive dermatitis in Guiyang city, China. Clin Exp Dermatol 2009;35:618-21.
- Al-Dhalimi MA, Aljawahiri N. Misuse of topical corticosteroids: A clinical study from an Iraqi hospital. East Mediterr Health J 2006;12:847-52.
- Smith EW. Do we need new and different glucocorticoids? A re‑appraisal of the various congeners and potential alternatives. Curr Probl Dermatol 1993;21:1‑
- Jha AK, Sinha R, Prasad S. Misuse of topical corticosteroids on the face: A cross-sectional study among dermatology outpatients. Indian Dermatol Online J 2016;7:259-63.
- Rathi SK, D’Souza P. Rational and ethical use of topical corticosteroids based on safety and efficacy. Indian J Dermatol 2012;57:251‑
- Saraswat A. Topical corticosteroid use in children: Adverse effects and how to minimize them. Indian J Dermatol Venereol Leprol 2010;76:225‑
- Kumar MA, Noushad PP, Shailaja K, Jayasutha J, Ramasamy C. A study on drug prescribing pattern and use of corticosteroids in dermatological conditions at a tertiary care teaching hospital. Int J Pharm Sci Rev Res 2011;9:132‑
- Bhat YJ, Manzoor S, Qayoom S. Steroid‑induced rosacea: A clinical study of 200 patients. Indian J Dermatol 2011;56:30‑
- Rathi SK, Kumrah L. Topical corticosteroid‑induced rosacea‑like dermatitis: A clinical study of 110 cases. Indian J Dermatol Venereol Leprol 2011;77:42‑
- Saraswat A. Contact allergy to topical corticosteroids and sunscreens. Indian J Dermatol Venereol Leprol 2012;78:552‑
- Rathod SS, Motghare VM, Deshmukh VS, Deshpande RP, Bhamare CG, Patil JR. Prescribing practices of topical corticosteroids in the outpatient dermatology department of a rural tertiary care teaching hospital. Indian J Dermatol 2013;58:342‑
- Coondoo A, Chattopadhyay C. Use and abuse of topical corticosteroids in children. Indian J Paediatr Dermatol 2014;15:1‑
- Verma SB. Sales, status, prescriptions and regulatory problems with topical steroids in India. Indian J Dermatol Venereol Leprol 2014;80:201‑
- Mishra AK, Saraswat D. Topical corticosteroid abuse in dermatology.IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) Volume 15, Issue 7 Ver. IX (July. 2016), PP 110-114
Corresponding Author
Dr Soumya P. Tirkey
C/O Dr. Alok Tirkey, House No. 444, New Kalyanpur, Road No. 6, Singh More, Hatia, Ranchi 834003, India
Ph No. +91 7352095748, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.184
