Topical corticosteroid abuse on the face: A prospective, multicenter study of dermatology outpatients (original) (raw)
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Misuse of topical corticosteroids on the face: A cross-sectional study among dermatology outpatients
Indian Dermatology Online Journal, 2016
Background: Topical corticosteroids (TC) are being misused widely on the face without a prescription from the dermatologist. Aim: To evaluate the misuse of TC-containing preparations on the face and the adverse effects due to its application. Materials and Methods: A questionnaire-based analysis was done among patients attending the dermatology outpatient department of a tertiary care hospital between March 2014 and March 2015. Patients with various facial dermatoses were asked about their current use of topical preparations and on further followup questioning, those who revealed the use of TCs (25g or more) continuously or intermittently for a minimum duration of four weeks were included in the study and observed for local adverse effects. Results: A total of 410 patients were observed, 306 were females (74.6%) and 104 were males (25.3%). One hundred and seventy-eight patients (43.4%) used topical steroids alone, 124 (30.2%) used creams containing TC, hydroquinone, and tretinoin, 108 (26.3%) used creams containing a combination of TC, antibiotic, and/ or antifungal. One hundred and seventy-six patients (42.9%) bought TC or TC containing creams over the counter on their own, without the prescription of a dermatologist, 35 (8.5%) were recommended TC by a beautician (beauty parlors), 82 (20%) by their friends, family members, or neighbors, 75 (18.2%) by a non-dermatologist practitioner, and 42 (10.2%) by a dermatologist. Limitations: The sample size was small. Conclusion: Dispensing of TCs must be regulated in India; they should only be issued against a doctor's prescription.
Topical Corticosteroids Misuse on Face: A Cross-Sectional Study from Jharkhand
journal of Medical Science And clinical Research, 2019
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.
Indian Journal of Dermatology, 2018
Background: Awareness against abuse of topical corticosteroids (TC), especially over the face, has been going on for last 5 years in India. In spite of that we are getting lots of cases in our hospitals. Aims: The aims of this study were to ascertain the demographics, magnitude and clinical features of TC misuse on the face among the dermatology outpatient department (OPD) attendees and to analyze its causes. Methods: This study was conducted in a tertiary care medical center of eastern India. Patients with relevant facial dermatoses were asked about their current use of topical formulations and confirmed to be TSDF were included in the study. Results: A total of 748 patients with facial dermatoses were screened, of which 271 (36.22%) were using TC. Of them mostly young adults between 20 and 29 years (37.10%) were using TC. Average duration between starting of use of medication and the onset of symptoms was 5 months. Ninety-eight (36.16%) patients were using topical corticosteroid for the treatment of acne and 74 (27.30%) were using as depigmenting cream. About 108 (39.85%) patients bought medicine over the counter being recommended by pharmacist/shop owner. Rosacea like features with photosensitivity was the most common adverse effect found in 79 (29.15%) patients whereas comedonal acne/acne exacerbation were found in 68 (25.09%) patients. Most of them (227, 83.76%) were unaware about the side effects of steroids. Conclusions: TC misuse in patients with facial dermatoses is still quite common even after efforts to grow the awareness among population.
Journal of Medical Science And clinical Research
Background: Introduction of topical corticosteroids (TC) by Sulzberger and Witten in 1952 led to the emergence of a new therapeutic era in dermatology. But soon the usefulness of these medication became a double-edged sword, owing to their misuse due to easy over the counter availability. The study is aimed at evaluating the range of side effects on the face from misuse of topical steroids. Aim and Objectives: The primary outcome measures were to find out the most common steroid being used and the reason for its use. Secondary outcome measures were to find the age group and the gender most commonly affected, duration of steroid use, source of these prescriptions, source of procurement and whether the patient is aware of these side effects or not. Materials and Methods: A total of 322 patients, diagnosed with topical corticosteroid induced face damage attending the outdoor patient department over a period of one year were included in the study. They were examined thoroughly and data obtained was recorded on designed proformas. Results: Most common steroid being used was Betamethasone vale rate (38.82) mainly for melasma. Most vulnerable age group for TC misuse was between 20 to 39 years and majority (83%) were females. More than half of study group patients (55%) belonged to rural area. Majority were educated population as 34.47% were graduates. In about 64% cases, suggestion for starting TC was given by friends, relatives and neighbors. Steroid induced rosacea (55.59%) was the most common presentation. Conclusion: The main responsibility for the misuse of topical corticosteroids in our study could be attributed to chemists, the patient himself/herself, friends and family. Apart from this strict implementation of the Government policies is the need of the hour.
Topical corticosteroid abuse on the face: a prospective, study on outpatients of dermatology
Our Dermatology Online, 2014
Introduction: Topical corticosteroids (TCS) are widely misused. Uncontrolled use of steroids can cause undesirable adverse effects especially on face. Aim: The aim of this study was to assess the skin manifestations of TCS misuse over the face in the patients attending dermatology outpatient and to analyze various factors contributing to such misuse. Material and Methods: A total of 200 patients with facial dermatoses using topical steroids over face for minimum period of 1 month, reported between June 2010 and May 2011 were enrolled in the study. Details about the usage of topical corticosteroids and their side effects were recorded. The patients were educated about the misuse. Results: Majority of the patients were females (71%). The most common reason for misuse was acne (61%) followed by use as a fairness cream (23%). The average duration of usage was 6 months to 1 year, longest being 8 years. The drug most commonly misused was Betamethaone Valerate (71%). The commonest side effect noted was acne form eruptions (52%) followed by steroid dependent face (SDF) (36%). There were no cases of allergic contact dermatitis or perioral dermatitis. The exacerbation of the lesions on stoppage of steroid cream (90%) fairness effect (10%) were the reasons for continued use. (100%) were unaware of side effects of topical steroids. Conclusions: Steroids have been misused by patients on their own or by doctors for various reasons. Hence the awareness about their correct usage is essential.
Background: Topical corticosteroids , one of the widely used formulation in field of Dermatology is associated with an emerging problem of its own. Over the counter availability and its unlabelled presence in cosmetics has lead to widespread misuse. This study was aimed at studying the pattern of topical steroid misuse and the reason behind it. Materials and Methods: This was a cross sectional observational study done in outpatient department of Dermatology, Venereology and Leprosy over a period of 6 months from July 2019-Dec 2019 .Results: During the study period 109 patients were found to be misusing steroids. Out of these majority (81.7%) were females .The age group most commonly misusing steroid was between 20-30 yr(42.2%). The study revealed that skin lightening / fairness effect (38.4%) was the most common reason for abuse followed by acne(24.7%). In most of the cases friends / family(43.1%) was the promoting factor behind topical corticosteroid misuse while pharmacists (27.8%) also played a significant role for the same. Betamethasone was found as the most commonly abused preparation .Conclusion: Topical corticosteroids are becoming a double edged sword in todays world. The issue of misuse associated with it is increasing day by day both in magnitude and severity. It needs urgent attention and necessary measures from the Medical Fraternity as well as the Government and the General Public .
Journal of Medical and Health Sciences (JMHS)
The aim of the study was to determine the side effects associated with the misuse of topical corticosteroids in Litein Town, Kericho County. A convenient random sample of 57 respondents was selected for the study. Self-developed structured questionnaire was used in data collection. In this study, figures were used to present data. The latest version of the SPSS data analysis tool was used to derive frequencies and percentages from the demographic information provided the use of corticosteroids and side effects associated with the use of corticosteroids. Common side effects related to the misuse of TCS include reduced immunity, change in skin pigmentation, thinning of skin, itching and abnormal drying. TCS are readily bought from community pharmacies for treatment and cosmetic purposes. Various brands are available in the market, with clozole cream as the most commonly known. The majority buy TCS for treatment purposes, while others for cosmetic purposes. Common side effects include ...
Topical corticosteroid abuse over face: A clinical study
IP innovative publication pvt. ltd, 2019
Introduction: Topical corticosteroids are extensively used in modern dermatological practice for their therapeutic effects. Incorrect and inappropriate use causes undesirable adverse effects especially the face. Materials and Methods: A questionnaire based clinical study was conducted for 1 year among 100 patients presenting with chief complaints due to topical steroid abuse over face and data was analysed. Results: Out of 100 patients, preponderance were seen in females (M :F= 1:2.5). Majority were from rural areas (56%). The most common age group was 21-30yrs (35%). Students constituted 27%. Majority of them (76%) used mid potent steroids. Although Betame thasone valerate 0.1% (32%) was commonest topical preparation abused, most of the patients had adverse effects due to steroid with antibiotic and antifungal combination. Most common indication for application was acne (35%). In majority of the patients (46%), suggestion for application was given by friends. In 79% of patients, mode of purchase was without prescription. Duration of usage was more than 1 year in 29% patients. Acneiform eruptions (19%) followed by pigmentation (16%) were the most common adverse effects. Discussion: Easy availability of these over-the-counter steroid preparations, rapidity of symptomatic relief in various facial dermatoses and recurrence of symptoms on discontinuing these medications are the main reasons for abuse. Patients are unaware of the risks posed by these products and continue to use them for longer periods. Conclusion: Topical corticosteroids abuse benefits manufacturers and vendors but ultimate victims are heedless human race. A careful assessment and proper counseling of these patients and general physicians against the use of these preparations over the face is the need of the hour.
Prevalence of Misuse of Topical Corticosteroid among Dermatology Outpatients
Journal of Nepal Medical Association, 2020
Introduction: Topical corticosteroids misuse has become one of the burning issues in many countries across the globe. They are known to cause a myriad of adverse effects which include local effects commonly and systemic effects rarely. In dermatology practice, one of the common problems we see these days are steroid-induced and steroid aggravated dermatoses. So, this study was done to find the prevalence of misuse of topical corticosteroid among dermatology outpatients. Methods: A descriptive cross-sectional study was done in the outpatient department of dermatology at atertiary care hospital for 18 months. Ethical clearance was obtained from the Institutional Review Committee of NMCTH (Reference no. 029-076/077). Convenient sampling was done. Statistical Package for the Social Sciences (SPSS) version 16 was used to tabulate the data and analyze the results. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of ...
Misuse of topical corticosteroids: A clinical study of adverse effects
Indian dermatology online journal, 2014
Misuse of topical corticosteroids is a widespread phenomenon among young people in India, especially women. The practice is associated with significant adverse effects and poor awareness of these effects among the general public. This study was conducted to examine the misuse and adverse effects of topical corticosteroids among the people in Bastar region in Chhattisgarh state of India. Data collected from patients presenting with at least one of the adverse effects of topical corticosteroids as the chief complaint, from November 2010 to October 2011. Out of the 6723 new patients, 379 (5.63%) had presented with misuse and adverse effects of topical corticosteroids, of whom 78.89% were females. More than 65% of the patients were in the age group 10-29 years. The main reason for using the topical corticosteroids was to lighten skin colour and treat melasma and suntan. Acne (37.99%) and telangiectasia (18.99%) were the most common adverse effects noted. Misuse of topical corticosteroid...