Topical corticosteroid abuse over face: A clinical study (original) (raw)
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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.
Indian Journal of Dermatology, Venereology, and Leprology, 2011
Background: Abuse of topical corticosteroids (TC), especially over the face, is prevalent worldwide, including in India. Data about the magnitude of this problem in our country is lacking. Aims: The aims of this study were to ascertain the demographics, magnitude and clinical features of TC misuse on the face in the dermatology outpatient department (OPD) attendees in order to raise awareness about this problem and to analyze its causes. Methods: This was a prospective multicenter questionnaire-based clinical study conducted at 12 dermatology centers nationwide. Patients with relevant facial dermatoses reporting to the investigator were asked about their current use of over-the-counter topical formulations and a structured questionnaire applied in case the same was confirmed to be TC. Results: A total of 2926 patients with facial dermatoses were screened, of which 433 (14.8%) were using TC. TC was used as a fairness/general purpose cream or aftershave in 126 (29%) and in 104 (24%) for acne. Steroid combinations were used by 258 (59.6%). Potent and superpotent TC were significantly (P = 0.05) more frequently used by the rural/suburban population. The younger age groups used more potent formulations. A non-physician recommendation for TC use was obtainable in 257 (59.3%) patients. Of these, 232 (90.3%) were for potent/ super-potent steroids. Among 176 physician prescriptions, 78 (44.3%) were from nondermatologists. All non-physician prescriptions and 146 (83%) physician prescriptions for TC were inappropriately refilled. Adverse effects were seen in 392 (90.5%) TC users. Acne/ exacerbation of acne was the most common adverse effect. 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 cohort. Limitations: This was an OPD-based study and, therefore, it may or may not accurately reflect the community data.
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 .
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...
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.