Misuse of topical corticosteroids on the face: A cross-sectional study among dermatology outpatients

Abstract

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.

Keywords: Misuse; combination cream; topical steroids.

Figure 1

Steroid-induced acne

Figure 2

Steroid-induced hypopigmentation

Figure 3

Steroid-induced erythema

Figure 4

Perioral dermatitis with hyperpigmentation

Figure 5

Steroid induced rosacea

Figure 6

Hirsuitism

Figure 7

Steroid-induced hyperpigmentation