Topical corticosteroid abuse on the face: a prospective, study on outpatients of dermatology

Hariharasubramony Ambika,Raghunath Nithya,Harikishan Yadalla,C.Sujatha Vinod,Anagha Ramesh Babu

doi:10.7241/ourd.20141.01

Abstract

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. Methods 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.

Highlights

Face is the commonest site of such misuse as its effect is cosmetically appreciable and it is most often used as fairness cream [2]. 23% of our patient were using it for fairness effect and 10% continued to use it for the same reason
Different names are given to steroid abuse lesions on face, most often called as steroid rosacea [3]
Sequence events that lead to steroid abuse is as follows-doctor will prescribe moderately potent steroid to get benefit and avoid side effects of potent steroid, for some dermatosis of face, impressed by response, patient continues to use it and often refer to friends

Summary

Introduction

Methods 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 most common reason for misuse was acne (61%) followed by use as a fairness cream (23%). The exacerbation of the lesions on stoppage of steroid cream (90%) fairness effect (10%) were the reasons for continued use. In spite of the widely prevalent steroid phobia, misuse of topical corticosteroids (TCS) on face continues occur as the benefits of steroids outweigh the risks. The instant subjective and objective relief that steroid give for various dermatosis of face, and the fairness effect are the important reasons for continued use of it even among the literate population. Aim of this study is to make awareness about misuse of steroids on face

Objectives

Methods

Results

Conclusion