Topical steroids are commonly used drugs in dermatology. They are used for various indications like psoriasis, lichen planus, eczema, lichen simplex chronicus, and other steroid-responsive dermatoses. However, because of their property of lightening of skin and reducing inflammation, they have been misused frequently. Acne, pigmentation, fungal infection, and pruritus are the common conditions for which topical steroids are misused, and also they have been used as a cosmetic or a skin cream for any type of rash. The free availability of these creams as an over the counter medication is one of the main reason for such misuse in our country. Also availability of various irrational combinations of topical steroids which cause more damage to the skin adds to the existing menace. There is a lack of awareness among general practitioners who regularly prescribe these creams as general skin creams for conditions varying from tinea to acne and as fairness creams. Various studies have tried to highlight the side effects and harm caused by misuse of topical steroids and its combinations. These studies have tried to bring to the notice of regulatory authorities about the damage caused by free availability of these creams. In this chapter we will try to discuss regarding the awareness among patients about these drugs and its side effects.

In 1952, Sulzberger and Witten were the first to use topical steroids in dermatology [1]. Followed by this, topical steroids of different potencies and formulations were introduced which revolutionized the treatment of various steroid-responsive dermatoses. The availability of topical steroids has immensely contributed to the dermatologist’s ability to effectively treat several difficult dermatoses [2]. They became popular rapidly and were considered as a panacea for all ills by both physicians and patients [3]. Topical steroids are one of the most commonly used drugs by dermatologists worldwide [4–6]. In India, the annual sales figure of TCs was 14 billion rupees in 2013, which accounts for almost 82% of total dermatological product sale in the country [7].

The misuse and abuse of these drugs by both non-dermatologists and patients is mainly because of the immediate and dramatic symptomatic relief from these creams. They are also used as fairness or cosmetic creams [8, 9]. Various side effects, both cutaneous and systemic, have been noticed because of the rampant misuse and abuse of these medicines [9–12].

Various studies have tried to highlight the menace caused by the use of topical steroids [13–17]. A multicentric study by Saraswat et al. has taken 2296 patients with facial dermatoses of which 433 patients were using topical steroids [13]. These studies have highlighted the various side effects encountered by the patients who were using topical steroid, and the patients who already had developed the side effects were included. Most of the patients in the study were not aware if the side effects they developed were because of the creams they had used.

We conducted a study to check for the awareness among people about the use of topical steroids [18]. Our study includes 1000 patients attending the dermatology outpatient department irrespective of their skin complaints. This was a questionnaire-based study to find out their awareness about the common topical steroid available over the counter in our area. The source of recommendation/knowledge about these creams, usage duration, and their awareness about the side effects of these creams were also assessed.