Topical Corticosteroid Awareness Among General Population and Dermatology Outpatients




© Springer Nature Singapore Pte Ltd. 2018
Koushik Lahiri (ed.)A Treatise on Topical Corticosteroids in Dermatologyhttps://doi.org/10.1007/978-981-10-4609-4_35


35. Topical Corticosteroid Awareness Among General Population and Dermatology Outpatients



T. S. Nagesh 


(1)
Department of Dermatology, Venereology and Leprosy, Sapthagiri Institute of Medical Sciences and Research Center, Bangalore, India

 



 

T. S. Nagesh



Abstract

Topical steroids are one of the most commonly abused drugs. There are few studies available which have highlighted the severity of this problem in India. However, these studies have concentrated mainly on the topical steroid abuse and its side effects over the face.

In this chapter we have tried to highlight about the awareness among the people about various commonly available topical steroids and its combinations irrespective of its usage and also the extent of misuse of these drugs. Along with this we also tried to find the source of recommendation of these medicines which will help to sensitize people about this menace.

Conclusion: Misuse of topical steroids as a general purpose skin cream or fairness cream is common not just over the face, but also on other parts of the body. It is most often recommended by general practitioners or pharmacists. Hence it is important to sensitize these people about the possible complications of these drugs and the extent of problem the society is facing because of irrational and unregulated use of these drugs.


Keywords
AwarenessTopical steroid abuse



Learning Points




  1. 1.


    Awareness about topical steroids is poor in general population.

     

  2. 2.


    It is important to sensitize general practitioners and pharmacists regarding the uses and misuse of topical steroids.

     


35.1 Introduction


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.


35.2 Awareness About Topical Steroids


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 [46]. 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 [912].

Various studies have tried to highlight the menace caused by the use of topical steroids [1317]. 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.

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Mar 5, 2018 | Posted by in Dermatology | Comments Off on Topical Corticosteroid Awareness Among General Population and Dermatology Outpatients

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