Alarming topical steroid misuse on face: A descriptive study
Abstract
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. The clinical lesions are non-inflammatory open and closed comedones and or papules, pustules and nodules of varying degree of inflammation and depth. A lot of steroid, cosmetic and Ayurvedic products containing unlabeled depigmenting agent and steroids are available readily over the counter sale. The side effects of these products are not documented and can lead to adverse effects of continuous usage. This study was aimed to find out various offending depigmenting agents (topical unlabeled steroid containing cosmetics) for treatment of Acne and its side effects with type of offering persons. This study was conducted on 1110 OPD patient of which 1000 (90.10%) patients are using steroid and unlabeled steroid containing cosmetics and only 110 (9.90%) patient not using any topical application. Mostly affected common age group was 11-20 years (58%) with slight female preponderance (M:F 0.96). Urban patients were more affected than rural (74% v/s 26%). Unmarrieds (76%) were more affected than married (24%). Friends appeared as chief culprit or suggestions given to them (39%) followed by family member(13.5%), self-application (12%) influenced by advertisements, chemist(11.5%), general practitioner (9.5%), neighbor (4.5%), compounder(1.5%), parlor(2%) and only 2% by dermatologist. Betamethasone (32.5%) was major offending agent followed by Clobetasol (25%), unlabeled steroid containing cosmetics (12.5%), Aloe Vera gel (7.5%). Monomorphic acne was main side effect diagnosed in 79% of patients followed by pustular acne (8%), nodular acne (4%), rosacea (4%), nodulocystic acne (3%) and perioral dermatitis (2%). Study concluded that misuse of topical steroids and unlabeled steroid containing cosmetics causing various side effects. It is unethical to sale and use without the prescription of an authorised person. So these depigmenting agents should be banned to sell without authorization and without the prescription of an authorised person.
Keywords
Download Options
Introduction
Acne vulgaris is one of the most common skin diseases worldwide, affecting all ethnicities and races. The highest prevalence of acne occurs in adolescence where it may be diagnosed in 80% of all teenagers. The age of onset has changed over time, paralleling the earlier onset of puberty reported in recent years. Acne commonly has a prolonged course, with acute or insidious relapse or recurrence over time.
Clinical presentation includes non-inflammatory and or inflammatory lesions. Topical steroids were introduced in 1951, when Sulzberger and Witten first used topical hydrocortisone.1 The antiinflammatory and anti-proliferative actions of topical steroids result not only in their therapeutic effect but also in their side effects. In this way steroids act as a double-edged sword, which makes it important to use it with the utmost caution. Topical steroids increase the proliferation of Propionibacterium acnes, and Demodex folliculorum, leading to an acne rosacea-like condition.
Conclusion
This present study concludes that 90.10% patients of Acne were using steroid and unlabeled steroid containing cosmetics and mostly were using on advice of their friends. Betamethasone was most commonly used agent followed by Clobetasol, unlabeled steroid containing cosmetics, Aloe Vera gel etc. Monomorphic acne was main side effect diagnosed.
Study concluded that misuse of topical steroids and unlabeled steroid containing cosmetics causing various side effects. It is unethical to sale and use without the prescription of an authorized person. So this depigmenting agent should be banned to sell without authorization and without the prescription of an authorized person.