Alarming tropical 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.