Abuse of topical corticosteroids in India: Concerns and the way forward

Iatrogenic Cushing Syndrome due to Application of Potent Topical Corticosteroid: A Case Report

“…Topical corticosteroids misuse for various dermatological conditions is a common problem in India and Nepal. 2,3,6 A nationwide Outpatient Department (OPD) based multi-centric study in India, among patients having facial dermatosis, 14.8% were using topical steroid, out of which 90.5% had various side effects due to steroid. 59.3% of those applying were non-prescriptional out of which 90.3% were potent/superpotent steroids.…”

“…Topical Corticosteroids are over the counter and cheaper drugs available in every medical stores in Nepal and India and often misused for treatment of Dermatophytic infections, Eczemas, Acne, undiagnosed skin rashes and as fairness cream by non-registered practitioners/ chemist. 2,3,4 In a Tertiary hospital in Nepal, almost 74.4 % had used topical steroid cream on face from recommendation of friends/pharmacist or from over the counter purchase. 5 In 2014-15 there was a sale worth $234 million in India which accounted for almost 82% of total dermatological product sale in the country.…”

“…5 In 2014-15 there was a sale worth $234 million in India which accounted for almost 82% of total dermatological product sale in the country. 2,3 Topical corticosteroids have various local side effects (skin atrophy, erythema, telangeictasia, acneiform eruptions, hypertrichosisetc) and rarely systemic side effects (suppression of hypothalamo pituitary adrenal axis, iatrogenic cushing syndrome, growth retardation etc.) on long term use at supraphysiological dosage.…”

Role of clinical pharmacist in cosmeto-vigilance of misuse and abuse of topical corticosteroids

“…The most common misuse and abuse of these preparations are in the form of prolonged use as “fairness creams.” This has seen to be resulting in serious complications such as acne, steroid dependence, atrophy, rosacea, and perioral dermatitis. [12]…”

Knowledge, attitudes and behavior regarding topical corticosteroids in a sample of pharmacy students: A cross sectional survey

“…The problem of TC abuse is a global issue now. [ 3 4 ] Pharmacists are key to addressing the problem of topical steroid abuse because in a country like India where patient awareness regarding drugs like TCs is low and people have easy access to the pharmacist in the pharmacy than they have to a qualified specialist. [ 1 5 6 ]…”