Impact of Abuse of Topical Corticosteroids and Counterfeit Cosmetic Products for the Face: Prospective Demographic Study in Basrah City, Iraq

Abstract

Background: Topical corticosteroids are highly effective compounds that are now widely used in dermatology for the treatment of various autoimmune and inflammatory disorders. Many corticosteroids are misused for diverse indications such as pigmentation, acne, pruritus, fungal or bacterial infections, rashes, and numerous other conditions. These products contain various constituents, most of which have hazards or toxic elements. Objective: The aim is to raise awareness among individuals in the city of Basrah, Iraq about the uses and abuses of applying fake products to the face to inform the consumers about potential harmful adverse effects. Methods: This study was a prospective multi-center clinic questionnaire of a demographic that involved the outpatient dermatology departments at the Al-Basrah teaching hospital and the Abu Al-Khaseeb hospital as well as the private clinics of two dermatology specialists in Basrah. A total of 235 patients with facial dermatoses secondary to the application of topical corticosteroids and counterfeit products or, a mixed formulation, for cosmetic purposes were recruited. Results: Most enrolled patients were female with 10-20 years aged group. The majority applied these products due to friends or pharmacy encouragement. Motivations for the use of these products included: skin fairness, lightening, and general cosmetic. Interestingly, acne and erythema were common whilst, atrophy, dryness, telangiectasia, and hirsutism appear on long- term use only. Conclusion: The abuse of counterfeit cosmetic products and topical corticosteroids is in progress and they have adverse health events. There are many causes behind the abuse but the lack of education, lack of restriction, profitable for sellers and low prices are the main.

Cutaneous and systemic adverse effect of topical corticosteroids misuse on glucocorticoid dependent women in Iraq.

“…TCS was used by women for cosmetic and fairness reasons. Surprisingly, these products enhance the lightening and redness of the skin (12). In reviewing the literature, skin lightening appeared to be the most common reason for using TCS (19,20), followed by fungal infection and acne (21).…”

“…Clobetasol, betamethasone, and dexamethasone are often included in these products (12). Indeed, cheap prices and widely available fake TCs at pharmacies, stores, and marketplaces in Iraq enable facial TC usage.…”

“…Lack of knowledge, an absence of limits, vendors making rapid gains, and inexpensive pricing are the primary reasons these compounds are abused in Basra city. Our city uses fake cosmetics and topical corticosteroids (12).…”

Systemic glucocorticoid prescriptions pattern and factors of inappropriate use in primary care institutions of Southwest China

“…Several studies ( 15 , 29 , 30 ) have also focused on the inappropriate use of systemic glucocorticoids in primary care institutions. Other studies have described prescribing patterns of topical glucocorticoids ( 31 – 35 ), and factors associated with their inappropriate use ( 36 – 39 ). However, few studies have comprehensively examined the prescription patterns and factors associated with inappropriate use of systemic glucocorticoid in primary care institutions.…”

The prevalence of topical steroid use and steroid induced Rosacea among Saudi Population, Hail city: A cross sectional study

“…It has been abused by the general public and has many side effects since topical corticosteroids are available at low cost and easily over the counter in some countries (Sendrasoa et al, 2017). Many corticosteroids are over used for a variety of reasons, including pigmentation, acne, pruritus, fungal or bacterial infections, rashes and a variety of other problems (Jaccob et al, 2020). Long term use of topical corticosteroids can lead to the development of dermatitis known as topical steroid induced rosacea like dermatitis (Diehl & Cohen, 2021).…”