MISUSE OF TOPICAL CORTICOSTEROIDS AMONG PATIENTS VISITING OUTPATIENT DEPARTMENT DHQ, GUJRANWALA

Background: The use of skin-color lightening products containing topical steroids is a practice amongst men and women of Pakistan. People of different age groups, socioeconomic status and marital status use a variety of these products. In addition to topical steroids, some products also contain mercury and hydroquinone derivatives. The use of such substances is associated with many aggravated skin conditions. OBJECTIVE: The aim of this study is to assess the magnitude of use of products containing topical steroids and their derivatives, the adverse effects stemming from their use, the motivation/cause of their use and the demographics of patients who used such products. METHOD: A cross sectional study was conducted at dermatology department DHQ Gujranwala during the period of 1April to 15 May, 2018. Preset questionnaires were filled out for patients who used topical steroid products on their face. RESULTS: Out of 7740 patients who visited OPD, DHQ Gujranwala, and 384 patients presented symptoms of facial dermatosis. 52% among them had used products containing topical steroids. 51% were unmarried and in the age group of 20-29 years. 14%were illiterate, 35% had passed matriculation. 47% were house wives. 60% belonged to urban areas. Majority of them (92%) were aware that use of steroids can be harmful. 14% used pure steroids while 86%used hand crafted mixtures. 47% were using steroids prescribed by relatives, 23% on recommendation of friends. 3% were prescribed by physicians and only 0.5% by dermatologist. 56% used them for whitening melasma and acne and 0.5% for treatment of tinea. 33% Presented adverse effects of melasma and freckles, 27% presented acne, 8% with burning on face. Symptoms of hypopigmentation and hyperpigmentation are rare (1%). Patients with extended use presented cases of plethora (24%), hypertrichosis (14%) cutaneous atrophy (5%). No side effects were seen in (25%)of the patients. CONCLUSION: The application of Topical steroids on the face leads to a multitude of side effects and skin conditions. It is essential to create awareness among the patients as well as the doctors regarding the proper use of these drugs.