The use of topical skin creams with corticosteroids in undisclosed or hidden quantities is becoming a big public health issue especially in third world countries such as India. Unlabeled and unmedically supervised powerful steroids are used in many fairness creams, antifungal combinations and over-the-counter quick-fix dermatological products.
Although corticosteroids may be useful in cases where they are used properly, they may be very damaging in the case of abuse and long-term use. Typical side effects are skin thinning, acnes that is caused by steroid use, pigmentation, rebound flare-ups, fungal resistance and delayed wound healing. Hypothalamic-pituitary-adrenal (HPA) may even be suppressed systemically in children, as well as in long-term users.
It is compounded with easy over the counter availability, misleading advertising, regulatory laxity, and lack of awareness by people. Users who use these creams over months without knowing their effects, be it treating acne or itching or pigmentation, just find themselves getting worse once they remove them in a loop of dependence called topical steroid addiction.
Medical workers are also meeting the cases of steroid-modified dermatophytosis and long-term skin damage, which are challenging to treat and dodge with appropriate control and education.
Combination creams should be controlled more rigidly, they should be labeled clearly, pharmacists should be responsible, and the populations should be educated. It is not a case of self-medication whereby skin conditions are to be diagnosed, not self-medicated and what seems like a quick fix could be a long term damage.
Have you ever looked at the label of a skin cream, and checked whether it has a steroid in it?
MBH/AB