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Topical Steroid Damaged Face (TSDF)

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What are Topical steroids?

Topical steroids, also known as corticosteroids, are medications applied directly to the skin to reduce inflammation and relieve various skin conditions. These synthetic drugs mimic the effects of natural hormones produced by the adrenal glands, helping to suppress the immune response that leads to inflammation.

Topical steroids come in different strengths, from mild to potent, and are commonly prescribed to treat skin conditions such as eczema, psoriasis, contact dermatitis, and rashes. While they can be effective in managing these conditions, it’s crucial to use them as directed by a healthcare professional to avoid potential side effects like thinning of the skin, stretch marks, or skin discolouration. Regular monitoring and proper application ensure the safe and effective use of topical steroids for skin ailments.

topical steroids damaged skin

Topical Steroid Damaged skin

Introduction: Topical glucocorticoids represent one of the most commonly prescribed and essential drugs for treating allergic skin disorders. They are available as combinations with antibiotics and antifungals; They should be only prescribed by a licensed medical practitioner in appropriate quantity and duration. However, because of their immediate suppressive actions, fairness-inducing effect and low cost, their misuse and abuse have increased, leading to several serious issues.

What are the problems with overusing topical steroids

  1. Incomplete treatment of skin disorders
  2. increases skin infections caused by bacteria, fungi or arthropods.
  3. dependence or addiction
  4. Side effects range from local effects such as atrophy, stretch marks, red blood vessels, increased hair growth on the face acne rtrichosis and acneiform eruptions, Some of these side effects are irreversible and impact quality of life adversely.

Why is this issue happening?

A major concern for dermatologists in recent years has been the rampant use of steroid creams due to selling by chemists as a non-prescription drug, as a counter(OTC)  product. Use as Fairness product: Another very important concern is the use of steroid creams for treating pigmentation and also to enhance fairness – An alarming situation in some countries is these creams are being advertised as beauty creams and sold online also. This has also lead to over-the-counter prescriptions, sales through beauty clinics, and online supplies. In India, this has lead to a constellation of symptoms and signs on the face called “ Topical steroid damaged face(TSDF).

What is the problem with using topical steroids for fungal infections?

Impact on Resistant and Recurrent Superficial Fungal Infections: In the past 5–7 years, there has been an alarming rise in the overall number of cases and an increasing proportion of difficult-to-treat chronic and recurrent fungal infections in India. Abuse of irrational “fixed drug combination”  creams containing topical steroids with antifungal and antibacterial agents that are available “over the counter” in India has led to the evolution of extensive, varied manifestations of fungal infections  which are difficult to treat, increasing the burden of such cases in the community is important to  recognize that

  1. Topical steroid abuse is a serious problem in several countries
  2. Topical steroids are being used as fairness creams in brown black population to overcome bias over black brown colour
  3. Such abuse is being augmented by the use of fixed-dose combinations of topical steroids with antibiotics and antifungals
  4. Such use is further being aided and abetted by over-the-counter sales and through beauty clinics
  5. This is leading to serious topical side effects on the face (TSDF ) and on body, steroid dependence and contribute to resistant superficial fungal infections

What are our recommendations?

  1. Patients should not do self-medication
  2. Patients should go strictly as per the advice of the doctor
  3. Cream should only be used for a limited time 1-2 weeks
  4. It should only be used over the area of disease
  5. It should not be used as fairness cream

 

Topical steroids and their abuse.

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