Stop Topical Steroid Abuse

An Appeal to Public by IADVL

( Indian Association of Dermatologists, Venereologists & Leprologists)

THEME IADVL 2019- “FIGHT TOPICAL STEROID MISUSE”

A man had itching in the groin

He went to a chemist’s shop

Hi, give me something for itching in the groin

Please go to a doctor. Let him examine you and decide the disease and the medicine.

Please give me now. I do not have time to visit a doctor.

Then try this.

Invariably he gives you combination of steroid, antifungal and antibacterial

Momentarily you saved your time and money

See what happened next

You apply the cream

You feel better

You stop applying the cream

Relapse

And the vicious cycle continues…

Waves of remissions and exacerbations

And then remission stops

Only exacerbation

and

Now SIDE EFFECTS start.

• So initially you thought you saved your time and money by getting a cream on the counter ( OTC).

• But in fact it cost you more time and money.

• Remember, a stitch in time saves nine.

And you also modified the disease by applying steroid cream. The doctor who examines you may not be able to diagnose such modified disease.

• Nowadays almost 20 to 25 % of patients seen by a dermatologist in India are of Ringworm ( Fungal Infection)

• Almost all are modified by application of topical steroid.

Large body area involvement

Disease common in even kids

And Infants

Waistline and groin commonly affected

Creams also have side

effects like tablets and injections.

It thins out the skin and leads to stretch marks.Walking becomes troublesome.

Stretch mark is permanent damage to the skin.

Ulcers occur in the stretch marks

Bleeding occurs underneath the skin

Steroid cream applied for a fungal infection.

Multiple stretch marks, thinning of skin.

Fungus still prevails.

It modifies infection

Simple diagnosable ringworm

Complicated, difficult to diagnose ringworm

Steroid cream applied all over – irreversible stretch marks

Severe recalcitrant fungal infection

Severe recalcitrant fungal infection

Doctor prescribes once

Patient continues lifelong

Leads to obesity, raised blood pressure & diabetes( Cushing’s syndrome)

Cream gets absorbed through skin.

• Many steroid combination creams are available with antifungal and antibiotics.

• There is no rationale behind it.

• We also educate general practitioners not to prescribe them.

For your skin problem consult a doctor,preferably skin

specialist.

One more issue which requires your attention

Tremendous craze for fairness in public, males are not behind.

We become prey of such advertisements and ruin our face

Growing craze of Fairness in youth

• There is rat race in the society to look fair.

• Market is flooded with fairness creams.

• Many such creams contain steroids.

• Youngsters use them on recommendation of friends, relatives, parlors, chemists and even pharmaceutical companies.

• Most of these youngsters then approach us (Dermatologists ) with variety of side effects on face.

• Some of them are irreversible side effects.

Permanent dilated blood vessels seen through thinned out skin- irreversible side effect

Perioral Dermatitis

Rosacea

Persistent Erythema ( Redness)

Erythema and unwanted hairs on face

Unwanted hairs on face – irreversible side effect

Pimple like rash on the face

50

Pimple like rash and unwanted hairs on face

Exacerbation Of Acne

30 Dec 2013 Prepared by IADVL egroup members 52

Melasma was unaffected but developed severe acne

She applied steroid cream for melasma

Even very low potency steroid cream can cause side effects

Skin becomes thin, sensitive with burning& stinging.

She applied steroid cream even on hands for fairness

Skin became thin leading to unsightly prominent veins –permanent damage.

Steroid cream applied near eyes caused Glaucoma

A spotless face with glow and confidence looks more beautiful than a fair face with spots and blemishes.

Still more important is “ BEAUTY LIES IN THE EYES OF BEHOLDER” You are /will be a special for somebody.

Total 6 skin types according to body colour. European- type 1, African- type 6 .We are between 2 to 5.

Craze to run behind something which we don’t have. She wants tanned skin.

Type 1 skin burns by sun exposure , Ours’ tan.. More darker the skin type, more the tanning.

So if at all you want to look fair , just avoid sun exposure. Use stroll, hats, sunscreens etc.

Just don’t bother what people say. BE YOURSELF , LOVE YOURSELF.

So is topical steroid dangerous to skin health?

NO

It is like other inventions like atomic energy, television, internet, mobile etc.

These inventions can be used for our benefit but can be misused also.

• Topical steroid is very safe and very useful if used for proper indication and in right potency.

• We dermatologists use it properly and judiciously. We use it daily for various skin indications.

• Even oral and injectable steroids are life saving and used for various inflammatory and allergic disorders.

How to identify whether a cream contains steroid

Those creams or their contents having letters like vate, derm , sone, sol, gm, mg, nm ,plus, mix or numbers like 3,4,5 or signs like + in their names are likely to have steroid in them.

There is an App prepared by a dermatologist to find out steroid in a cream. It’s name is “Steroid finder for your cream”. It is available on Playstore.

Many companies market their “combination” creams

as a” Blanket” treatment for all skin diseases.

One cream for ALL skin diseases.

Is it possible?

It is up to you to decide .

दाद, खाज, खुजली व एग़जजमा, जले, कटे, फोड,े फुनसी, जख्म, जाांघो की खुजली से तुरांत राहतत

Take Home Message

• Do not buy any cream without doctor’s advice/ prescription.

• Do not use any cream and especially steroid containing creams without doctor’s advice.

• Do not use any cream recommended by friend, relatives, parlor staff, chemists. It may contain steroid.

Take Home Message-contd.

• Do not use creams claiming for fairness without consulting a doctor. It may contain steroid and may ruin your face.

• For your skin problem consult a doctor, preferably a skin specialist.

• Do not use any cream prescribed to you long ago. This time your disease might be different or modified.

• Do not give your cream to your friend or relatives. His disease may be different.

Take Home Message-contd.

• Do not run behind fairness. Just avoid sun exposure to retain your original skin type.

• Skin is an important organ of the body. Kindly do not ruin it by using creams recommended by anybody else than a doctor or skin specialist.

A presentation by ITATSA(IADVL’s Taskforce Against Topical Steroid Abuse) in public interest

THANKS