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STEROIDS - THE MOST MISUSED 

The most common misconception everyone ( even in the medical field ) has about any skin condition is that it can be treated by simply using The Mighty- Steroids. 

Steroids, since the beginning of their application in Dermatology have been a game changer and sometimes life saving in grave situations. They are an arsenal for physicians in their day to day clinical practice.

Steroids, both oral and topical, are most commonly and extensively prescribed by dermatologists for varied skin disorders, owing to their anti- inflammatory and immunosuppressive properties. They also relieve pruritus (itching) and allergic reactions. But abuse* or misuse* of steroids can lead to severe and sometimes irreversible complications which has become a concern for dermatologists globally.

PS : *Abuse - improper and unregulated usage of the drug.

        *Misuse - incorrect usage of the drug.

WHY HAS THERE BEEN A RAPID RISE IN MISUSE OR ABUSE OF STEROIDS SINCE THE LAST DECADE?

 Few reasons include :

• No proper awareness of steroid abuse/misuse among the general public.

• Usage of steroids for every common skin condition like for skin infections, acne or pigmentation.

• Irrational prescriptions of steroids by family physicians for non indicted conditions.

• Unsupervised prescription by Quacks (non doctors)

• Advised by chemists/physicians and unregulated selling of them as OTC products ( heard from many patients).

• Usage of steroids by the patient beyond treatment period without checking with a dermatologist.

• Easily available and affordable for cheaper prices.

• Development of dependency (for eg usually seen in patients using  “fairness creams with no labelling“).

• Manufacturing and labelling misuse (many beauty parlour creams or fairness creams or herbal creams  have little amounts of steroids which can lead to dangerous side effects when used for years together).

WHAT ARE THE COMPLICATIONS OF STEROID ABUSE/MISUSE?

1. Oral Steroids Abuse/Misuse : Whether prescribed or taken unknowingly (like in protein powders or few herbal tablets), unwanted and unregulated usage of oral steroids for prolonged periods can lead to severe complications like obesity, diabetes, increased blood pressure, acne, baldness, cancers etc to name a few.

2. Topical Steroids Abuse/Misuse: The abuse and misuse associated with topical steroids among the public is on alarming rise.Topical steroids are even used as fairness creams or OTC products without doctors supervision. It is a menace that needs immediate and urgent regulations to curb.

Many patients use Topical Steroids for common skin indications like acne, pigmentation, eczema and infections mainly fungal infections leading to permanently damaged skin. 

Few complications* of Topical Steroid Damaged Skin (most of the times they are irreversible too)  include:

Acne

Pigmentation Changes 

Stretch Marks

Skin Atrophy Or Thinning

Redness Over Face

Irritation, Burning Sensation Or Itching

Unwanted Hair Growth

Cancers ( due to systemic toxicity )

PS: *All the above mentioned complications won't occur when steroids are used according to Dermatologists instructions and supervision.

Thus it is clear that irrational and unsupervised rampant usage of Steroids can lead to threatening side effects, which, in reality, can easily be avoided if Patients understand and adhere to Dermatologist advice.

This ludicrous peril needs our immediate and immense attention. Few effective measures at every level of the problem can assist in this fight against Steroid Abuse/Misuse. They include :

A) Medical Fraternity Level:

• Mention dose and duration of steroids properly and explain the same to the patient.

• Educate patients about steroid abuse and misuse.

• Keep awareness posters in their clinics or hospitals.

• Monthly campaigns or programs to aid the awareness.

• Educate patients not to use steroids as OTC products.

• Awareness about quackery and their role in this menace.

• Physicians shouldn’t prescribe steroids for non indicated conditions and refer patients to Dermatologists.

B) Patient Level :

• Don't use steroids (oral & topical) beyond the specified period mentioned by Doctors.

• Don’t keep on using steroids (oral & topical)  for faster and quicker responses. Consult with your     dermatologist. If you are using them without consultation, stop immediately and seek Doctors  supervision.

• If anyone you know is using steroids, educate them to stop and encourage them to seek doctors advice.

• Refrain from using steroids for every skin hair or nail conditions without doctors consultation. 

• Don't buy “All In One” type of medications.

• Don't apply OTC products or fairness creams with steroids without Doctors approval.

• Don't apply OTC products or fairness creams without any labelling.

• Don't buy unknown products on others' suggestions or social media ads.

C) Chemist Level

• Don't dispense steroids without prescription.

• Don't dispense steroids if the validity of prescription has expired.

• Refrain from dispensing steroids to every dermatology related condition.

• Educate patients about serious complications of steroid abuse/misuse.

D) Manufacturer Level :

• Mention the steroids dosage and generic name without fail.

• Don't include steroids in preparations as a cheap alternative.

• Don't manufacture and market  “All In One” type of medications.

• Educate patients about serious complications of steroid abuse/misuse.

I know that this post is long, but after consulting and counselling so many patients for steroid abuse/misuse and seeing their agony, it is my duty to educate and enlighten the public and my colleagues. If we all work as an unifying community, we can win against this impending doom. 

   

SAY NO TO ABUSE/MISUSE OF STEROIDS

EDUCATE YOURSELF AND ENLIGHT YOUR DEAR ONES TOO.