'Harmful' topical steroids use 'out of control' in India

The use of "harmful" skin creams and lotions that contain steroids is out of control in India, according to an expert.

Corticosteroids, also known as steroids, are anti-inflammatory medicines used for a range of conditions. However, these can lead to substantial and permanent damage, especially on thin skin, such as on the face and groin.

Side effects include pigmentation and breakdown of the skin, small and widened blood vessels on the skin, as well as bacterial and fungal infections. Misuse can lead to resistance of infections that can make these difficult to diagnose and treat.

Shyam B Verma, a consultant dermatologist based in Gujarat, says that Indian doctors are witnessing a pandemic of adverse effects induced by topical corticosteroids.

A study of 2,926 dermatology patients in 2013 showed that 433 were using topical steroids and 392 had harmful effects.

As required by law in India, strong steroids can be sold only with a registered medical practitioner's prescription. However, topical steroids are exempt and can be purchased over the counter, which needs urgent revision, according to Verma.

Another problem that leads to the inappropriate use of topical steroids is that too few specialist dermatologists are available. The majority of India's some 8,500 dermatologists are based in cities, while most of India's population is dispersed in villages.

In addition, he says the public, as well as doctors of all specialties, need to be informed and educated about safe use of topical corticosteroids.

The study appears in The BMJ.