A Prospective Study of Cutaneous Adverse Effects Among Patients With Topical Corticosteroid Abuse in a Tertiary Care...

Background Topical corticosteroids are widely used in dermatology because of their rapid anti-inflammatory effects. However, their easy availability and lack of awareness regarding their adverse effects have led to widespread misuse, resulting in a growing burden of steroid-induced cutaneous complications. Objectives This study aims to assess topical corticosteroid abuse, analyze the patterns and duration of use, identify the commonly used topical corticosteroid agents, and document the spectrum of associated cutaneous adverse effects. Methods A prospective observational study was conducted in the Department of Dermatology at Srinivasan Medical College & Hospital, Dhanalakshmi Srinivasan University, Trichy, Tamil Nadu, between November 2023 and December 2024. Adult patients with a history of topical corticosteroid use presenting with clinically evident corticosteroid-induced cutaneous adverse effects were consecutively enrolled after providing informed consent. Demographic data, indication for use, source of procurement, duration of application, and type of topical corticosteroid used were recorded. Patients underwent a detailed dermatological examination, and adverse effects were documented. Data were analyzed using descriptive statistics. Results A total of 120 patients were included, with a mean age of 33.88 ± 13.50 years. Females constituted the majority (60.8%, n=73). Non-prescription use of topical corticosteroids was observed in 60% (n=72) of patients. The most common indication for use was dermatophytosis (58.3%, n=70), followed by melasma (10%, n=12) and acne (5.8%, n=7). The duration of misuse ranged from less than one month to more than two years, with 31.7% of patients using topical corticosteroids for 1-3 months. Tinea incognito (33.3%, n=40) was the most frequent adverse effect, followed by acneiform eruptions (15%, n=18), acne flare (15.8%, n=19), and pigmentary changes. Conclusion Topical corticosteroid abuse is common and is largely driven by non-prescription use, particularly for fungal infections. The resulting cutaneous adverse effects cause significant morbidity. Strengthening regulatory control, promoting rational prescribing, and improving public awareness are essential to curb this preventable problem.