JOIN USSteer clear of steroids
Despite movements that reiterate that black and brown are beautiful, many people still feel that a fair complexion is more beautiful. Therefore, everything from cleansers to creams to capsules and intravenous treatments to skin lightening/fairness methods continue to evolve. But some products and procedures are unhealthy and do more harm than good. Steroid-based skin lightening creams do fall into this category.
What are steroids?
Steroids are manmade medicines, the same as, or similar to, certain naturally occurring hormones in the body. The body produces steroids to support functions such as fighting stress and boosting growth and development. There are two main types of steroids: anabolic-androgenic steroids and corticosteroids. Anabolic steroids are different from corticosteroids and are often used without medical advice by some people to improve their muscle mass and athletic performance. On the other hand, corticosteroids are anti-inflammatory medicines used to treat various conditions. They quickly fight inflammation in the body.
Steroids on skin
Topical corticosteroids, which come in creams, lotions, and gels, have been used for more than six decades to treat skin conditions, including eczema, contact dermatitis, and psoriasis. Similarly, topical corticosteroids turn down the immune system processes that trigger inflammation. However, corticosteroids should only be used on the skin for a short period and under the supervision of a doctor, ideally a dermatologist, because long-term use can lead to severe skin damage. The side effects include:
Itching
Burning/stinging sensation
Acne and acneiform eruptions
Redness & dryness
Atrophy (skin thinning)
Facial rash in which bumps develop around the mouth (perioral dermatitis)
Modified fungus infections like tinea incognito
Pigmentation
Excess facial hair growth (hirsutism)
Striae (stretch marks)
Easy bruising and tearing of the skin
Telangiectasia (enlarged blood vessels) and Photosensitivity (reactions to sunlight caused by an immune response to ultraviolet rays)
Furthermore, in the recent past (2008), a medical phenomenon known as Topical Steroid Damaged/Dependent Face (TSDF) threw up a plethora of symptoms caused by a usually unsupervised misuse/abuse/overuse of topical corticosteroid of any potency on the face over an unspecified and/or prolonged period. This misuse causes semi-permanent or permanent damage to the skin and seriously affects the user’s quality of life in general. Management is complicated and necessitates psychological counselling to build up mental health and physical soothing for sensitive skin.
Dependency on steroids
Corticosteroids also have a depigmenting effect that is thought of as desirable by many women and men especially affected by colourism. Women in Asia, Africa, and Hispanic communities where fair skin and Eurocentric beauty are adored, regularly misuse topical corticosteroids to lighten the skin cosmetically. This misuse of the drug often results in steroid-dependent skin. Once the skin is addicted to steroids, it is hard to stop using them without proper medical treatments. Or it may lead to irreversible side effects in the future if continued.
Moreover, as per the recent white paper published in Endocrine Abstracts (2020), the findings suggest men and women who abuse corticosteroid creams for skin lightening might be at risk of developing lower baseline cortisol levels, a sign of weakened cortisol function. In addition, it has been reported these steroid-based creams are being wrongly used to treat fungal infections in the groin area. Since the skin in the genitals is already sensitive, using steroid creams or ointments over that area can lead to severe damage even though they might temporarily mask the infection and give relief.
Therefore, awareness about the side effects of using steroid creams is a must to prevent people from compromising their unique natural complexion as well as damaging their health severely.
In India, most topical steroids are only available on prescriptions. Unfortunately, most of these restricted creams can still be bought over-the-counter country-wide. We require strict regulations to avoid entirely selling these strong steroids over the counter. Only then can this abuse be controlled.
Avoid steroid abuse
If you are contemplating buying instant fairness or whitening cream, your friends suggest checking the ingredient list, and learning about key ingredients is always advisable. A little bit of reading goes a long way. Just google the jaw-breaker names that you are unfamiliar with. If you find ingredients like Betamethasone, Clobetasol Propionate, Mometasone, and Hydrocortisone, drop the idea of using the fairness cream.
Or, if you are already using a steroid-containing product to lighten your skin, stop applying immediately and consult a dermatologist to help you out of this addiction.
If you use a steroid cream for a long time and it is difficult to stop using it because you get symptoms like acne breakouts, red skin, and rashes, visit a registered dermatologist ASAP. Your doctor will slowly put you off the cream by using some substitute as the skin has become dependent on the steroid.
(The author is a dermatologist.)