By Abolude Yusuf
In the absence or inadequacy of health knowledge, human being may unknowingly abuse their body. In this regards, human skin which is the largest organ of the integumentary system has been under mutilation from misuse of topical steroids among unaware populace in Nigeria.
What are topical steroids?
These are steroids containing medicines which exists as ointments, lotions, creams, gels, solutions or aerosols that can be appplied locally on the skin. They are known clinically for their vast usefulness and unique suffixes such as dexamethasone, triamcinolone, fluocinolone, hydrocortisone and the odd to this suffixes are the clobetasol dipropionate,desonides, amcinonide and their likes.
To be precise these drugs are popularly becoming available for purchase over the counter in different brand names where they either exist as mainly steriod ointments such as dermovate or movate, kenalog, betnovate, locoid and derma-smoothe or as combination with topical antibacterial or antifungal such as in epiderm cream, funbact A cream and skineal.Unfortunately topical steroids are having an easy ride into a different use by vast sections of Nigerians with growing interest in unimaginable facial beautification.This is just one of the many misuse which might be too costly.
This topical steroids are of immense benefits in field of dermatology to a dermatologist and sufferer of various forms of inflammatory skin disorders such as eczema, atopic dermatitis to mention but a few. This is due to extraordinary ability of these drugs to suppress or cure various inflammatory disorders that can affect human skin. However the menace that can arise from misuse of it outside the watch of a dermatologist is reaching a pinnacle of relevance in our country with looming public health implications.
Misuse in this context may be referred to as use of this drug for purposes it was not intended for or using in excessive quantities for purpose it was suited. This is an area of warning to Nigerians as topical steroids are like double edged sword whose health risks has no mercy on any age group who misuse it as most of the side effects are irreversible once sets in.
Notable implications of this misuse include but not limited to:
-Unimaginable rate of topical steroids (Cortisone) usage in toning
Topical steroids are becoming an active ingredients in achieving facial or body whitening nowadays. Many are increasingly available in gels containing steroids alone or coexisting with other lightening agents. Infact, it has reached a point of epidemic significance as latest study ranked Nigeria as the leading users of toning creams in Africa with more than 75% of our women accounting for such high rate.This is a bad signal at a time we are combating infectious diseases and non communicable diseases.
-Overzealous use in treatment of acnes or skin spots which is gradually becoming a self treatment care among our teeming youths.
-Unbelievable increase in home concocted topical steroids and body cream combination, as a daily topical measures to combat any form of skin eruptions in children and maintain a fine tone.This is a scary misuse that has no evidence and poses a great danger to children in whom penetration of topical steroids through their skin is marked.
All these could be attributed to the increasing prevalence of eurocentric beauty standards,unrelenting craze for skin beautification, rapidly expanding over the counter sales of topical steroids and increasing number of mothers with aversion for afrocentric beauty.
This urgently demands that, an health conscious person should beware of misuse and need for suspected populace to awake from their slumber.
Health risks associated with misuse of topical steroids are not far fetched and could be explained briefly here. They are either localised (limited to site of topical application) or systemic side effects (disrupting internal functions of some body systems).
The localised side effects of topical steroids misuse include:
-Skin atrophy or thinning: This is the commonest side effects of topical use which arise from gradual loss of protective epidermal layer of human skin. The integrity of human skin is jeopardised in users.
-Striae or stretch marks: This is different from stretch marks of pregnancy or excessive weight gain. This is due to effects of topical steroids on dermal layers of human skin.
-Easy bruising of skin to microtrauma,delayed wound healing and minute bleeding spot on the skin could be seen over few weeks of usage.
-Mucocutaneous infections: Very common with misuse. This is as a results of steroid suppressed natural ability of skin to mount immune response to microbial infections of skin.
-Hypertrichosis: Sudden appearance of vellous hair growth at sites of application.
-Loss of skin pigmentation (hypopigmentation): This is quite observed in dark skinned individuals who are regular users of topical steroids.
-Risk of allergy: Exaggerated skin reactions informs of sudden itching,skin swelling or redness at sites of topical use. This is common with hydrocortisone and budesonide ointments.
-Risk of addiction to steroids.
-Tachyphylaxis: Condition in which the body is becoming less sensitive to the topical drug which may necessitate switching to abuse potent alternative and at the end leads to more severe side effects in such individual.
Systemic effects of public health significance are;
-RIsk of glaucoma and cataracts: An observed effects in people with topical misuse of steroids on the face over time which is dangerous in this period where facial cosmetics is becoming an hobby among vast section of Nigerians.
-Risk of secondary hypertension: an overlooked contributor to global burden of hypertension should not be awaken and must be nipped in bud among abusers of topical steroids especially hydrocortisone.
-Risk of diabetes mellitus: Misuse of topical steroids could unmask latent diabetes mellitus or triggering elevated blood sugar levels over time, bearing in mind the burden of diabetes melitus in Nigeria and world at large.
The above points,are the notable side effects out of many that misuse of steroids outside watch of a dermatologists could predispose to;hence a note of warning to unaware populace that it will be SUICIDAL to subject your skin to steroids misuse under any non medical recommendation.
To this end, there is a tripod onus to curb this menace that behoves on Nigerian government, Nigerian dermatologists and pharmaceutical industries to save the so called unaware populace.
Dr. Yusuf is a medical practitioner based in Ondo
