IATROSACEA FOLLOWING ABUSE OF TOPICAL STEROIDS AS A FACE-WHITENING CREAM IN MOSUL CITY

Abstract

Objectives: To highlight the knowledge, frequency, types, and the clinical aspects of overusing TCs on the face as well as the motivation for such 
practice, with the aim of rising the public awareness in Mosul City. Methods: This prospective observational study included 180 patients aged 13-53 
years, with steroid dermatitis resembling rosacea "Iatrosacea" with history of using TCs on face > 1 month, were evaluated at Al-Qudis Health Center 
for Family Medicine. Patients contradicted using TCs, or with classical rosacea were excluded. Results: The majority were females (90%). Duration 
was 2 months to 7 years. The motives were fairness (55%) and melasma (19%). The commonly abused drug was Betamethasone Valerate (35%). The 
reported side effects were facial erythema (84%), telangiectasia (79%), rebound phenomenon (66%), rosacea (56%), and acne (42%). The exacerbation 
on stopping TCs (63%) and skin lightening (37%) were the main reasons behind continued use; 59% were unaware about side effects of TCs; 42% 
obtained the products from cosmetic shop/Beautician and 27% from nurse clinic. In spite of observable side effects, 74% of abusers didn't feel guilty 
for applying them for protracted periods. Conclusion: Inappropriate use of TCs for cosmetic purposes is still commonly encountered in our environment, 
with believe TCs will correct any facial imperfection. As fair skin is correlated with beauty and social privilege, both genders of different ages, social, 
and educational status are indulged in this practice that exposed them to medical and social problems. It is a multiphase issue necessitates collaboration 
of different sectors to raise public awareness and control their easy availability to overcome this dilemma.