Original Research
Knowledge and attitudes regarding topical misuse of corticosteroids in Libya
Intesar A.A. Alkilane, Mustafa A. Alssageer, Fatima A. Almahdi and Fatima K. Ahmed
Abstract :
Prescription drug misuse has emerged as a significant problem over the past decade, particularly topical corticosteroids for skin lightening. This study aimed to assess the misuse of topical corticosteroids among the female population in southern Libya; to determine prevalence, awareness, attitude, and practice regarding this drug misuse. A descriptive, cross-sectional questionnaire was distributed on January 2022 to females aged between 16-45 years old in southern Libya. Out of 200 distributed questionnaires, 155 were returned with a response rate of 77.5%. The majority of the participants were aged 16-25 years (n=138, 89.0%) and over two-thirds of participants, said they obtained lightening products containing cortisone from pharmacies (n=107, 69.0%) while 36 participants indicated they obtained these products from cosmetic shops (23.2%). More than three-quarters of the participants said they were aware that they should read product ingredients (n=120, 77.4%). Just over one-quarter of respondents indicated they used the product on their face almost daily (n=41, 26.5%) while 28 participants denied using it (18.1%). The most common source of information about topical corticosteroids among participants was the Internet (n=51, 32.9%), followed by dermatologists (n=41, 26.5%), and pharmacists (n=31, 20.0%). Almost half of respondents were aware that topical corticosteroids can cause harmful effects (n=75, 48.4%). The most common indications reported for using topical corticosteroids were whitening (23.3%), and acne treatment (54.2%). Over two-thirds of participants, declared they would not use topical lightening products if they contained corticosteroids (n=107, 69.0%). In a similar attitude, nearly a third of participants stated that they would never use corticosteroid medications again if they knew about the negative effects of whitening (n=51, 32.9%). The majority of females, (87.7%), concur that only pharmacies should be able to sell and prescribe topical corticosteroid medications. The study's findings indicate that topical corticosteroids are frequently misused and that to lessen contraindications, especially for prolonged use, it is imperative to provide basic care to females who continue using topical corticosteroids in public or unlicensed marketing settings.
References
1. Novak SP, Håkansson A, Martinez-Raga J, Reimer J, Krotki K, Varughese S (2016) Nonmedical use of prescription drugs in the European Union. BMC Psychiatry. 16 (1): 274. doi: 10.1186/s12888-016-0909-3
2. Hernandez-Juyol M, Job-Quesada JR (2002) Dentistry and self-medication: a current challenge. Medicina oral. 7 (5): 344-347. PMID: 12415218.
3. El yamani MA, Fathi M. Sherif FM (2021) Assessment of drug prescribing pattern and prescription errors in elderly patients. Mediterranean Journal of Pharmacy and Pharmaceutical Sciences. 1 (2): 46-50. doi: 10.5281/ zenodo.5171325
4. Dhafiri MA, Alali AB, Alghanem ZA, Alsaleh ZW, Boushel EA, Alali ZB, Alnajjar AA (2022) Topical steroid damaged face: a cross-sectional study from Saudi Arabia. Clinics and Practice. 12 (1): 140-146. doi: 10.3390/ clinpract12010018
5. Hughes J, Rustin M (1997) Corticosteroids. Clinics in Dermatology. 15 (5): 715-721. doi: 10.1016/ s0738-081x(97)00020-5
6. Saraswat A, Lahiri K, Chatterjee M, Barua S, Coondoo A, Mittal A, Panda S, Rajagopalan M, Sharma R, Abraham A, Verma SB, Srinivas CR (2011) Topical corticosteroid abuse on the face: a prospective, multicenter study of dermatology outpatients. Indian Journal of Dermatology, Venereology and Leprology. 77 (2): 160-166. doi: 10.4103/0378-6323.77455
7. Dey VK (2014) Misuse of topical corticosteroids: A clinical study of adverse effects. Indian Dermatology Online Journal. 5 (4): 436-440. doi: 10.4103/2229-5178.142486
8. Jha AK, Sinha R, Prasad S (2016) Misuse of topical corticosteroids on the face: A cross-sectional study among dermatology outpatients. Indian Dermatology Online Journal. 7 (4): 259-263. doi: 10.4103/2229-5178.185492
9. Ladizinski B, Mistry N, RKundu RV (2011) Widespread use of toxic skin lightening compounds: medical and psychosocial aspects. Dermatologic Clinics. 29 (1): 111-123. doi: 10.1016/j.det. 2010.08.010
10. Dadzie OE, Petit A (2009) Skin bleaching: highlighting the misuse of cutaneous depigmenting agents. Journal of the European Academy of Dermatology and Venereology. 23 (7): 741-750. doi: 10.1111/j.1468-3083.2009.03150.x
11. Joana A, Obinnim E, Selase GR, Emefa AF (2016) Skin bleaching and it’s negative effects on the physical appearance of the black skin. A case study of youthful ladies and women in Houston municipality in Ghana. Research in Humanities and Social Sciences. 6 (12): 67-73. doi: Nil.
12. Wone I, Tal-Dia A, Diallo OF, Badiane M, Touré K, Diallo I (2000) Prevalence of the use of skin bleaching cosmetics in two areas in Dakar (Sénégal)]. Dakar Medical. 45 (2): 154-157. PMID: 15779174.
13. Hengge UR, Ruzicka T, Schwartz RA, Cork MJ (2006) Adverse effects of topical glucocorticosteroids. Journal of American Academy of Dermatology. 54 (1): 1-15. doi: 10.1016/j. jaad.2005.01.010
14. Al-Samman DK, Al-Banna IM, Al-Shakarchy WN, Attar-bashi MM (2019) The effect of misuse of topical corticosteroids on skin. Iraqi Journal of Pharmacy. 14 (1): 63-75. doi: 10.33899/ iphr.2019.161196
15. Alssageer MA, Hassan AO, Rajab MO (2021) Descriptive analysis to use the community pharmacy by patients and customers. Mediterranean Journal of Pharmacy and Pharmaceutical Sciences. 1 (4): 59-66. doi: 10.5281/ zenodo.5806134
16. Jaccob AA, Yaqoub AA, Rahmani MA (2020) Impact of abuse of topical corticosteroids and counterfeit cosmetic products for the face: prospective demographic study in Basrah City, Iraq. Current Drug Safety. 15 (1): 25-31. doi: 10.2174/1574886314666191001100357
17. Sendrasoa FA, Ranaivo IM. Andrianarison M, Raharolahy O, Razanakot HO, Ramarozatovo LS, Rapelanoro Rabenja F (2017) Misuse of topical corticosteroids for cosmetic purpose in Antananarivo, Madagascar. BioMed Research Internation. ID: 9637083. 1-4. doi: 10.1155/2017/ 9637083
18. Hesse BW, Nelson DE, Kreps GL, Croyle RT, Arora NK, Rimer BK, Viswanath K (2005) Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey. Archives of Internal Medicine. 165 (22): 2618-2624. doi: 10.1001/archinte.165.22.2618
19. Närhi U (2007) Sources of medicine information and their reliability evaluated by medicine users. Pharm. World Science. 2 (6): 688-694. doi: 10.1007/s11096-007-9131-1
20. Seo H, Song SY, Kim D, Park JH, Shin Y, Lee KH, Choi SA, Lee J-Y, Kim DY, Shin WG, Kim E (2022) General public knowledge regarding topical corticosteroids: a nationwide survey in South Korea. Korean Journal of Clinical Pharmacy. 32 (2): 84-92. doi: 10.24304/kjcp.2022. 32.2.84
21. Al Tannir M, Alharbi AI, Alfawaz AS, Zahran RI, Altannir M (2016) Saudi adults' satisfaction with community pharmacy services. SpringerPlus. 5: ID 774. 1-5. doi: 10.1186/s40064-016-2442-8
22. Majed D, Alnujaidi M, Almohammadi N, Kokandi A (2018) Use of topical steroids on the face among university students in Saudi Arabia. Biomedical Research. 29 (13): 2786-2789. doi: 10.4066/ biomedicalresearch.29-17-3818
23. Shakeel S, Nesar S, Iffat W, Rehman H, Aziz S, Mumtaz T, Hadi H, Jamshed S (2021) Pharmacists’ insights and behaviors in preventing the misuse of topical corticosteroids in Pakistan: a mixed-method study. Cosmetics. 8 (3): 72. doi: 10.3390/cosmetics8030072
24. AlSamanhodi H, Almeshary M, Amoh K, Aldekhael S, Alkatheri A, Alharbi S, AlAmmari M, AbuRuz S, Albekairy A (2017) Evaluation of the causes and cost impact of returned intravenous medications at a tertiary care hospital in Riyadh, Saudi Arabia. Tropical Journal of Pharmaceutical Research. 16 (1). 231-237. doi: 10.4314/tjpr.v16i1.31
25. Karekar SR, Marathe PA, Nagarajan VB, Khopkar US, Chikhalkar SB, Desai PK, Dongre MS (2020) Use of topical steroids in dermatology: a questionnaire-based study. Indian Dermatology Online Journal. 11 (5): 725-730. doi: 10.4103/idoj.IDOJ_566_19
26. Kang MJ, Park JH, Park S, Kim NG, Kim EY, Yu YM, Kim DY, Lee JY, Shin WG, Choi SA (2020) Community pharmacists’ knowledge, perceptions, and practices about topical corticosteroid counseling: A real-world cross-sectional survey and focus group discussions in Korea. PLoS One. 15 (7): e0236797. doi: 10.1371/ journal.pone.0236797
27. Millard AN, Stratman EJ (2019) Assessment of topical corticosteroid prescribing, counseling, and communication among dermatologists and pharmacists. JAMA Dermatology. 155 (7): 838-843. doi: 10.1001/ jamadermatol.2018.5353
Citation :
Alkilane et al. (2024) Knowledge and attitudes regarding topical misuse of corticosteroids in Libya. Mediterr J Pharm Pharm Sci. 4 (1): 111-120. [Article number: 149]. https://doi.org/10.5281/zenodo.10732533