Topical Steroid-Dependent Face

Abstract

Unsupervised and long-term use of fluorinated/potent topical steroids on the face can lead to side effects such as acne, skin thinning, photosensitivity, and a typical clinical presentation of a topical steroid-dependent face (TSDF) with rebound flushing, burning, dryness, and scaling on attempted withdrawal of the potent topical steroid cream. To evaluate the response of a commercially available nasal decongested solution of xylometazoline 0.05% in patients of long-term potent topical steroid abuse on the face. Two patients with a history of long-term, indiscriminate, and unsupervised topical steroid use on the face were asked to use a commercially available nasal decongestant solution, on face. Patients were asked to use the decongestant solution on face, once daily for 2 weeks. Follow-up after 2 weeks demonstrated excellent improvement in flushing and erythema. Side effects reported were transient tingling and stinging sensation. Xylometazoline, being an alpha-adrenergic agonist, presents an effective new option for treatment in patients of flushing and erythema, resulting from long-term topical steroid use on face.

Clinical profile of Tinea pseudoimbricata: an observational study from a tertiary care institution in western Maharashtra, India

“…History of potent topical steroid application steroids prior to appearance of lesions was present in all our patients. Our findings of this demographic data is similar to the finding by Singal et al, Verma et al, Verma et al, Jakhar et al and Kakkar et al [4][5][6][7][8] This suggests that many women are seeking treatments in order to have fair skin. Lack of resources, wrong notion among the general population and especially the pharmacists that steroid application helps in brightening of skin, supply of drugs by pharmacists without prescription has lead to steroid misuse.…”

Dermoscopy of topical steroid-dependent or damaged face: A cross-sectional study

“…7 TSDF presents as a stumbling block for the patient as well as the treating dermatologist. 8 At first, patients may initiate using TCS for some minor dermatosis such as acne or melasma upon suggestion by friends and relatives. 9 Ab initio, the anti-inflammatory and vasoconstrictive effects of steroids result in what appears to be clearing of primary dermatitis, but their incessant use culminates in atrophy of epidermis, degeneration of dermal structure, and collagen deterioration over several months.…”

“…9 Ab initio, the anti-inflammatory and vasoconstrictive effects of steroids result in what appears to be clearing of primary dermatitis, but their incessant use culminates in atrophy of epidermis, degeneration of dermal structure, and collagen deterioration over several months. 8 Various studies have stressed upon the diverse clinical manifestations of TSDF. Female predominance has been reported by most investigators, which was the finding in this study as well.…”

Xylometazoline and oxymetazoline - unusual effects of everyday drugs (literature review)

“…Transient tingling and prickling sensations were reported adverse reactions. [9] Xylometazoline, which is an alpha-adrenergic receptor agonist, is an effective new treatment option for patients with redness and erythema resulting from long-term topical steroid use on the face. Similar to the aforementioned cases, the property of imidazole derivatives is being attempted in the treatment of rosacea, telangiectasias and port-wine stains [10].…”

“…Recent reports also suggest new uses for xylometazoline and oxymetazoline. In combination with lidocaine, an intranasal solution of xylometazoline has shown efficacy in the anesthesia of maxillary teeth in patients with minor carious lesions [9], and a beneficial therapeutic combination of oxymetazoline and dye laser (PDL) has also been reported for the treatment of rosacea, among others [10].…”