Assessment of over-the-counter utilization of topical corticosteroids in Addis Ababa, Ethiopia
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Date
2015-12
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Addis Ababa University
Abstract
Topical corticosteroids (TC) are generally safe when used rationally which otherwise may
cause significant morbidity among people. Over-the-counter (OTC) use of TC is prevalent
worldwide and is found to cause undesirable adverse effects. Particularly its use for cosmetic
purpose is a very common practice in Africa including in Ethiopia. The purpose of this study
was to assess the extent of OTC use of TC, identify factors contributed for the same, the most
common types of facial dermatoses noted among the dermatology outpatient department
attendees of the selected health facilities, and also to assess the extent of availability of TC in
selected cosmetics shops of Addis Ababa. A cross sectional study was carried out in the
dermatology OPD attendees of Alert Hospital and Rank clinic, and also in selected cosmetics
shops of Addis Ababa from February 10 to March 10, 2015. Data was collected by using
screening question format, pretested questionnaires, observation check list and key informant
interview. A total of 927 patients with facial dermatoses were screened; of those 200 (21.6%)
reported to have used TC on their face. The age of the patients ranged from 18 to 65 years
with mean age of 29.96 years (SD=8.56 years). Of the 200 patients who had used TC on their
face, 158 (79.0%) obtained the drug as OTC. More females reported OTC use of TC as
compared to males (p = 0.049). The types of facial dermatoses noted in majority 46 (29.1%)
of the patients was found to be Acne, followed by Melasma in 32 (20.3%) and Rosacea in 23
(14.6%). Community pharmacies for 78 (49.4%) of the patients and cosmetics shops for 50
(31.6%) were the commonest drug sources. Out of the total 9 cosmetics shops surveyed; TC
containing preparations were available in 7 cosmetics shops. The easy access as OTC, the
unregulated sales and use of TC for cosmetics purpose are the contributing factors identified
for misuse of these groups of drugs. Public education, proper regulation of sales practice of
TC and the introduction of a continuing medical education programme or training for health
professionals are critical to reduce irrational use of TC.
Keywords: Topical corticosteroids, OTC, drug retail outlets, facial dermatoses
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Keywords
Topical corticosteroids; OTC;Drug retail outlets;Facial dermatoses