Use of topical steroids on the face among university students in Saudi Arabia. Dhiyaa Majed 1 , Mahdi Alnujaidi 1 , Nawaf Almohammadi 1 , Amal A Kokandi 2* 1 Faculty of Medicine, King Abdulaziz University, Rabigh, Jeddah, Saudi Arabia 2 Department of Dermatology, Faculty of Medicine, King Abdulaziz University, Saudi Arabia Abstract Background: Topical corticosteroids are widely used to treat dermatological problems. The aim of this study is to assess the scale of topical steroid usage on the face among the university students. Methods: An online questionnaire has been sent by e-mail to all students of King Abdulaziz University (Jeddah, Saudi Arabia). It included questions about the use of topical steroids on the face for the last 5 y. Different photos of commonly used topical steroids including combination formulas were shown and asked if they have been used. Results: 1626 students responded. Only 56 responded as they have used topical steroids on the face in the previous 5 y. At least 189 had used one of the presented photos (which contained steroids) and 637 said that they did not know that they contained steroids. Sources of prescription included dermatologists, other doctors, pharmacists, friends and relatives, beauticians or saloon staff and others. Different recognized side effects were reported. Conclusion: Considerable number of university students use topical steroids on the face without knowing its nature. Additionally, Topical steroids are being prescribed and advised by non-medical personnel. Public awareness actions can be implemented to warn against the use of topical steroids without proper medical consultation. Keywords: Face, Side effects, Topical corticosteroids. Accepted on June 08, 2018 Introduction Topical corticosteroids are widely used to treat dermatological problems. They are used to ameliorate inflammation and for other purposes. They come in different formulations and different potencies. Mild formulations are usually used for children and for sensitive areas. Although topical steroids are used for many skin diseases, they are contraindicated in some diseases and might cause side effects if used inappropriately. If they are used for prolonged periods of times they can cause side effects [1]. Topical steroids misuse can cause numerous side effects. In one study, tinea incognito and acne were reported mostly [2]. In another study (involving 100 patients) investigating the side effects of side effects of steroid use on the face, pruritus, acne from eruption, erythema, photo sensitivity, steroid dependency and telangiectasia were reported [3]. One of the common topical side effects of topical steroids is whitening of the skin. Unfortunately, this side effect is being used by some people to lighten skin pigmentations or to lighten their natural color or to lighten hyper-pigmentations [4-6]. This phenomenon was also found to be used in Saudi for the same purpose [7]. Steroids are added illegally as well to whitening products to lighten skin or to enhance the lightening effect of other ingredients [8]. The regulation on the sale of topical steroids differs among countries. In Saudi currently, topical steroids in different strengths can be purchased without medical prescription from pharmacies. Additionally, they can be purchased through different routes such as herbal shops or online. Some steroid containing creams and ointments are particularly popular in our country. In clinical practice some of these are very well known to be used by public without prescription or advocated by non- medical personnel. Some of these formulations are combination formulas containing antibacterial or anti-fungals. Potent steroids are very commonly used as well as combination formulas. The aim of this study is to assess the scale of topical steroid usage on the face among the university students. Methods An online questionnaire has been sent through e mail to all students of King Abdulaziz University (Jeddah, Saudi Arabia) through a questionnaire program (survey monkey). The questionnaire has been sent through the deanship of higher education following a standard procedure of ethical approval from the biomedical research committee and an approval from the deanship to around 30,000 students with registered e-mails. ISSN 0970-938X www.biomedres.info 2786 Biomedical Research 2018; 29 (13): 2786-2789 Biomed Res 2018 Volume 29 Issue 13