ArticleCureus2026
Topical Corticosteroid Misuse and Awareness of Steroid-Induced Dermatoses Among Adults in Saudi Arabia: A Cross-Sectional Survey.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTopical corticosteroids are among the most commonly used medications in dermatology and play a pivotal role in the management of inflammatory skin diseases. However, inappropriate use, unsupervised access, and cosmetic misuse may lead to significant adverse effects and steroid-induced dermatoses. Data regarding public awareness, knowledge, and misuse of topical corticosteroids in Saudi Arabia remain limited.
methodsA national cross-sectional survey was conducted among adults residing in Saudi Arabia between January and March 2026. Data were collected using a structured, self-administered online questionnaire assessing demographic characteristics, topical corticosteroid use, knowledge, awareness of steroid-induced dermatoses, adverse effects, and misuse practices. Topical corticosteroid misuse was defined as the presence of at least one inappropriate behavior, including non-prescription use, cosmetic use, social media-driven use, medication sharing, prolonged unsupervised use, reuse of previous prescriptions, or use for fungal infections. Multivariable logistic regression analysis was performed to identify independent predictors of misuse.
resultsA total of 1,248 participants were included in the analysis, of whom 736 (59.0%) were female. Previous topical corticosteroid use was reported by 842 participants (67.5%). Among users, 289 (34.3%) obtained topical corticosteroids without a prescription, 264 (31.4%) purchased them directly from pharmacies without a prescription, and 178 (21.1%) reported cosmetic use. Overall, 362 participants (29.0%) met the definition of topical corticosteroid misuse. Knowledge regarding corticosteroid safety was generally favorable, with 971 participants (77.8%) recognizing skin thinning as a potential adverse effect and 1,112 (89.1%) acknowledging the importance of medical supervision during prolonged use. Nevertheless, awareness of hidden corticosteroids in cosmetic products was lower (693 participants, 55.5%). Among corticosteroid users, 247 (29.3%) reported at least one adverse effect, most commonly acneiform eruptions (164 users, 19.5%). Social media recommendation was the strongest independent predictor of misuse (adjusted odds ratio (aOR): 3.48; 95% confidence interval (CI): 2.51-4.82; P<0.001), followed by facial application (aOR: 1.89; 95% CI: 1.40-2.55; P<0.001), female sex (aOR: 1.72; 95% CI: 1.29-2.31; P<0.001), and non-healthcare occupation (aOR: 1.64; 95% CI: 1.08-2.48; P=0.02). Postgraduate education was associated with lower odds of misuse (aOR: 0.63; 95% CI: 0.41-0.97; P=0.036).
conclusionsTopical corticosteroid use is highly prevalent in Saudi Arabia, and nearly one-third of adults engage in at least one misuse behavior. Although overall knowledge regarding corticosteroid safety is generally satisfactory, important gaps persist regarding steroid-induced dermatoses and hidden corticosteroids in cosmetic products. Targeted educational interventions, improved patient counseling, and enhanced regulatory oversight may help reduce misuse and promote safer use of topical corticosteroids.
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