Topical steroid abuse in commercial sex workers: a cross-sectional analytical study in a tertiary care center


  • Sarankumar Sudhakar Department of STD, Government Stanley Medical College, Chennai, Tamil Nadu
  • Kayalvizhi V. A. Department of STD, Government Stanley Medical College, Chennai, Tamil Nadu, India
  • Syediqbal Sikkanthar Department of STD, Government Stanley Medical College, Chennai, Tamil Nadu, India
  • Madhanchand Muthukrishnan Department of STD, Government Stanley Medical College, Chennai, Tamil Nadu, India



Commercial sex workers, Fairness creams, Topical steroid abuse


Background: Abuse of topical corticosteroids (TCs), especially over the face, is prevalent worldwide with India as no exception. Lack of adequate specialist services, the practice of self-medication and easy access over the counter (OTC) has resulted in widespread abuse. Aim of this study was to assess the magnitude of topical steroid abuse and its diverse cutaneous side effects in commercial sex workers.

Methods: A cross-sectional analytical study was conducted among commercial sex workers (both females and transgender) attending STI clinic in the study institution for 6 months. A semi-structured questionnaire was given and type of steroid cream used, frequency, duration, the reason for application and source of information for its use were recorded. Clinical patterns of side-effects were noted. Clinical photographs were taken. Descriptive statistical analysis was done, (SPSS 21.0).

Results: Out of the total 180 commercial sex workers (CSWs), 80 were transgender and 100 were females. The most common steroid used was betamethasone valerate followed by the triple regimen containing mometasone. The reasons for TCs use were fairness (72%) followed by melasma (18%) and acne (10%). Side effects were seen in 77.5% of transgender and 66% of female CSWs. Common side effects noted were erythema (40%), acne (26%) and, pigmentation (18%).

Conclusions: The main reason for TCs abuse in our country as a fairness agent is obsessiveness with fair skin colour. Various studies on TCs abuse were done in the general population but none of the studies focuses on a particular group as in this study.


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