The Government may restrict the sale of 14 steroid-based creams and ointments in view of their rampant misuse leading to 'tinea' infections-- superficial fungal infections caused by three species of fungi collectively known as dermatophytes.
Commonly, these infections are named for the body part affected, including tinea corporis (general skin), tinea cruris (groin), and tinea pedis (feet).
Dermatologists say that topical cortisteroid preparations are being sold unrestricted by the chemists and general practitioners to anyone complaining of itching, soreness, acne or any common skin complaint, resulting in various side effects.
With fungal infection cases reaching out of proportion, the highest decision making body of the Union Health Ministry on technical matters, Drug and Technical Advisory Board (DTAB) under the DCGI has recently advised the Government to ensure that these steroids are not sold without doctor's prescription .
The aim is to prevent their misuse which is making treatment of the fungal infection in the country almost nightmare for the dermatologists, said sources in the DCGI.
Just a few months ago, the Ministry had banned steroids containing Fixed Dose Combinations (FDCs) following complaints from The Indian Association of Dermatologists and Venereologists and leprologists (IADVl). It had alleged that treating fungal infections was becoming a therapeutic nightmare due to the indiscriminate use of topical corticosteroids, leading to rapid resistance to current antifungal drugs.
Past President of IADVl and lucknow-based dermatologist Devesh Mishra said that because of the unawareness, patient are purchasing these steroid based ointments and creams from the chemists shops on their own or on the recommendations of the chemists. However, these steroids just give immediate relief but are not permanent treatment for the infection. By the time the patients reach us, their infection is aggravated and in some cases it is untreatable, he added.
"We had sought inclusion of all topical steroids in schedule H; clobetasol propionate, betamethasone, mometasone furoate, fluticasone propionate, clobetasone 17-butyrate and hydrocortisone," said the IADVl in its letter to the DCGI.
In addition, irrational use of topical steroids has also resulted in various systemic side effects (glaucoma, hypertension, hyperglycemia etc, said Mishra.
