Baby's hospitalisation from skin cream bought online shouldn’t deter proper use of topical steroids for some conditions

It is unfortunate to hear of a family’s experience with an unlabelled topical steroid product and we wish the baby a speedy recovery.

The purchase of unfamiliar medicinal products online is risky as the product composition cannot be guaranteed, nor its suitability in the treatment of an individual’s condition.  

At the same time, we are concerned that readers may have the impression that topical steroids are generally harmful and should be avoided altogether. We wish to provide a specialist's position on this.

Topical steroids are a mainstay of treatment for numerous skin diseases. They reduce inflammation, bring about symptomatic relief and, in many cases, heal the underlying skin condition.

The use of topical corticosteroids has been proven and supported by various international medical guidelines.   

Nonetheless, as with all medications, inappropriate use may result in adverse effects.

Topical corticosteroids are not “one size fits all” but exist in several formulations with strengths ranging from very mild to highly potent.

The choice of topical steroids depends on the type of skin condition to be treated, the site of disease as well as the patient’s age. 

Highly potent steroids, such as the one mentioned in the report, have a greater propensity for causing adverse effects.

Medical doctors, in particular dermatologists, are trained to prescribe steroid medications judiciously. Patients are also appropriately counselled and followed up for any response.

If chronic usage is indicated, monitoring and early mitigation of any adverse effects are also carried out.

We hope the public is reassured that topical steroids are both appropriate and effective for treating certain skin diseases, and can be safely administered with medical guidance and monitoring.

ABOUT THE WRITERS:

Dr Tee Shang-Ian is chairman, chapter of dermatologists, College of Physicians, Academy of Medicine Singapore. Associate Professor Lee Haur Yueh is president of the Dermatological Society of Singapore.