Topical Steroids Sold as Fade Creams in Beauty Supply Stores: A Danger for Cosmetic Consumers
September 2024 | Volume 23 | Issue 9 | 709 | Copyright © September 2024
Published online September 1, 2024
Janeth R. Campbell MD MSa, Alexandra G. Perez BSb, Heather Woolery-Lloyd MD FAADc
aGeorgetown University School of Medicine, Washington, DC
bUniversity of Miami, Miller School of Medicine, Miami, FL
cSkin of Color Division, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL
Abstract
Topical corticosteroids are used extensively in dermatology. Class 1 high potency topical steroids (HPTS) can result in unwanted side effects such as skin hypopigmentation, atrophy, and acneiform eruptions. HPTS are only legally available by prescription to ensure appropriate use in the United States (US). The authors have noticed a recent increase in patients presenting with steroid acne after buying HPTS products in beauty supply stores. These products are marketed as fade creams to treat hyperpigmentation and uneven skin tone. We assessed skincare products containing HPTS (clobetasol or betamethasone) in 33 beauty supply stores in Miami, FL; Washington, DC; and Baltimore, MD. Out of 33 beauty supply stores, 14 (42.42%) contained HPTS skincare products, and they were all located in Miami. Out of 15 stores visited in Miami, 14 (93.33%) contained skincare products with clobetasol, and 5 (33.33%) contained skincare products with both clobetasol and betamethasone. Of the stores selling HPTS skincare products, the number of different brands available ranged from 1 to 7, with an average of 4.21 different brands per store. Our study reveals that HPTS are readily available in over-the-counter skincare products in many beauty supply stores. HPTS skincare products were only available in one of three cities suggesting there may be a regional supplier distributing these products. It may also indicate that there is less oversight of retail stores in Miami with HPTS products. More studies are needed to quantify the availability of these products in different locations throughout the US. Further studies can help identify this problem and raise awareness among consumers of the dangers of HPTS skincare products in beauty supply stores.
J Drugs Dermatol. 2024;23(9):709-712. doi:10.36849/JDD.7608
INTRODUCTION
Topical corticosteroids are used extensively in the field of dermatology to treat a wide range of conditions such as psoriasis, eczema, and other inflammatory skin diseases. Topical steroids have both anti-inflammatory and immunosuppressive effects.1 Topical corticosteroids are classified by potency. Class one high potency topical steroids (HPTS) includes betamethasone dipropionate, halobetasol propionate, diflorasone diacetate, and clobetasol propionate. Class 1 HPTS are generally not used on the face and can result in unwanted or harmful side effects such as skin hypopigmentation and atrophy, acneiform eruptions, striae, telangiectasia, hypertrichosis, rosacea, and photosensitivity.2 In the US, these topical drugs are only legally available by prescription to ensure appropriate use. However, there are reports of patients purchasing prescription HPTS over-the-counter (OTC).3,4 Studies outside of the US have also shown that some over-the-counter (OTC) cosmetic products contain illegal steroids.5,6 The authors have noticed a recent increase in patients presenting with steroid acne after buying HPTS skincare products in beauty supply stores that are being marketed as fade, or "bleaching," creams to treat hyperpigmentation and uneven skin tone. A local beauty supply store is typically a neighborhood shop that sells cosmetics in the form of skincare, haircare, and nail care products. We thought to assess the presence of class 1 HPTS, clobetasol, or betamethasone, containing skincare products available OTC in local beauty supply stores in Miami, FL; Washington DC; and Baltimore, MD.
MATERIALS AND METHODS
From August to October of 2022, we went to 33 beauty supply stores located in 3 cities: 8 in Washington, DC, 15 in Miami, FL, and 10 in Baltimore, MD. For each store, we determined if class 1 HPTS were present by looking at the product's labeled ingredients. If class 1 HPTS containing products were present, we recorded the total number of brands associated with each store.
RESULTS
Out of 33 beauty supply stores, 14 (42.42%) contained HPTS skincare products, and they were all located in Miami. Of 15
