Cortisone Creams Without a Prescription: What a Saudi Study of 720 People Found
Medically reviewed by Dr. Shaikah Al-Aojan — Consultant
A cream that "calms the itch" or "brightens the skin" may be a topical steroid without you knowing it. In a published Saudi study of 720 adults who had used a topical corticosteroid in the previous two years, 43.1% had used one without a prescription, and the face was the most common place it was applied. [1]
The study was led by Dr. Shaikah Al-Aojan, consultant dermatologist at Avant Clinics, and published in the Journal of Dermatology and Dermatologic Surgery. This article summarises what it found and what it means for you before you put any cream on your skin.
What are topical corticosteroids, and why use them with medical advice?
Topical corticosteroids are anti-inflammatory creams and ointments used to treat many skin conditions. They work well when a doctor chooses the right strength, duration and area, but using them without medical supervision can cause side effects. [1]
The study explains that the strength, formulation and duration of a steroid cream depend on how severe the problem is and where it is, even when the diagnosis is the same. Reusing an old prescription for a new problem or a different area is therefore not automatically safe. [1]
For the basics of safe use and how strengths differ, read our topical corticosteroids guide.
What did the Saudi study find?
An Arabic questionnaire was shared in May 2020 with adults across different regions of Saudi Arabia who had used a topical corticosteroid in the previous two years, and 720 participants completed it. Key findings: [1]
- 43.1% had used a topical corticosteroid without a prescription.
- Women were more likely to use one without a prescription; this was the only factor linked to it in the study, and education level made no difference.
- 30.7% did not know that what they used was a steroid, and 22.8% were not sure.
- The face was the most common application site (51.3%).
- 25.6% of participants reported side effects.
Why do people buy them without a prescription?
The two most common reasons given by those who bought one without a prescription were that the problem seemed too minor to see a doctor (36.6%) and previous experience with the same medicine (35.3%). The cost of a visit was the reason for only 8.8%. [1]
Recommendations came from several places: a previous prescription from a doctor (42.4%), family and friends (40.8%), a pharmacist (20.3%), and websites or social media (16.5%). [1]
The researchers also observed that some participants obtained steroids from beauty salons or from unknown people who mix them into moisturisers, and that some influencers promote beauty products containing them. [1]
For lightening and after laser: uses without medical advice
Among those who used a topical steroid without a prescription, reported uses included itch without a skin disease (23.7%), cosmetic reasons such as skin lightening (19.9%) and use after laser hair removal (13.9%); some even used it as a moisturiser (2.2%). Eczema, a genuine medical use, accounted for 15.3%. Some participants said they used it on and off before special occasions for a brighter look. [1]
Lightening the skin is not a medical use of topical corticosteroids, and the study counted uses such as lightening or acne among its unwanted outcomes. [1]
If your skin is red or itchy after a laser session, ask the treating team what aftercare suits you rather than using a cream whose contents you do not know. To learn what to expect after sessions, read reducing hair growth with laser.
Which side effects did participants report?
25.6% of participants reported side effects. The most common were lighter patches of skin (hypopigmentation) (9.8%), itching (6.3%), redness and skin sensitivity (5.7%), small visible blood vessels (4.4%), extra facial or body hair (4.4%) and acne (4.1%). [1]
The product most often used without a prescription was mometasone furoate 0.1% cream (55.1%), classed in the study as medium strength, but it was most often applied to the face, where the skin absorbs medicine more readily. The study warns that this, combined with not knowing what a cream contains, can lead to significant side effects. [1]
How can you tell whether a cream contains a steroid?
- Read the ingredients and ask the pharmacist directly: does this product contain a steroid?
- Avoid unlabelled mixes or creams with unknown ingredients, especially if they promise fast lightening.
- Do not use an old prescription or someone else's prescription for a new problem or a different area, especially the face.
- If you have been using a steroid cream for a long time, do not stop it suddenly before asking your doctor how to stop it.
If you keep needing the same cream, the cause needs a diagnosis.
When should you see a dermatologist?
- If the problem comes back whenever you stop the cream.
- If you notice lighter patches, small blood vessels, new spots or extra hair where you applied it.
- If your goal is lighter skin or treating pigmentation such as melasma; these need a diagnosis and a different plan.
- Before using any strong cream on the face, skin folds or a child's skin.
In medical dermatology at Avant Clinics, the consultation starts by reviewing what you currently use and examining your skin before any plan is set.
Sources
- Al-Aojan S, Al-Marzoug A, Alaujan A, Abanmi S, AlJasser MI. Prevalence of topical corticosteroid use without prescription in Saudi Arabia: a cross-sectional study. J Dermatol Dermatol Surg. 2021;25:76-9. doi:10.4103/jdds.jdds_21_21
Frequently asked questions
Does every cream that calms itching quickly contain a steroid?
Not necessarily, but 30.7% of participants in the study did not know that what they used was a steroid. Read the ingredients and ask the pharmacist before using it.
Does cortisone lighten the skin?
Lightening is not a medical use of topical corticosteroids, and the study counted using them for this purpose among its unwanted outcomes. Lighter patches of skin (hypopigmentation) were the side effect participants reported most often.
Should I use a steroid cream after a laser session?
Do not use one on your own; follow the treating team's aftercare instructions. In the study, 13.9% of those who used a steroid without a prescription used it after laser hair removal.
Can I reuse an old prescription for the same problem?
The strength, formulation and duration of a steroid depend on how severe the problem is and where it is, even with the same diagnosis, so a new problem needs an assessment.