Topical Steroid Damaged Face (TSDF): A growing public health concern in South Asia – A clinical perspective from Bangladesh

Title : Topical Steroid Damaged Face (TSDF): A growing public health concern in South Asia – A clinical perspective from Bangladesh

Abstract:

Introduction: Topical Steroid Damaged Face (TSDF) has emerged as a significant dermatological and psychosocial public health challenge in South Asia, driven by unregulated steroid access, fairness-cream culture, and social media misinformation. Awareness among patients and non-dermatology healthcare workers remains limited.

Aim: To present clinical characteristics, triggers, and treatment response patterns of TSDF patients in an urban dermatology practice in Bangladesh.

Methods: A prospective 12-month observation of 150 clinically confirmed TSDF cases was conducted. Data included demographics, steroid usage source, symptoms, psychosocial impact, and response to standardized management with steroid withdrawal, immunomodulators, barrier repair, and supportive therapies.

Results: Most patients were females aged 18–35 years (87%). OTC steroid purchase (71%), salon/social media recommendation (48%), and fairness cream marketing (36%) were key contributors. Common findings included erythema, acneniform eruption, telangiectasia, and burning. 63% reported emotional distress. Clinical improvement noted between 8–12 weeks, though persistent sensitivity remained in chronic cases.

Conclusion: TSDF is rapidly rising in South Asia, requiring urgent educational, regulatory, and dermatology-led community initiatives. Early detection and proper withdrawal-based treatment significantly improve outcomes.

Keywords: TSDF, topical steroids, misuse, South Asia, Bangladesh, dermatology, oral presentation.

Biography:

Dr. Nubayra Tasneem is a Consultant Dermatologist specializing in clinical, aesthetic, and procedural dermatology. She completed her MBBS followed by postgraduate training in Dermatology and Venereology at Shaheed Suhrawardy Medical College and Hospital, Dhaka. She holds DDV and MCPS (BCPS) qualifications, reflecting her strong academic and clinical foundation in dermatology.

She has undertaken advanced international fellowships in Aesthetic Dermatology (India and Germany), Cutaneous and Laser Surgery (Thailand), and Aesthetic Dermatology (Turkey), gaining extensive exposure to modern aesthetic and laser-based dermatologic procedures. She also holds an MSc in Sexology and Psychosexual Counselling (India), allowing her to integrate a holistic approach in managing dermatological and psychosexual health concerns.

Her clinical expertise includes aesthetic dermatology, laser surgery, injectables such as botulinum toxin and dermal fillers, non-surgical facial rejuvenation, hair disorders, and regenerative treatments including PRP. She is actively engaged in evidence-based dermatology and continuous professional development.

Dr. Tasneem is a regular participant and speaker at national and international dermatology conferences and is associated with multiple professional dermatological organizations. She currently serves as Consultant Dermatologist at Continental Hospital PLC, Dhaka, Bangladesh.