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ILDS Warns Against the Misuse of Topical Corticosteroids and Calls for Global Action on Skin-bleaching

31 Mar 2025

Updated position statement advocates for improved patient protection and education

The International League of Dermatological Societies (ILDS) has issued an updated position statement on the Safe and Appropriate Use of Topical Corticosteroids, addressing mounting concerns over the misuse of these medicines in skin-bleaching products.

ILDS Position Statement 12325 . - Safe and Appropriate Use of Topical Corticosteroids final

In its statement, the ILDS highlights the harmful practice of skin-bleaching as a growing global public health crisis that demands urgent action.

Read the position statement now
Ncoza Dlova_Headshot

Skin-bleaching is reaching epidemic levels and, for the first time cases of squamous cell carcinoma are being reported, which is a serious concern. The dermatology community must work together to address this problem, both through education and by tackling the socio-political influences of this practice. Dr Ncoza Dlova, Head of Dermatology at the University of Kwa-Zulu Natal, South Africa (Contributor)

Skin-bleaching is widespread in some regions of Africa, Asia, South America and the Caribbean, driven by socio-cultural pressures that favour lighter skin tones. This demand has fuelled rapid growth in the global skin-bleaching industry, which is projected to reach $15.5 billion by 2032.

In certain countries, facial skin-bleaching products - often containing potent or super-potent corticosteroids - constitute a significant segment of the skincare market. Alarmingly, these products are frequently sold without medical oversight, posing severe risks to public health. The misuse of corticosteroid-based bleaching agents may be linked to:

  • treatment-resistant fungal infections
  • irreversible skin damage
  • systemic side effects
  • negative impacts on mental health
The ILDS position statement calls for decisive action to address this issue with key recommendations including:
  • the stricter regulation and enforcement of regulations that prohibit the use of monotherapy and/or fixed-dose combinations containing potent or super potent corticosteroids without a prescription from an appropriately trained healthcare professional
  • clearer guidelines to protect patients and the public from the risks of overuse and misuse of potent topical corticosteroids
  • improved patient and public education on the dangers of skin-bleaching
  • advocacy efforts to promote safer dermatological practices globally.

A contributor to the updated position statement, Dr Ramesha M Bhat, Professor of Dermatology & Head of Research, Father Muller Medical College, Kankanady, Mangalore, India, said:

Dr Ramesha Bhat

"The widespread misuse of skin-bleaching creams containing corticosteroid and sold over the counter is a serious public health concern. It is exacerbated by the misapplication of combination creams, containing potent corticosteroids, antifungals, and antibiotics, as antifungal treatments. Used in this way, they provide temporary relief but ultimately worsen the condition by suppressing the patient’s immune response.

Unregulated access and misleading marketing are fuelling this crisis, particularly in communities where lighter skin is preferred culturally. We hope the updated ILDS position statement will encourage national governments to enforce stricter regulations, promote the rational use of corticosteroids, and ban potent topical corticosteroid combinations marketed as skin-lightening or antifungal treatments." Dr Ramesha M Bhat

ILDS position statements serve as evidence-based guidelines for healthcare providers, regulatory authorities, and public health organisations. The updated Safe and Appropriate Use of Topical Corticosteroids Position Statement is available online via the link below.

ILDS President, Prof Henry W. Lim, said:

Henry Lim_Headshot

As the leading global advocate for skin health, the ILDS is dedicated to advancing education, clinical care, and research to address the pressing dermatological challenges we face. Our updated position statement underscores the growing concerns raised by our member societies about the misuse of corticosteroids in skin-bleaching products. It also outlines key recommendations to combat this serious public health crisis.

Endorsements from ILDS Members

Over 50 ILDS Member Societies from different regions of the world have reaffirmed the updated position statement. We will continue working with them, our wider membership and other stakeholders to bring about the changes necessary to promote the safe use of topical corticosteroids worldwide.

Position Statement - Endorsements from ILDS Members FINAL 1.4.2025

Click here to view the full list

Contributors

Thank you to the experts who contributed to the development of this updated statement: Prof Henry W. Lim, Prof Lars French, Dr Ivonne Arellano, Prof Ramesha Bhat, Prof Seemal Deesai, Prof Ncoza Dlova, Prof Khaled Ezzedine, Dr Claire Fuller, Prof Daudi Mavura, Dr Venkat Mysore, Prof Archana Singal, Prof Stephen Shumack and Prof Rashmi Sarkar.

ILDS Position Statement

Read the updated Safe and Appropriate Use of Topical Corticosteroids Position Statement by visiting our resources page

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