International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 5, Issue 2 | Case Report | Open Access DOI

Paradoxical Worsening of Acne Due To Topical Steroid Misuse for Skin Whitening: A Case Report from Pakistan

Qasim Zia^*

Qasim Zia1*, Muhammad Salman Khan2, Amana Qayum3, Muhammad Nabeegh Khan4, Hasnat Amir5, Ayesha Abbas6, Uzain Sardar7, Hafiz Raees Imtiaz Sindhu8, Muhammad Sheeraz9, Muhammad Abdullah Tariq10

1Ibne Seina Hospital & Research Institute, MMDC, Multan

2Ibne Seina Hospital & Research Institute, MMDC, Multan

3Sofia Medical University, Sofia

4Nishtar Medical University, Multan

5RHC Makhdoom, Khanewal

6Bahawal Victoria Hospital, Bahawalpur

7Buch International Hospital, Multan

8Saeed Medicare Hospital, Mian Channu

9Nishtar Medical University, Multan

10Benazir Bhutto Hospital, Rawalpindi

^*Correspondence to: Qasim Zia 

Abstract

Misuse of topical corticosteroids for cosmetic skin whitening is a growing problem in South Asia, particularly in Pakistan, where fairness creams are easily available without regulation. Prolonged and unsupervised facial application of potent corticosteroids can lead to paradoxical dermatologic reactions. We report the case of a 24- year-old woman who developed painful inflammatory facial eruptions following five months of over-the- counter use of a fairness cream. Clinical examination revealed erythematous papules, pustules, and telangiectasias on the cheeks and forehead, without comedones. Chemical analysis of the cosmetic product identified clobetasol propionate 0.05%. A diagnosis of steroid-induced acneiform eruption was made. The patient improved significantly after discontinuation of the offending agent and treatment with oral doxycycline and topical metronidazole. This case highlights the harmful consequences of cosmetic steroid misuse and emphasizes the need for public awareness and stricter regulatory control.

Keywords:

Steroid-induced acne; Topical corticosteroids; Skin whitening; Clobetasol propionate; Pakistan

Citation:

Qasim Zia, Muhammad Salman Khan, Amana Qayum, Muhammad Nabeegh Khan, Hasnat Amir, Ayesha Abbas, Uzain Sardar, Hafiz Raees Imtiaz Sindhu, Muhammad Sheeraz, Muhammad Abdullah Tariq. Paradoxical Worsening of Acne Due To Topical Steroid Misuse for Skin Whitening: A Case Report from Pakistan. Int Clinc Med Case Rep Jour. 2026;5(2):1-5.