Awareness, knowledge, attitude, and behaviors related to topical corticosteroid use among population in Hail, Saudi Arabia: A cross-sectional study.

Abstract

Corticosteroids are widely used for inflammatory conditions, yet misuse and limited public awareness can cause preventable harm. In Hail, Saudi Arabia, community knowledge appears limited, warranting targeted assessment. To assess knowledge, awareness, attitudes, and use patterns of topical corticosteroids (TCSs) among adults in Hail, Saudi Arabia. We conducted a cross-sectional online survey (October 2024-March 2025) among adults aged ≥18 years. Of 535 respondents, 419 (78.0%) reported prior TCS use and were included in behavioral analyses, while 116 (21.0%) were non-users. Descriptive statistics summarized patterns, and bivariate analyses examined associations between awareness and behaviors. Prescription use was more common than self-medication (58.9% vs 41.1%), and most users applied corticosteroids once daily (60.6%). Mometasone was the most frequently reported agent (33.9%), although 36.8% could not name the product; acne, melasma, and tinea were common indications. Awareness was moderate: 62.8% recognized potency categories, and 55.4% were aware of adverse effects. Overall, 45.0% reported ≥1 adverse effect, most often mood changes, pruritus, increased thirst/urination, or skin thinning. Most had discontinued at least once (79.5%); tapering was more frequent than abrupt cessation (58.9% vs 41.1%), and relapse occurred in 23.7%, often within a week. Awareness aligned with safer practice: aware users were more likely to have a prescription (65.0% vs 48.7%) and to recognize adverse effects (73.8% vs 24.4%); prescribed users also tapered more often than they stopped abruptly (67.6% vs 43.9%). TCS use is prevalent in Hail and is accompanied by self-medication and important knowledge deficits. Strengthening pharmacist counseling, improving labeling, regulating access to higher-potency agents, and implementing community education initiatives may enhance safety and reduce avoidable adverse outcomes.