Thread by @shakiratgold

#dermatologyteaching. This is going to be a very long thread and it is long overdue. @SandraGee_ made remember that its next only list.
Let's talk about triple action creams. Infact I saw a quadruple action cream yesterday and I was like😮😮😮.

Aka gbogbonìse or one size fits all as I like to call them. It is important to talk about it because they have become like oxygen. You'll find them EVERYWHERE you go.

What do triple action creams contain?

Usually a combination of a high or mid potency steroid like clobetasol dipropionate or betamethasone dipropionate, an antifungal like clotrimazole or ketoconazole and an antibacterial like neomycin.

Steroids are drugs that are used to calm inflammation.

It is important for you to note that when you use them in most conditions, you WILL get a transient relief. It's like using panadol to treat the fever associated with malaria without using antimalarial drugs.

Treating symptoms without treating cause. You definitely know that all you're doing is similar to applying foundation and layers of powder to cover up acne WITHOUT treating the acne itself. This will further clog up your pores and predispose you to more acne.

The antibiotics in the triple action creams is usually neomycin most times. This antibiotic is a potent skin sensitizer that predisposes you to allergic contact dermatitis. Medicine is an ever evolving field.

It is definitely not one of the first or second line topical antibiotics for the skin anymore.

The antifungal in it has been rendered almost useless by combining it with the other two ingredients listed.

Side effects of steroids especially long term use include:

Increased risk of skin infections (bet you didn't know that)
Skin thinning called atrophy
Lightening of the skin (and not in a good way)

Striae aka stretch marks and they're usually the unsightly ones...purple, broad striae.
Skin failure especially in babies who have a large surface area compared to body mass and can easily absorb anything applied on the skin easily.

Systemic absorption especially if high potency ones are used for a long time and can lead to diabetes and hypertension
And so many others. And don't think these side effects don't occur. I have personally seen almost ALL of them due to the use of these creams.

To buttress my point, if you've been using triple action creams for some time, any attempt to stop it results in whatever you're trying to treat becoming 'angry' and looking worse than before. That's because all you've been doing is suppressing the condition with the steroid.

You sef think am...How will you be using something that can predispose to skin infections to treat infections for a long time? Doesn't make any sense.

So with triple action and quadruple action creams...all you're doing, is sitting on a ticking skin time bomb which would explode

If one has a fungal infection...Antifungal is what should be prescribed.
If it's a bacterial infection...an antibacterial should be prescribed.

If there's any need to use steroids, it is prescribed separately in a controlled way with instructions on how to stop the use.

Stop mixing triple action creams with your body cream. It is not maradan🙄.

Stop mixing it with your baby's shea butter...please damage your skin and perish on your own if you must. Leave the poor children's skin. This picture shows how I feel like when I see caregivers mix poor innocent shea butter with triple action cream.

Stop using triple action creams to treat candidiasis especially vaginal...you're looking for trouble.
Stop using triple action creams for acne treatment...you're just deceiving yourself and putting your skin at risk of steroid induced acne.

There is NO place for 'one size fits all' in medicine. Another line they use to sell these creams to you is that...'E ma worry...it will treat all the skin infections you have'. Tell them you've been educated better now.

Olóhun ò kí n se oba ìkà. God is merciful.

It is highly unlikely that you'll find one person plagued with these conditions that will now need an antifungal, antibacterial and a steroid at the same time.

Be kind to your skin. You may not understand now. But as you grow older, you will understand better...inugo?

Just a friendly warning, it is very easy to damage the skin. And more difficult to repair it. Be careful who you hand over your skin to.

The fact that it has a NAFDAC no....doesn't mean it is good for your skin. That you find them on Amazon doesn't mean you should buy them. Aimoye jagbajantis lori Amazon🙄.

Infact, these creams are not just a menace in Nigeria, they have crossed the borders to the 'abroad'. At the last World Congress of Dermatology (WCD) in Milan, we had to have a talk about this craziness of using triple action creams.

Please health workers, stop prescribing triple/quadruple action creams. We end up with all the damaged skin.
I have taken my time to break it down today.This is because we keep saying it is bad for you
If we don't explain why, you won't understand when we ask you to avoid it.

If after all my grammar, you still decide that's the way forward for you....All the very best. You hear..? But please spare the children thos horror.
Well done if you read this to the very end. Lol

P.S...Common examples of triple action creams are skineal and funbact A.

I would answer any questions or clarifications on the thread. You can send me a DM if you have further questions and you're a doctor

My Instagram page which would be focused on skin health and common skin conditions coming up soon.

All pictures from google images 😊