Corticosteroids are one of the anti-inflammatory drugs that are used widely by dermatologists. Significant local adverse effects can happen if topical corticosteroids (TCs) are used incorrectly. This study aimed to assess the prevalence of facial TCs misuse and its adverse effects. This was cross-sectional research: a self-reported questionnaire was distributed among a population of Saudi Arabians aged 16 years and above who were using TCs consecutively. Statistical analysis was performed using SPSS version 26. A total of 611 participants were enrolled in the survey: 401 (65.6%) were university graduates, while 187 (30.6%) were below high school level of education. The number of participants using TCs was 279 (45.7%), while 332 (54.3%) did not use steroids topically. The most used TCs were Mometasone furoate 0.1% cream (18.2%), followed by Fusidic acid/Betamethasone cream (16.7%). A total of 46 reported facial TCs’ side effects. Peeling (52.2%) was the most reported side effect, followed by redness (41.3%). In conclusion, the use of facial TCs among the Saudi population is not uncommon (16.5%). A large population are not aware of the side effects of the unsupervised use of TCs. An effort should be made to increase awareness of the adverse effects of TCs.

Background: Topical retinoids are commonly prescribed for dermatological conditions during reproductive years; however, concerns regarding teratogenicity have persisted due to the established risks associated with oral retinoids. This systematic review and meta-analysis aimed to evaluate the association between first-trimester topical retinoid exposure and risks of major congenital malformations (MCM) and spontaneous abortion (SAB). Methods: Following PRISMA 2020 guidelines, we searched PubMed, Scopus, Cochrane Library, Web of Science, and Google Scholar up to November 25, 2025. Studies comparing pregnancy outcomes in women exposed to topical retinoids versus unexposed controls were included. Random-effects meta-analysis, Bayesian hierarchical modeling with multiple prior specifications, and Robust Bayesian Model-Averaged (RoBMA) analysis were performed. Results: Eight studies with total of 3,632,118 pregnancies were included. Topical retinoid exposure was not significantly associated with MCM risk (risk ratio [RR] 0.83, 95% CI 0.64–1.07, P-value = 0.14, I ² = 0%) or SAB risk (RR 0.99, 95% CI 0.68–1.43, P-value = 0.94, I ² = 0%). Bayesian analysis with three prior specifications yielded posterior estimates ranging from RR 0.86 to 0.89, all with credible intervals crossing unity. RoBMA demonstrated 74.1% posterior probability favoring the null hypothesis (BF ₁₀ = 0.35). Leave-one-out sensitivity analysis identified Refsum et al., 2025 as influential for MCM (+29.6% change when omitted). E-value analysis indicated findings were not significant to unmeasured confounding. Conclusion: Topical retinoid exposure during the first trimester was not associated with increased risks of MCM or SAB. These findings support the relative safety of topical retinoids in early pregnancy; however the results were driven mainly by a single large registry study.