HSA Alert: ‘Lung Tan Tsao’ found to contain potent topical steroid

The Health Sciences Authority (HSA) is alerting members of the public not to purchase or consume the product below. These products may pose serious health risks as they were tested to contain potent medicinal ingredients including a steroid and an antihistamine.

Product namePotent medicinal ingredients
‘Lung Tan Tsao’
‘蘢膽草清血解毒藥(丸)’
Chlorpheniramine
Dexamethasone

How potent is Dexamethasone?

Dexamethasone is a long-acting, systemic corticosteroid; its potency is about 25 times greater than the short-acting products.

What are the side effects and risks of short-term systemic steroid?

Side effects are rarely serious if a systemic steroid has been prescribed for one month or less. The following problems may arise, particularly when higher doses are taken:

  • Sleep disturbance
  • Increased appetite
  • Weight gain
  • Increase in postprandial blood sugar
  • Psychological effects, including increased or decreased energy.

Rare and potentially serious side effects of a short course of corticosteroid include:

  • Severe infection
  • Mania, psychosis, delirium, depression with suicidal intent
  • Heart failure
  • Peptic ulceration
  • Diabetes mellitus
  • Avascular necrosis of the hip. 

The risk of a serious side effect increases with increasing dose. The longer it is applied, the higher chance of getting Topical Steroid Withdrawal (TSW).

Adverse Effects On The Skin

Cutaneous adverse effects from long-term systemic steroids may include:

  • Bacterial infections: cellulitis, wound infection
  • Fungal infections: tinea, candida, pityriasis Versicolor
  • Viral infections: herpes zoster
  • Skin thinning, purpura, fragility, telangiectasia and slow wound healing, especially in sun-damaged areas
  • Stretch marks (striae) under the arms and in the groin
  • Steroid acne
  • Hypertrichosis and hair loss.

Consumer experienced adverse effects after taking ‘Lung Tan Tsao’

A woman in her 40s experienced weight gain and swelling of the face after taking ‘Lung Tan Tsao’. This product was labelled for the relief of various conditions including eczema, allergies and pain. It was also falsely labelled to contain a variety of natural herbs. The woman had obtained the product from her friend who purchased it in Malaysia. Her doctor became suspicious of the product as it cleared the woman’s eczema as rapidly as a prescription medicine would do.  

HSA tested ‘Lung Tan Tsao’ and detected chlorpheniramine (an antihistamine) and dexamethasone (a steroid). These potent medicinal ingredients can cause serious adverse effects when used without medical supervision. Long-term unsupervised use of steroids can cause serious adverse effects including increased blood glucose levels (which may lead to diabetes) and Cushing’s syndrome (a round face or ‘moon face’ appearance and upper body obesity with thin limbs).

How can topical steroid withdrawal be prevented?

Prevention is best, with patients and doctors being alert to the risk and avoiding prolonged frequent and prolonged use of moderate to high potency topical corticosteroids. The higher the potency, the longer the period of application (ie more than one year), and the more frequent the application (more than once daily), the more likely that topical corticosteroid withdrawal may occur.

Concerns about the risk of topical corticosteroid withdrawal should not prevent appropriate management of atopic dermatitis with topical corticosteroids, as far more people respond to appropriate topical corticosteroid use than develop a withdrawal rash.

What you can do to prevent reoccurrence?

  • Be wary of health products that carry exaggerated claims or deliver unexpectedly quick and miraculous results. Be cautious even if the product appears well-packaged or have logos of international standards printed on them.
  • Avoid purchasing health products from unfamiliar sources, and exercise caution when buying such products online or from well-meaning friends. You cannot be certain where and how these products were made. They can contain potent ingredients that can seriously harm your health.
  • Buy from reputable brands and be wary when results are too fast to be true. These are usually signs of antibiotics or topical steroids.

Our Commitment To Ethical Products

Mummybrand has always been committed to ethical product development and every product undergo experience testing by a group of Eczema and TSW sufferers. We do not believe in short term recovery and will always advise against potent medication to see short term result.