Background: Topical corticosteroid-modified dermatophytosis has emerged as a significant public health concern in India, with widespread misuse of irrational combination steroid preparations leading to altered clinical presentations and treatment challenges. This study aims to analyse the demographic characteristics, medication usage patterns, and adverse effects associated with topical corticosteroid-modified dermatophytosis in a tertiary care setting. Methods: A cross-sectional study was conducted among 175 patients who had been clinically diagnosed with dermatophytosis and had used topical corticosteroids. Data on demographic characteristics, distribution of the lesions, steroid usage patterns, sources of medication, and associated adverse effects were collected and analysed. Results: Most of the study population was between 20 - 40 years of age (46.3%), with female preponderance (54.3%). Multiple site involvement was more common (64.5%), with Tinea corporis + cruris being the most frequent (26.8%). Super-high potency steroids were used by 46.9% of participants, primarily in combination formulations (59.8%).Alarmingly 87.4% obtained steroids over-the-counter without a prescription, primarily from healthcare workers (35.3%) and pharmacists (32%). The most frequently used combination was ICSP 8 (Clobetasol + Neomycin + Ketoconazole) in 19.0% of patients. Hypopigmentation was the most commonly reported adverse effect (24%) followed by acneiform eruptions (20.6%) and striae (18.9%). Conclusion: This study demonstrates concerning patterns of steroid misuse in dermatophytosis, with high-potency combination preparations readily accessible without prescription oversight. The epidemic of topical corticosteroid-modified dermatophytosis requires immediate regulatory intervention and comprehensive educational initiatives to address this growing clinical challenge.