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Wednesday, July 23, 2025

Beclometasone skin cream


Beclometasone (also called beclomethasone dipropionate) is a potent topical corticosteroid formulated as a cream, ointment, or lotion for the treatment of inflammatory skin conditions. It is used to reduce redness, itching, swelling, and irritation in steroid-responsive dermatoses. The topical form is distinct from its inhaled, oral, or nasal formulations, which are used for asthma or rhinitis.

Brand Names

Beclometasone skin cream is marketed under various brand names globally, including:

  • Beclo®

  • Propaderm®

  • Becloderm®

  • Beclate® Cream

  • Becomet®

  • Belogent® (when combined with gentamicin)

Available in different potencies and bases:

  • Cream (oil-in-water base): preferred for moist or weeping lesions

  • Ointment (water-in-oil base): preferred for dry, lichenified skin

  • Lotion or scalp solution: for hairy areas or large surfaces

Typical strength:

  • Beclometasone dipropionate 0.025% w/w (equivalent to 250 micrograms/g)

  • Classified as a potent (Group III) corticosteroid in many therapeutic guidelines

Mechanism of Action

Beclometasone is a synthetic glucocorticoid that acts locally at the skin level by:

  • Binding to intracellular glucocorticoid receptors in keratinocytes and immune cells

  • Reducing transcription of pro-inflammatory cytokines (e.g., TNF-α, IL-1)

  • Inhibiting phospholipase A2 and thus prostaglandin and leukotriene synthesis

  • Stabilizing lysosomal membranes

  • Reducing capillary dilation and permeability

  • Decreasing leukocyte migration and adhesion

The result is a reduction in redness, swelling, and pruritus in inflamed skin.

Therapeutic Uses

Beclometasone topical cream is used in the treatment of steroid-responsive dermatoses, including:

Primary Indications

  • Atopic dermatitis (eczema)

  • Contact dermatitis (irritant or allergic)

  • Seborrheic dermatitis

  • Psoriasis (excluding widespread plaque psoriasis)

  • Discoid lupus erythematosus

  • Lichen planus

  • Lichen simplex chronicus

  • Pruritus ani and vulvae

  • Insect bite reactions

  • Neurodermatitis

  • Nappy rash (if inflammation is severe and not infected)

Combination Products

  • With antibiotics (e.g., neomycin, gentamicin): For secondarily infected dermatoses

  • With antifungals (e.g., clotrimazole): For fungal infections with inflammatory component

Dosage and Administration

Adults and Children ≥1 year:

  • Apply a thin layer to the affected area once or twice daily

  • Frequency reduced once improvement is noted

  • Maximum duration: 2–4 weeks without medical review

Method:

  • Clean and dry the skin before application

  • Use the fingertip unit (FTU) to guide dosing:

    • One FTU ≈ 0.5 g, enough for a palm-sized area

  • Do not occlude unless directed by a physician

  • Avoid contact with eyes, mucous membranes, and open wounds

Contraindications

  • Untreated skin infections (bacterial, viral, fungal)

  • Rosacea

  • Acne vulgaris

  • Perioral dermatitis

  • Perianal and genital pruritus (without underlying inflammation)

  • Hypersensitivity to beclometasone or any cream excipients

Precautions

  • Avoid long-term continuous use, especially on face, axillae, groin, and intertriginous areas

  • Use with caution in:

    • Elderly: Thinner skin more prone to atrophy

    • Children: Increased percutaneous absorption and systemic effects

    • Pregnant or lactating women: Limit use to small areas and short durations

  • Do not use under occlusive dressings unless directed

  • Monitor for secondary infections; discontinue if infection develops

  • Do not use on ulcerated, weeping, or fissured skin without supervision

Side Effects

Local side effects are generally dose-dependent and more likely with potent steroids, prolonged use, or occlusion.

Common:

  • Burning or stinging sensation on application

  • Itching

  • Dryness or peeling

  • Skin thinning (atrophy) with prolonged use

  • Striae (stretch marks) on areas like thighs, abdomen, axillae

  • Telangiectasia (visible blood vessels)

  • Hypopigmentation

  • Folliculitis

  • Acneiform eruptions

Rare/Systemic (especially in children or large-area use):

  • HPA axis suppression

  • Cushing’s syndrome

  • Growth retardation

  • Hyperglycemia

  • Increased intracranial pressure (headache, bulging fontanelle in infants)

Drug Interactions

Topical beclometasone is not systemically absorbed in significant amounts under standard usage, so drug interactions are rare. However:

  • Avoid combining with other topical corticosteroids unless prescribed

  • Avoid concurrent use of skin irritants (e.g., salicylic acid, benzoyl peroxide) without supervision

  • Do not mix with emollients or moisturizers unless spaced apart by 15–30 minutes

Use in Special Populations

Pediatric Use:

  • Not recommended for children under 1 year

  • In children over 1 year, use under strict medical supervision

  • Do not use for more than 5–7 days on the face or diaper area

  • Prefer mild steroids (e.g., hydrocortisone) for infants when appropriate

Pregnancy:

  • Use only if clearly necessary

  • Avoid use on large surface areas, prolonged duration, or under occlusion

Lactation:

  • Safe for limited use

  • Do not apply on or near nipple area before breastfeeding

Comparison with Other Topical Corticosteroids

Beclometasone is classified as a potent corticosteroid (Group III in UK, Class II or III in US systems), meaning it is stronger than hydrocortisone, but weaker than clobetasol or betamethasone dipropionate 0.05%.

Compared to hydrocortisone 1%, beclometasone is more effective in controlling moderate to severe inflammation, but also carries higher risk of adverse effects.

Compared to mometasone or betamethasone valerate, beclometasone is equivalent or slightly less potent but remains effective for short-to-intermediate term use in resistant eczema or psoriasis.

For facial dermatitis or pediatric use, mild corticosteroids are preferred.

Patient Counseling Points

  • Apply thinly, only to affected areas

  • Do not apply to broken, infected, or sensitive areas unless prescribed

  • Avoid long-term use on the face, especially near eyes

  • If symptoms worsen or persist beyond 7–10 days, seek medical advice

  • Avoid covering treated areas with airtight dressings unless directed

  • Wash hands after application

  • Do not use for cosmetic skin conditions (e.g., pigmentation, acne)

Storage and Handling

  • Store below 25°C in a cool, dry place

  • Keep tube tightly closed and away from sunlight

  • Discard after expiry date

  • Keep out of reach of children

Regulatory Status and Availability

  • Prescription-only in most countries due to potency

  • Widely used in Europe, Middle East, Africa, and Asia

  • May be available OTC in some regions in low-potency or combination formulations



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