“If this blog helped you out, don’t keep it to yourself—share the link on your socials!” 👍 “Like what you read? Spread the love and share this blog on your social media.” 👍 “Found this useful? Hit share and let your friends know too!” 👍 “If you enjoyed this post, please share the URL with your friends online.” 👍 “Sharing is caring—drop this link on your social media if it helped you.”

Sunday, July 27, 2025

Clobetasone


Clobetasone is a moderately potent topical corticosteroid used primarily to treat inflammatory skin conditions such as eczema, dermatitis, and allergic rashes. It belongs to the corticosteroid class and works by suppressing inflammation, redness, itching, and swelling associated with dermatologic disorders. It is commonly found in formulations like Clobetasone butyrate 0.05%, available as a cream or ointment, and occasionally combined with antibacterial agents for infected eczema.

Pharmacological Classification

  • Drug Class: Topical corticosteroid

  • Potency: Moderately potent (Category II out of IV in the UK)

  • Formulations: Cream, ointment, ophthalmic preparations (rare), and combination creams with antimicrobials

Brand Names

  • Eumovate® (UK and international markets)

  • Trimovate® (clobetasone + oxytetracycline + nystatin)

  • Generic Clobetasone butyrate 0.05% creams and ointments

Mechanism of Action

Clobetasone acts by:

  • Penetrating the skin and binding to glucocorticoid receptors

  • Modifying gene expression to:

    • Suppress the production of inflammatory cytokines

    • Inhibit leukocyte infiltration, prostaglandin synthesis, and capillary dilation

    • Reduce vasodilation and vascular permeability

This results in reduced inflammation, itching, redness, and swelling in affected skin areas.

Therapeutic Indications

Clobetasone is used for the short-term management of the following steroid-responsive dermatoses:

  • Eczema (including atopic eczema, discoid eczema, varicose eczema)

  • Seborrhoeic dermatitis

  • Contact dermatitis (allergic or irritant)

  • Psoriasis (excluding widespread plaque psoriasis or pustular psoriasis)

  • Insect bites or stings with inflammation

  • Lichen simplex

  • Intertrigo

  • Otitis externa (in selected topical ear preparations)

Combination Use (e.g., Trimovate®)

  • Infected dermatoses caused by bacterial and/or fungal agents

  • Conditions where both anti-inflammatory and antimicrobial effects are needed

Dosage and Administration

  • Form: Cream or ointment containing 0.05% clobetasone butyrate

  • Frequency: Apply twice daily (morning and evening) to affected area

  • Use the fingertip unit (FTU) method to estimate the appropriate amount:

    • One FTU (approx. 0.5 g) covers an area twice the size of an adult hand

Maximum Duration

  • Typically for up to 7–14 days

  • Intermittent use in chronic conditions may be recommended to prevent flares

  • Long-term use or application to large areas should be avoided due to risk of systemic absorption

Areas of Use

  • Suitable for use on the face, flexures, and genital areas, where milder corticosteroids are needed

  • Can be used on children for short durations under supervision

Pharmacokinetics

  • Absorption: Minimal systemic absorption when applied appropriately

  • Increased absorption:

    • With occlusive dressings

    • On broken or inflamed skin

    • When used over large body surface areas

  • Metabolism: Rapidly metabolized in the liver

  • Excretion: Via urine and bile

Contraindications

  • Untreated skin infections (bacterial, fungal, viral)

  • Rosacea

  • Acne vulgaris

  • Perioral dermatitis

  • Pruritus without inflammation

  • Primary skin infections (e.g., herpes simplex, chickenpox, tuberculosis of the skin)

  • Hypersensitivity to clobetasone or any component of the formulation

Precautions and Warnings

  • Avoid long-term use especially on delicate areas like the face, groin, or underarms

  • Not recommended for children <1 year unless prescribed

  • Use sparingly in pregnancy and breastfeeding

  • Avoid application to broken skin or ulcerated areas

  • May mask or worsen skin infections—consider concurrent antimicrobial therapy if indicated

  • Use caution in patients with diabetes, as corticosteroids may impair glycemic control if absorbed systemically

  • Avoid use with occlusive dressings unless advised

Adverse Effects

Local Side Effects

  • Skin thinning (atrophy)

  • Striae (stretch marks)

  • Telangiectasia (visible blood vessels)

  • Perioral dermatitis

  • Acneiform eruptions

  • Contact dermatitis (allergic or irritant)

  • Hypopigmentation

  • Hypertrichosis (excess hair growth)

  • Folliculitis

Systemic Side Effects (rare)

  • HPA axis suppression

  • Cushing’s syndrome features (e.g., moon face, weight gain)

  • Especially with:

    • Long-term use

    • Occlusive dressing

    • High potency or large surface area

Rebound flares

  • Withdrawal after prolonged use may lead to rebound worsening of the condition

Drug Interactions

Clobetasone is a topical agent and systemic absorption is minimal when used correctly; however, theoretical interactions include:

  • Ritonavir, itraconazole, or other CYP3A4 inhibitors: may enhance corticosteroid effects if systemic absorption occurs

  • Other topical products: May dilute or interfere with clobetasone if applied simultaneously

  • Vaccines: Live vaccines should not be administered to immunosuppressed patients using large amounts of corticosteroids over long periods

Use in Pregnancy and Lactation

Pregnancy

  • Category not explicitly defined, but:

    • Use only when necessary

    • Prefer short durations

    • Avoid application to large surface areas

Breastfeeding

  • Can be used with caution

  • Avoid application to the nipple area

  • If applied to the chest, wash off before nursing

Storage

  • Store at room temperature below 25°C (77°F)

  • Do not freeze

  • Keep away from direct sunlight

  • Close the cap tightly after use

Patient Counseling

  • Use a thin layer; more is not better and increases risk of side effects

  • Apply only to affected skin, not normal skin

  • Do not use longer than prescribed

  • Avoid eye contact; rinse with water if exposure occurs

  • Wash hands after application unless treating hands

  • Inform the clinician if the condition worsens or doesn't improve within 7 days

  • Do not use on infected skin unless part of a combination cream

  • For children, monitor for growth suppression with long-term use

  • Educate on intermittent therapy for flare control

Alternatives

  • Mild steroids: Hydrocortisone 1%

  • Potent steroids: Betamethasone valerate, mometasone furoate

  • Non-steroidal options: Pimecrolimus, tacrolimus (especially for facial use)

  • Combination therapy: Trimovate, Fucibet (with fusidic acid), Daktacort (with miconazole)




on
Labels:

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)