Clobetasol is a very potent topical corticosteroid indicated for adults, the elderly and children over 1 year for the short-term treatment only of more resistant inflammatory and pruritic manifestations of steroid-responsive dermatoses unresponsive to less potent corticosteroids. These include the following:
– Psoriasis (excluding widespread plaque psoriasis)
– Recalcitrant dermatoses
– Lichen planus
– Discoid lupus erythematosus
– Other skin conditions which do not respond satisfactorily to less potent steroids.
Creams are especially appropriate for moist or weeping surfaces.
Adults, Elderly and Children over 1 year
Apply thinly and gently rub in using only enough to cover the entire affected area once or twice a day until improvement occurs (in the more responsive conditions this may be within a few days), then reduce the frequency of application or change the treatment to a less potent preparation. Allow adequate time for absorption after each application before applying an emollient.
Repeated short courses of clobetasol propionate may be used to control exacerbations.
In more resistant lesions, especially where there is hyperkeratosis, the effect of clobetasol can be enhanced, if necessary, by impeding the treatment area with polythene film. Overnight occlusion only is usually adequate to bring about a satisfactory response. Thereafter improvement can usually be maintained by the application without occlusion.
If the condition worsens or does not improve within 2-4 weeks, treatment and diagnosis should be re-evaluated.
Treatment should not be continued for more than 4 weeks. If continuous treatment is necessary, a less potent preparation should be used.
The maximum weekly dose should not exceed 50gms/week.
Therapy with clobetasol should be gradually discontinued once control is achieved and an emollient continued as maintenance therapy.
The rebound of pre-existing dermatoses can occur with abrupt discontinuation of clobetasol.
Application to the face: Courses should be limited to five days if possible and occlusion should not be used.