About topical betamethasone
|Type of medicine||Potent topical corticosteroid|
|Used for||Inflammatory skin conditions such as severe eczema|
|Also called||Betamethasone valerate, betamethasone diproprionate, Betnovate®, Diprosone®, Betacap®, Betesil®, Bettamousse®|
|Available as||Cream, lotion, ointment, foam scalp application, scalp application, and medicated plasters|
Betamethasone is a potent topical corticosteroid (also referred to as a topical steroid). Topical steroids are used in addition to emollients (moisturisers) for treating inflammatory skin conditions such as eczema and dermatitis. A topical steroid is used when patches of eczema or dermatitis flare up. It is not a cure for your condition, but it will help to relieve the symptoms of a flare-up by reducing inflammation, itching and redness.
Short courses of betamethasone may also be useful in the the treatment of psoriasis for small areas such as the scalp, soles of the feet, or palms of the hands.
There are also betamethasone preparations available which contain an antibacterial agent (such as clioquinol, neomycin or fusidic acid), or an antifungal agent (such as clotrimazole). You may be prescribed one of these preparations for short-term use if your skin has become infected. Some preparations of betamethasone also contain an ingredient called salicylic acid. The salicylic acid in these formulations can help the steroid to be absorbed more effectively by your skin, but they are only prescribed for a short period of time.
Before using betamethasone
To make sure this is the right treatment for you, before you start using betamethasone it is important that your doctor or pharmacist knows:
- If you have any areas of infected skin.
- If you have rosacea or acne.
- If you are pregnant or breast-feeding.
- If you have ever had an allergic reaction to a skin preparation.
How to use betamethasone
- Before you start using this preparation, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about topical steroids and a full list of side-effects that you may experience from using them.
- Apply a small amount on to the areas of skin which are inflamed. Then gently rub it into the skin until it has disappeared. If you are using a scalp application, apply it to dry hair, rub it in gently, and then allow the area to dry again naturally.
- Your doctor will tell you how often to apply betamethasone. It must not be applied more than twice a day, and once a day is often sufficient.
- Do not use betamethasone on any areas of open or infected skin unless you have a preparation which also contains an antibacterial or antifungal agent (such as Fucibet®, and Lotriderm®). If you are using one of these preparations, use it regularly twice daily for one week only, unless you have been directed otherwise by your doctor.
- The amount of topical steroid that you should apply is commonly measured by fingertip units (FTUs). One FTU is the amount of cream or ointment that is squeezed out along an adult's fingertip (that is, from the very end of the finger to the first crease in the finger). As a guide, one FTU is enough to cover an area twice the size of an adult hand. Your doctor will give you an idea of how many FTUs you will need to cover the area of your skin which is affected.
- If you are using more than one topical corticosteroid, make sure you know how and where to use each one. If you are unsure, check with your doctor or ask your pharmacist for further advice.
- After you have applied betamethasone, wash your hands (unless your hands are the treated area).
- If you are using betamethasone for psoriasis, make sure you follow your doctor's instructions carefully. It should not be used for large areas of psoriasis or for long periods of time, as these can cause your symptoms to flare up afterwards. If you are using the medicated plasters, carefully follow the directions on the printed information leaflet from inside the pack.
Getting the most from your treatment
- If you are using an emollient along with this preparation, apply the emollient first. Then wait 10-15 minutes before applying betamethasone. This allows time for the emollient to be absorbed before the topical corticosteroid is applied. (Your skin should be moist but not slippery when you apply betamethasone.)
- Do not use this preparation on your face unless your doctor has said you should. If you have been told to use it on your face, be careful not to get any preparation near your eyes and do not use it for longer periods of time than you have been advised.
- Unless advised to do so by your doctor, do not apply a bandage or dressing to the area being treated as this will increase absorption of the preparation and increase the risk of side-effects.
- Continue to use betamethasone until the flare-up has gone and then stop it. A course of treatment for 7-14 days is often sufficient. If your symptoms have not improved after this time (or if they get worse), speak again with your doctor for further advice. Topical corticosteroids like betamethasone should not be used for long periods of time or on large areas of the body, especially in children. You may be given a less potent topical steroid to use for a while after you stop betamethasone, to make sure your symptoms go completely.
- If you are using betamethasone with clioquinol, be careful not to let the preparation come into contact with your clothing, as it may stain.
- Even after you have finished using topical steroids, continue to use your emollients every day. This will help to prevent a further flare-up.
Can betamethasone cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. You can reduce the risk of side-effects from topical corticosteroids like betamethasone, by applying the preparation thinly, no more than twice a day, and to the affected areas only.
|Side-effects of topical betamethasone||What can I do if I experience this?|
|Thinning of your skin, striae (like stretch marks), bruising, discolouration, or thin spidery blood vessels||Speak with your doctor if you notice any of these|
If you experience any other symptoms which you think may be due to betamethasone, speak with your doctor or pharmacist.
How to store topical betamethasone
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- Manufacturer's PIL, Betnovate® Cream; Manufacturer's PIL, Betnovate® Cream, GlaxoSmithKline UK, The electronic Medicines Compendium. Dated October 2007.
- Manufacturer's PIL, Betnovate® Lotion; Manufacturer's PIL, Betnovate® Lotion, GlaxoSmithKline UK, The electronic Medicines Compendium. Dated July 2011.
- Manufacturer's PIL, Betnovate® Scalp Application; Manufacturer's PIL, Betnovate® Scalp Application, GlaxoSmithKline UK, The electronic Medicines Compendium. Dated July 2011.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall