Clobetasol propionate scalp
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Cutaneous scalp preparations containing clobetasol propionate.
Drugs List
Therapeutic Indications
Uses
Eczema - scalp
Psoriasis - scalp
Foam and Scalp applications
For the short term treatment of steroid responsive dermatoses of the scalp such as psoriasis which have not responded adequately to less potent topical steroids.
Shampoo preparations
For the topical treatment of moderate scalp psoriasis in adults.
Dosage
Treatment should be discontinued once therapeutic control is achieved.
Repeated short courses may be used to control exacerbations. However if continuous treatment is required a less potent topical steroid should be used.
Adults
Foam Preparations
Apply to the affected area(s) twice daily.
A small amount of foam (approximately 1 teaspoon) should be dispensed directly onto the affected area. Alternatively dispense a small amount of foam into the cap of the container or other cool surface. The foam should be gently massaged into the scalp until it has been completely absorbed.
A single treatment course should be limited to two consecutive weeks, and a maximum quantity of 50 g/week should not be exceeded.
Scalp application
Apply sparingly to the scalp night and morning until improvement occurs.
If symptoms are controlled and improvement has been achieved once a day or less frequent application may be used.
Shampoo Preparations
A small quantity of shampoo (approximately half a tablespoon or 7.5 ml) should be applied directly onto a dry scalp once daily. The shampoo should be left in place for 15 minutes before rinsing with water or washing out with additional regular shampoo if required for cleaning.
A maximum treatment period of 4 weeks is recommended.
Elderly
(See Dosage; Adult)
Children
Scalp application
Children 1 to 18 years of age
(See Dosage; Adult)
The treatment should be reviewed weekly and if possible a few days course is recommended.
Shampoo Preparations
Children 2 to 18 years of age (unlicensed)
(See Dosage; Adult) though not recommended by the manufacturer
Foam Preparations
Children 12 to 18 years of age
(See Dosage; Adult)
Contraindications
Burns
Children under 1 year
Acne vulgaris
Genital pruritus
Perianal pruritus
Perioral dermatitis
Rosacea
Skin infection
Precautions and Warnings
Children under 18 years
Breastfeeding
Pregnancy
May mask symptoms or signs of infections
Not all available brands are licensed for all age groups
Not all available brands are licensed for all indications
May contain polysorbate
Some formulations contain cetyl alcohol
Some formulations contain propylene glycol
Some formulations contain stearyl alcohol
Advise patient to wash hands after use
Avoid contact with eyes
Avoid contact with nostrils or mouth
Avoid occlusive dressings
Avoid use in open/infected wounds
If accidental contact with the eyes occurs, rinse thoroughly with water
Not to be applied to the face
Risk of glaucoma if preparation enters eye
Some preparations are flammable: Advise patient not to use near naked flame
Adrenal suppression may occur even without occlusion
Prolonged use may cause atrophic skin changes
Rebound effect may occur after cessation of treatment
Refer immediately visual disturbances to a specialist
Risk of generalised pustular psoriasis with use of topical corticosteroids
Withdraw gradually if adrenal suppression suspected
Discontinue if hypersensitivity reactions occur
Discontinue therapy and use antimicrobials if secondary infection occurs
Avoid prolonged use
When treating children and adolescents below 18 years of age, it is recommended that treatment should be reviewed on a weekly basis.
Hypercortisolism (Cushing's syndrome) and reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, leading to glucocorticosteroid insufficiency, can occur in some patients, particularly in children as a result of increased systemic absorption of topical steroids. If either are observed, withdraw treatment gradually by reducing the frequency of application, or by substituting a less potent corticosteroid. Abrupt withdrawal of treatment may result in glucocorticosteroid insufficiency.
Pregnancy and Lactation
Pregnancy
Use clobetasol propionate with caution in pregnancy.
The manufacturer does not recommend using clobetasol during pregnancy unless it is clearly necessary.
Topical administration of corticosteroids in pregnant animals produced adverse effects on foetal development such as cleft palate and intrauterine growth retardation (IUGR). There are some epidemiological studies and a meta-analysis of such studies which show a risk of oral clefts consistent with animals studies.
If it is necessary to use topical clobetasol during pregnancy the treatment time should be brief and the area to be covered should not be extensive.
Lactation
Use clobetasol propionate with caution in breastfeeding.
The manufacturer states to use clobetasol when breastfeeding only if clearly necessary.
There is limited information regarding excretion into breast milk with topical steroids. LactMed does state that since only extensive application of the most potent corticosteroids may cause systemic effects in the mother, it is unlikely that short-term application of topical corticosteroids would pose a risk to the breastfed infant. However, it would be prudent to use the least potent drug on the smallest area of skin possible and that it is particularly important to ensure that the infant's skin does not come into direct contact with the areas of skin that has been treated.
Side Effects
Adrenal suppression
Application site reaction
Blurred vision
Burning sensation (local)
Cataracts
Central serous chorioretinopathy
Contact dermatitis
Cushing's syndrome
Erythema at application site
Exacerbation of acne
Exacerbation of infection
Exacerbation of psoriasis
Eye irritation
Folliculitis
Hypersensitivity reactions
Hypertrichosis
Immunosuppression
Increased intra-ocular pressure
Osteonecrosis
Pain at application site
Paraesthesia
Perioral dermatitis
Pruritus
Pustular psoriasis
Rosacea like dermatitis
Secondary infections
Skin irritation
Skin pigmentation changes
Skin tenderness
Skin tightness
Striae
Superficial vascular dilation
Suppression of the hypothalamic-pituitary-adrenal axis
Telangiectasia
Thinning of skin
Urine abnormality
Urticaria
Wound healing retarded
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: December 2021
Reference Sources
Summary of product characteristics: Clarelux 500 microgram/g cutaneous foam in pressurised container. Pierre Fabre Limited. Revised February 2021.
Summary of product characteristics: Dermovate Scalp application. GlaxoSmithKline. Revised March 2021.
Summary of product characteristics: Etrivex 500 micrograms/g shampoo. Galderma UK Limited. Revised May 2021.
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://www.ncbi.nlm.nih.gov/books/NBK501922/
Clobetasol Last revised: 18 January 2021
Last accessed: 13 December 2021
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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