1. Introduction
Betamethasone is a potent corticosteroid used topically to manage inflammatory skin conditions such as eczema, psoriasis, and dermatitis. It reduces redness, itching, and swelling by suppressing inflammatory and immune responses in the skin.
2. Indications
- Approved Indications:
- Eczema and atopic dermatitis.
- Psoriasis (excluding widespread plaque psoriasis).
- Contact dermatitis.
- Seborrhoeic dermatitis.
- Lichen planus.
- Lupus erythematosus (discoid).
- Off-Label Uses:
- Symptomatic relief of insect bites or stings.
3. Dosage
- Adults and Children >1 year:
- Apply a thin layer to the affected area once or twice daily.
- Duration: Use for no more than 2 weeks in most cases, unless advised by a healthcare provider.
- Children <1 year:
- Use only under specialist advice.
4. Administration
- Clean and dry the affected area before application.
- Apply a thin layer of the cream or ointment and gently rub into the skin.
- Avoid application on broken skin, mucous membranes, or areas prone to occlusion unless directed.
- Wash hands thoroughly after application unless the hands are being treated.
5. Forms Available
- Cream: 0.1% or 0.05% (betamethasone valerate or dipropionate).
- Ointment: 0.1% or 0.05%.
- Lotion: 0.05% (for hairy areas).
6. Side Effects
6.1. Common Side Effects
- Burning or stinging at the application site.
- Itching.
6.2. Less Common Side Effects
- Skin dryness or cracking.
- Folliculitis (hair follicle inflammation).
6.3. Rare but Serious Side Effects
- Skin thinning or atrophy.
- Striae (stretch marks).
- Perioral dermatitis (rash around the mouth).
- HPA axis suppression with prolonged or extensive use.
7. Warnings
- Not for use on the face, groin, or underarms unless directed by a healthcare provider.
- Avoid use in untreated skin infections (bacterial, fungal, or viral).
- Do not cover the treated area with bandages or occlusive dressings unless instructed.
8. Precautions
- Use the lowest effective dose for the shortest duration.
- Discontinue use if skin irritation or worsening of the condition occurs.
- Avoid prolonged use in infants and young children due to the risk of systemic absorption.
9. Interactions
- Drug-Drug Interactions:
- CYP3A4 inhibitors (e.g., ritonavir, itraconazole) may increase systemic absorption of betamethasone.
- Drug-Food Interactions:
- None reported for topical use.
10. Monitoring Parameters
- Improvement of symptoms within 1–2 weeks.
- Monitor for signs of skin thinning or localised infection with prolonged use.
11. Use in Children
- Approved for use in children >1 year for short-term treatment of inflammatory skin conditions.
- Avoid long-term use or application to large areas of the body.
12. Use in Pregnancy
- Use only if the potential benefit outweighs the risk.
- Prolonged or extensive use during pregnancy should be avoided due to potential effects on the foetus.
13. Use in Elderly
- No specific dosage adjustments required, but the skin may be more fragile, increasing susceptibility to side effects such as skin thinning.
14. Use in Kidney Disease
- No dose adjustments required; systemic absorption is minimal with topical use.
15. Use in Liver Disease
- No dose adjustments required; systemic absorption is minimal.
16. Patient Counselling Points
- Apply only a thin layer to the affected area; avoid overuse.
- Do not use on broken skin, near the eyes, or on sensitive areas unless directed.
- Wash hands thoroughly after application.
- Inform patients to seek medical advice if there is no improvement after 7–14 days of use.
- Store at room temperature and away from direct sunlight.
17. Table of Brand Names, Manufacturers, and Prices
Brand Name | Manufacturer | Price (USD) |
---|---|---|
Betnovate | GlaxoSmithKline | $5–10 (15 g tube, 0.1%) |
Diprosone | Merck | $10–15 (15 g tube, 0.05%) |
Luxiq (lotion) | Prestium Pharma | $15–20 (50 mL, 0.05%) |
Generic Options | Various | $3–8 (15 g tube, 0.1%) |
18. FAQs (15 Questions)
- What is betamethasone used for on the skin?
It is used to treat inflammatory and allergic skin conditions such as eczema, dermatitis, and psoriasis. - How does betamethasone work?
It reduces inflammation and suppresses the immune response in the skin. - Can betamethasone be used on the face?
It is not recommended unless specifically directed by a healthcare provider due to the risk of skin thinning. - What are the common side effects of betamethasone?
Burning, stinging, and itching at the application site. - How long can betamethasone be used?
Typically, it should be used for no longer than 2 weeks unless instructed otherwise. - Is betamethasone safe for children?
Yes, but only for short-term use and under medical supervision. - Can pregnant women use betamethasone?
It should only be used if necessary, with caution to minimise exposure. - How should betamethasone be applied?
Apply a thin layer to clean, dry skin and rub in gently. - What happens if I miss a dose?
Apply it as soon as you remember, but do not double the dose. - Can betamethasone be used on open wounds?
No, it should not be applied to broken or infected skin. - Does betamethasone interact with other medications?
CYP3A4 inhibitors may increase its systemic absorption, though this is rare with topical use. - Can betamethasone cause skin thinning?
Yes, prolonged use may cause thinning of the skin. - How should betamethasone be stored?
Store at room temperature, away from direct sunlight and moisture. - Can betamethasone treat fungal infections?
No, it is not effective for fungal infections and may worsen them. - What should I do if my symptoms don’t improve?
Consult a healthcare provider if there is no improvement after 7–14 days.