Betamethasone for severe inflammatory skin conditions

About topical betamethasone

Betamethasone is classed as a potent topical corticosteroid. Topical corticosteroids are also referred to as topical steroids. Topical steroids are used in addition to moisturisers (emollients) for treating inflammatory skin conditions such as eczema and dermatitis. A topical steroid is used when patches of eczema or dermatitis flare up. Betamethasone relieves the symptoms of a flare-up by reducing inflammation, itching and redness. It is not a cure for the condition, but it will help to relieve the symptoms. Short courses of betamethasone may also be prescribed for the treatment of psoriasis for small areas such as the scalp, soles of the feet, or palms of the hands.

Betamethasone is available in a number of different preparations. It is likely you will be prescribed a cream if the affected areas of your skin are moist or weeping, an ointment if your skin is dry, or a lotion for larger or hairy areas of skin. It is also available as an application for the scalp. Betamethasone is not generally suitable for children, although short courses of up to two weeks may occasionally be prescribed for a child by a skin specialist doctor.

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. They are typically used twice a day for one week only. 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 these are also only prescribed for short periods 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 knows:

• If you have any areas of infected skin.

• If you have rosacea or acne.

• If you are pregnant or breastfeeding.

• If you have ever had an allergic reaction to a skin preparation.

How to use betamethasone

• Before you start using the preparation, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about topical steroids and will provide you with a full list of the side-effects that you may experience from using them.

• Apply a small amount 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.

• 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® or 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.

• 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.

• If you are using more than one topical corticosteroid, make sure you know when 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, remember to 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 again afterwards.

Getting the most from your treatment

• If you are using a moisturiser along with this preparation, apply the moisturiser first. Then wait 10-15 minutes before applying betamethasone. This allows time for the moisturiser to be absorbed before the topical corticosteroid is applied. Your skin should be moist but not slippery when you apply betamethasone.

• Do not use betamethasone on your face unless a skin specialist 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.

• After you finish using betamethasone, continue to use your moisturiser every day. This will help to prevent a further flare-up. Your doctor may also prescribe a less potent steroid cream for you to use when needed.

• If you are using a preparation of betamethasone containing clioquinol, be careful not to let the preparation come into contact with your clothing, as it may stain.

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 betamethasone by applying the preparation thinly, no more than twice a day, and applying it to the affected areas only.

If you experience any other symptoms which you think may be due to betamethasone, speak with your doctor or pharmacist for further advice.

There is a risk of fire when creams and ointments are absorbed by fabrics (such as clothing or bedsheets), making them flammable. A spark or flame can easily ignite the fabric. The risk is highest when large amounts of paraffin-based products are applied and absorb into fabrics. However, there is also a risk when non-paraffin products are used. Be aware of this fire hazard when repeatedly using large amounts of any skin product. Do not smoke or go near naked flames. When used as directed by your doctor, betamethasone will be applied in small quantities on small areas of skin. There should be minimal absorption into fabrics and a lower risk of fire.

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