Betamethasone topical: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on July 5, 2023.

1. How it works

• Betamethasone topical is a corticosteroid preparation that may be used to treat certain inflammatory conditions of the skin or scalp.
• Experts aren't exactly sure how betamethasone topical works but suggest it may be through the induction of phospholipase A2 inhibitory proteins (called lipocortins) which decreases arachidonic acid release from membrane phospholipids. Arachidonic acid is an essential fatty acid and a precursor in the biosynthesis of potent inflammatory mediators, such as prostaglandins, thromboxanes, and leukotrienes. By decreasing arachidonic acid release, betamethasone topical decreases inflammation.
• Betamethasone topical belongs to the class of medicines known as topical steroids. It may also be called a synthetic fluorinated corticosteroid.

2. Upsides

• May be used to relieve inflammation and itch associated with corticosteroid-responsive dermatoses (skin conditions, defects, or lesions).
• Generally most effective at treating acute or chronic dermatoses such as seborrheic or atopic dermatitis, localized neurodermatitis, Itching around the anus or genitals (anogenital pruritus), psoriasis, late phase of allergic contact dermatitis, or inflamed dry skin (inflammatory xerosis).
• Available as a cream, foam, gel, lotion, or ointment.
• Topical betamethasone therapy is associated with fewer adverse effects than oral or injectable therapy.
• The dosage form chosen should reflect the location of the lesion. Cream preparations are suitable for most skin conditions, ointments provide some occlusion and are usually used for dry, scaly lesions. Lotions may be used if weeping eruptions are present, especially in areas such as the groin, foot, or armpits that are prone to chafing. Lotions, gels, or aerosols may be used on hairy areas, such as the scalp.
• Potency varies depending on the vehicle used, the betamethasone salt, and its concentration (see response and effectiveness below).
• May be used in combination with clotrimazole to treat symptomatic inflammatory tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea corporis (ringworm).
• May be used in combination with calcipotriene to treat plaque psoriasis or chronic, moderate-to-severe plaque psoriasis of the scalp in adults.
• The effectiveness of treatment can be increased by using a higher concentration of betamethasone or using an occlusive dressing (however, this should only be done under a doctor's advice and does not apply to all betamethasone preparations).
• Usually applied once to three times daily depending on the product and the condition being treated.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Irritation, burning, itching, stinging, dry skin, dryness, folliculitis (infection of the hair follicles), excessive hair growth, acne, hypopigmentation, perioral dermatitis, infection, stretch marks, and miliaria, are possible side effects that may occur more frequently if betamethasone topical is used under an occlusive dressing.
• Prolonged use may cause thinning of the skin; areas such as the elbow or knee flexors, facial areas, or areas where skin touches are more at risk. Do not use betamethasone topical in areas where the skin is already thinned.
• Rarely intracranial hypertension has been reported in young children.
• Some preparations are not for use in children less than 12 years of age. Fixed combination clotrimazole/betamethasone preparations are not for use in children aged less than 17 years. Children may be more sensitive to side effects.
• Should only be applied to the skin or the scalp. Avoid contact with the eyes.
• Do not use augmented forms of betamethasone topical or combination betamethasone dipropionate/calcipotriene on the face, groin, or armpits.
• Not for oral or intravaginal use.
• Topical treatment generally only controls the symptoms of fungal infections, the cause should be eliminated as well (this is why there is a fixed combination topical product containing betamethasone and clotrimazole).
• Treatment failure has been reported when topical betamethasone is used in combination with clotrimazole in the treatment of Microsporum canis infections.
• An individual's response may vary from one corticosteroid preparation to another.
• May not be suitable for some people such as those who have had previous allergies to betamethasone, with known disorders of calcium metabolism, or some forms of psoriasis (such as pustular or erythrodermic).
• The anti-inflammatory effects of betamethasone topical may vary depending on the vehicle (this is the cream, ointment, gel, liquid, or foam that betamethasone is dissolved in). Other factors, such as drug concentration, site of application, the condition being treated and patient factors also play a role.
• Diluting a preparation with another vehicle may decrease its effectiveness.
• Evaluate periodically for hypothalamic-pituitary-adrenal (HPA)-axis suppression, those who apply topical betamethasone to a large surface area, for long periods, or use betamethasone under occlusion. Children are more susceptible to corticosteroid-induced HPA-axis suppression and Cushing's syndrome than adults because of a greater surface area to body weight ratio. Manifestations of adrenal suppression include height retardation, delayed weight gain, and low plasma cortisol concentrations. Children are also at greater risk of glucocorticoid insufficiency on discontinuation.
• Do not exceed more than 45 grams per week of augmented cream or ointment or 50 grams per week of augmented gel. Do not exceed more than two weeks of consecutive treatment.
• For the fixed combination betamethasone/calcipotriene ointment, do not exceed 100 grams/week and do not apply to more than 30% of the body surface area. Do not exceed more than 4 consecutive weeks of therapy (suspension, 8 consecutive weeks).
• Topical corticosteroids such as betamethasone topical may mask the signs of bacterial, fungal, or viral infections, prevent recognition of the ineffectiveness of the antimicrobial, or suppress a hypersensitivity reaction. If a concurrent skin infection is present or develops, always initiate appropriate anti-infective therapy.
• Fixed combination betamethasone/clotrimazole preparations may lead to a decreased cure rate because of suppression of the inflammatory response.
• There is not enough data to know whether using betamethasone topical on the skin will harm an unborn baby. Women who are pregnant should only use betamethasone topical if the risks outweigh the benefits and only under a doctor's advice.
• It may not be safe to breastfeed while using this medicine. If breastfeeding and your doctor has advised you to use betamethasone topical, do not apply it to any areas of your chest likely to come into contact with the baby's mouth.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Betamethasone topical is the name for multiple betamethasone preparations that vary in potency from medium to super-high depending on the concentration of betamethasone, the vehicle, the salt used, and if the vehicle is augmented or not. Betamethasone topical may be used to relieve inflammation and itching associated with skin and scalp conditions responsive to corticosteroids although some preparations are not suitable for the face, armpits, or groin area.

5. Tips

• Apply thinly and exactly as directed by your doctor. Rub in gently. Once a favorable response has been seen, decrease the frequency of applications to a level that still maintains control. Discontinue as soon as possible; betamethasone should not be used continuously for long periods. Talk to your doctor about this.
• Do not use betamethasone topical on your face, groin, or armpits, and do not take it by mouth. Do not apply to broken or infected skin and avoid applying it to open wounds. Always wash your hands thoroughly after applying betamethasone topical.
• Discontinue if irritation occurs.
• Do not cover the treated area with plastic film or a dressing unless your doctor tells you to because this may increase how much of the product is absorbed through your skin.
• If you are using the foam, dispense a small amount onto a cool surface (such as a saucer) to prevent melting and then massage it into the affected area. Do not apply directly to the hands. Wash hands thoroughly after rubbing in.
• Betamethasone lotions should be shaken before use.
• Call your doctor if you develop an infection, if your symptoms do not improve, or if they get worse.
• Do not apply any other topical steroid medications to the same areas that you are treating with betamethasone topical unless your doctor tells you to.
• Betamethasone topical should not be used to treat acne; bacterial, fungal, or viral skin infections (such as herpes simplex, shingles, or chickenpox); eyelid conditions; perioral dermatitis; phimosis (a tight foreskin of the penis); rosacea; scabies; skin conditions caused by vaccinations, tuberculosis, or syphilis.
• Betamethasone topical may increase your risk of glaucoma or cataracts. Report any visual symptoms to your doctor who may refer you to an ophthalmologist for evaluation.
• Tell your doctor if you experience any worrying side effects such as unexpected weight gain, moon face, severe headache, severe nausea and vomiting, dizziness, muscle weakness, fatigue, confusion, increased thirst, excessive passing of urine, or skin changes.
• Do not smoke after applying Betamethasone topical foam/spray as it is flammable and your hair or areas of skin could catch fire. Do not go near a heat source or open flame during or immediately following application.
• Tell your doctor if you are pregnant, plan to become pregnant, or breastfeeding as betamethasone topical may not be suitable for you.

6. Response and effectiveness

• Medium potency: betamethasone dipropionate 0.05% cream, betamethasone valerate 0.1% cream, and betamethasone valerate 0.12% foam.
• High-range potency: betamethasone dipropionate 0.05% ointment, betamethasone dipropionate 0.05% augmented ointment, betamethasone dipropionate 0.05% augmented cream, betamethasone dipropionate 0.05% augmented lotion, betamethasone dipropionate 0.05% in combination with clotrimazole 1% cream or lotion.
• Super high potency: betamethasone dipropionate 0.05% augmented gel.
• Augmented means the vehicle (which may be either a cream, foam, gel, lotion, or ointment) has been formulated in a way that allows betamethasone to be better absorbed through the skin.

7. Interactions

Betamethasone topical is unlikely to interact with any other drugs that are taken orally because it is applied topically to the skin. However, excessive use of betamethasone topical may increase the risk of absorption of betamethasone topical, and possible interactions.

The product information for betamethasone topical lists only minor interactions. These include:

• acid suppressants, such as famotidine, or omeprazole (corticosteroids can increase irritation of the stomach)
• diabetic medications, such as insulin, glyburide, glimepiride, or glipizide (betamethasone topical may increase blood sugar levels)
• nitroblue-tetrazolium test for bacterial infection (concurrent use of betamethasone topical may cause a false-negative result)
• oral or topical corticosteroids, such as prednisone (may increase the risk of HPA suppression).

Note that this list is not all-inclusive and includes only common medications that may interact with betamethasone topical. You should refer to the prescribing information for betamethasone topical for a complete list of interactions. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

References

• Betamethasone (Topical). Updated 01/2023. ASHP. https://www.drugs.com/monograph/betamethasone-topical.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use betamethasone topical only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2024 Drugs.com. Revision date: July 5, 2023.

Medical Disclaimer