Betamethasone with clotrimazole

How it works

Betamethasone suppresses local inflammation, vasodilatation and immune activity, while clotrimazole inhibits fungal ergosterol synthesis to disrupt the cell membrane of dermatophytes and yeasts.

Prescribing in practice

• The corticosteroid component can mask and worsen an untreated infection, so use should be short-term and limited to genuinely inflamed fungal disease rather than as a routine antifungal.
• Avoid prolonged application to the face, flexures or large areas, and avoid occlusion, which increases corticosteroid potency and absorption.
• Not appropriate as monotherapy for established dermatophyte infection if inflammation is minimal — a plain antifungal is preferred.

Monitoring

Review the response after a short course and reassess the diagnosis if the rash fails to clear or recurs, considering skin scrapings for mycology.

Counselling the patient

• Apply a thin layer to the affected area as directed and do not cover with airtight dressings unless told to.
• Stop and seek advice if the area becomes more sore, weepy or fails to improve.

Evidence & guidelines

Use is guided by SPC recommendations and standard dermatology practice for inflamed superficial fungal infection; consult current prescribing references.