Potent corticosteroid + keratolytic Pregnancy: Safety of topical corticosteroids in pregnancy is not established - use in pregnancy only if the potential benefit justifies the potential risk to the foetus, and not extensively, in large amounts or for prolonged periods. For breast-feeding, decide whether to discontinue nursing or the drug (UK SPC §4.6)

Betamethasone with salicylic acid

Brand names: Diprosalic

A topical fixed-combination ointment of the potent corticosteroid betamethasone with the keratolytic salicylic acid, used for hyperkeratotic, scaly inflammatory skin conditions such as plaque psoriasis and lichenified eczema.

Adult dose

Dose: A thin film applied to cover the affected area

Route: Topical (cutaneous)

Frequency: Twice daily in most cases (range once to twice daily)

Max: Maximum weekly dose should not exceed 60 g

UK SPC: Betamethasone (dipropionate) + salicylic acid 0.05% w/w + 3% w/w ointment. For some patients adequate maintenance therapy may be achieved with less frequent application. It is recommended that the product is prescribed for two weeks and that treatment is reviewed at that time; long-term continuous therapy should be avoided in all patients irrespective of age. Occlusion must not be used, since the keratolytic action of salicylic acid may lead to enhanced absorption of the steroid. Paediatric: dosage in children should be limited to 5 days (the same 5-day limit applies if used on the face). Systemic absorption may be increased if extensive body surface areas or skin folds are treated for prolonged periods or with excessive amounts - take particular precautions in infants and children. Avoid contact with eyes and mucous membranes. Discontinue if irritation, sensitisation or excessive dryness develops.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to any of the ingredients
Rosacea, acne, perioral dermatitis
Perianal and genital pruritus
Tuberculous and most viral lesions of the skin, particularly herpes simplex, vaccinia, varicella
Napkin eruptions, and fungal or bacterial skin infections without suitable concomitant anti-infective therapy

Side effects

Burning, itching, irritation and dryness of the skin
Local skin atrophy, striae and superficial vascular dilation, particularly on the face, with continuous uninterrupted application
Folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation
Perioral dermatitis and allergic contact dermatitis; prolonged use of salicylic acid preparations may cause dermatitis
Maceration of the skin, secondary infection, skin atrophy, striae and miliaria (more frequent with occlusive dressings)
Vision blurred (frequency not known)
Withdrawal reactions - redness which may extend beyond the initial affected area, burning or stinging, itch, skin peeling, oozing pustules (frequency not known)

Clinical monograph

How it works

Betamethasone suppresses inflammation and epidermal proliferation, while salicylic acid softens and removes scale, improving penetration of the corticosteroid into thickened plaques.

Prescribing in practice

Avoid application over large body-surface areas, as systemic salicylate absorption (salicylism) can occur, particularly in children, and combined with the potent steroid raises adrenal-suppression risk.
Avoid the face and flexures and prolonged uninterrupted use, which risks skin atrophy.
Use with caution in patients with extensive psoriasis and do not apply to broken or weeping skin.

Monitoring

Reassess plaques after a defined course and limit the duration and surface area treated to minimise both salicylate absorption and corticosteroid effects.

Counselling the patient

Apply only to the thickened, scaly patches as directed and not over large areas of skin.
Do not use airtight dressings unless specifically advised.

Evidence & guidelines

Cautions on salicylate absorption and corticosteroid potency reflect the SPC and standard psoriasis management guidance.

Reference: NICE CG153; BAD; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways