Potent topical corticosteroid Pregnancy: Inadequate evidence of safety in human pregnancy; topical corticosteroids in pregnant animals can cause foetal abnormalities (cleft palate, intra-uterine growth retardation), so there may be a very small risk in the human foetus (eMC §4.6). US labelling: Pregnancy Category C.

Betamethasone Valerate

Brand names: Betnovate, Bettamousse

Betamethasone valerate is a potent topical corticosteroid used for inflammatory skin conditions such as eczema and psoriasis that are unresponsive to milder steroids.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply sparingly to the scalp

Route: Topical (scalp application)

Frequency: Night and morning until improvement is noticeable, then reduce to once daily or less frequently

eMC §4.2 (Betacap Scalp Application) — for adults, including the elderly, and children over the age of one year. Once improvement is noticeable, sustain by applying once a day or less frequently. For seborrhoeic dermatitis in children, do not use for longer than 5 to 7 days. Long-term continuous topical therapy should be avoided where possible, particularly in infants and children, as adrenal suppression can occur even without occlusion. For external use only; keep away from the eyes. US labelling (cream 0.1%): apply a thin film to affected skin one to three times a day (dosage once or twice a day often effective) — form/strength differs from the UK scalp product.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Bacterial, fungal or viral infection of the scalp
Sensitivity to any of the ingredients
Children under the age of one year

Side effects

Hypersensitivity
HPA axis suppression / hypercorticism (more likely in infants/children and with occlusion)
Skin atrophy (particularly under occlusion, after prolonged use)
Pustular psoriasis
Topical steroid withdrawal reactions (redness, burning/stinging, itch, skin peeling, oozing pustules); blurred vision

Interactions

None known (eMC §4.5)

Clinical monograph

How it works

It binds glucocorticoid receptors to exert anti-inflammatory, immunosuppressive and vasoconstrictive effects in the skin.

Prescribing in practice

As a potent steroid, prolonged or extensive use, especially on the face, flexures or under occlusion, risks skin atrophy and systemic absorption, so use the lowest effective amount for the shortest time.
Avoid use on untreated infected skin, as corticosteroids can mask or worsen cutaneous infection.
Step down to a less potent preparation as the condition improves.

Monitoring

No routine blood monitoring is required for typical topical use; review treated skin for atrophy and resolution.

Counselling the patient

Apply a thin layer to affected areas only and avoid the face and skin folds unless specifically advised.
Do not use on broken or infected skin without advice.
Use for the duration advised and reduce strength as the skin improves.

Evidence & guidelines

Topical corticosteroids of appropriate potency are recommended by NICE for eczema and psoriasis using the lowest effective strength.

Reference: NICE CG57 Atopic Eczema; British Association of Dermatologists Guidelines; 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.

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