Very potent topical corticosteroid Pregnancy: Avoid unless absolutely necessary. Significant risk of systemic absorption.

Clobetasol Propionate

Brand names: Dermovate, Clarelux

Adult dose

Dose: Apply thinly once or twice daily for up to 4 weeks

Route: Topical (cream, ointment, or scalp foam)

Frequency: Once or twice daily

Max: 50 g/week (body); never exceed

0.05% (very potent — highest potency class). Used for severe psoriasis (non-facial), severe eczema, lichen planus, discoid lupus. Max 4 weeks continuous use then step down. Face and flexures: AVOID. Annual cumulative dose maximum 50 g.

Paediatric dose

Route: Topical

Frequency: Once daily

Max: Avoid in children <1 year; use only under specialist guidance in children

Use only under specialist supervision in children. Very high systemic absorption risk in children. Rarely justified in paediatric practice — prefer lower potency. Annual cumulative dose much lower.

Dose adjustments

Renal

No systemic adjustment for topical use.

Hepatic

No systemic adjustment for topical use.

Clinical pearls

Reserve for severe, treatment-resistant conditions only
Max 4 weeks then review — step down to less potent steroid
DO NOT use on face, groin, axillae — very high absorption
Scalp foam (Clarelux) useful for scalp psoriasis — less systemic absorption than other formulations
Annual cumulative limit: 50 g total per year to prevent systemic effects

Contraindications

All contraindications of topical steroids apply
Face, flexures, or large body surface areas
Children <1 year

Side effects

All side effects of potent steroids (more severe due to high potency)
Significant HPA axis suppression with excessive use
Skin atrophy, striae (irreversible)
Cushing's syndrome (systemic absorption with misuse)

Interactions

Occlusive dressings significantly increase systemic absorption

Monitoring

Skin integrity
Body weight
Blood glucose
Signs of adrenal suppression (prolonged large-area use)

Reference: BNFc; BNF; BAD Psoriasis Guidelines; BAD Lichen Planus Guidelines. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Clobetasol propionate · Very potent topical corticosteroid

Pathways