Clobetasone butyrate

How it works

It activates glucocorticoid receptors in skin cells to reduce inflammation, suppress local immune activity and cause vasoconstriction.

Prescribing in practice

• Although less potent than the strongest steroids, prolonged or extensive use can still cause skin atrophy and, rarely, systemic absorption, so apply sparingly for the shortest effective period.
• Use cautiously on the face and in flexures, and avoid applying to infected skin without appropriate antimicrobial cover.
• Step down to an emollient-led regimen as the flare settles and review if the condition fails to improve.

Monitoring

Monitor the treated skin clinically for response and for local corticosteroid side-effects, particularly with longer courses.

Counselling the patient

• Apply thinly to the affected area and continue regular emollients between flares.
• Use only for the duration advised and avoid spreading onto unaffected skin.
• Seek advice if the rash worsens or shows signs of infection.

Evidence & guidelines

Use reflects standard topical corticosteroid potency selection in line with NICE eczema and dermatitis guidance.