Betamethasone

Topical Glucocorticoid·Dermatology - Topical Corticosteroids

Severe eczema, psoriasis, lichen planus, discoid lupus

Authority requiredPBSSTEROIDDiprosone, Eleuphrat, BetnovateCream/Ointment 0+2

Potency

POTENT

Max Use

<=4 WEEKS

Face Safe

NEVER

Systemic Abs.

RISK

Rapid Summary

Overview

Potent topical corticosteroid. Highly effective for thick, lichenified, or severely inflamed skin conditions. Can cause severe local tissue damage if abused.

Maximum Dose

Apply a thin film once or twice daily; do not use continuously for more than 4 weeks without specialist review.

Clinical Focus

If applied to large body surface areas or placed under occlusion (wraps/bandages), enough drug is absorbed to suppress the adrenal glands systemically.

Bottom Line

Betamethasone is a potent topical corticosteroid for severe eczema and inflammatory dermatoses, but must not be used on the face or flexures due to skin atrophy and telangiectasia risk.

Formulation & Access

Brand Names

Diprosone, Eleuphrat, Betnovate

Topical Routes

Cream/Ointment 0.05% (Diprosone). Scalp lotion. (Diprosone OV is *Optimised Vehicle*, making it ultra-potent).

Prescribing & PBS

Authority Required (PBS). S4.

Indications & Use

Primary

PBSTGA

Severe eczema, psoriasis, lichen planus, discoid lupus.

Clinical Place

Third-line step-up. Used for thick, scaly plaques where weaker steroids cannot penetrate.

Quick reference

Class & Role

Topical Glucocorticoid — Potent topical corticosteroid.

Route / Formulation

Cream/Ointment 0.05% (Diprosone). Scalp lotion. (Diprosone OV is *Optimised Vehicle*, making it ultra-potent). (Diprosone, Eleuphrat, Betnovate)

Usual Dose & Max

Topical Apply OD to BD to the body or limbs. Apply a thin layer OD or BD for max 2 weeks.

Key Indication Doses

Severe Dermatoses / Psoriasis: Topical Apply OD to BD to the body or limbs. Scalp Psoriasis: Topical Apply scalp lotion/drops OD.

Best Uses

Betamethasone is a potent topical corticosteroid for severe eczema and inflammatory dermatoses, but must not be used on the face or flexures due to skin atrophy and telangiectasia risk.

Avoid / Cautions

Face, groin, axillae. Untreated infections. Pregnancy Category C. (Mild/moderate steroids preferred, though topical Betamethasone is often required and used cautiously).

Key Risks

Dermatological: Rapid skin atrophy (paper-thin skin that tears easily), permanent striae, prominent telangiectasia, masking of fungal infections (Tinea Incognito). Endocrine: HPA axis suppression (Cushingoid features) if used over large areas for months.

Key Interactions

NONE — Significant systemic interactions are rare unless heavily abused.

Monitoring

Teach the patient to use 'pulse therapy' (e.g., use for 5 days, take 2 days off) to prevent tachyphylaxis (loss of efficacy) and skin thinning.

Clinical Pearl

If you prescribe Betamethasone for a 'rash' that is actually a fungal infection, the steroid turns off the immune system's redness/itching, making the rash *look* better. Meanwhile, the fungus grows wildly out of control into deep tissues (Tinea Incognito). Always rule out fungus.

Access

Authority requiredDiprosone, Eleuphrat, Betnovate

Brand: Diprosone, Eleuphrat, Betnovate
PBS status: Authority required

Betamethasone

Topical Glucocorticoid·Dermatology - Topical Corticosteroids

Severe eczema, psoriasis, lichen planus, discoid lupus

Authority requiredPBSSTEROIDDiprosone, Eleuphrat, BetnovateCream/Ointment 0+2

Potency

POTENT

Max Use

<=4 WEEKS

Face Safe

NEVER

Systemic Abs.

RISK

Rapid Summary

Overview

Potent topical corticosteroid. Highly effective for thick, lichenified, or severely inflamed skin conditions. Can cause severe local tissue damage if abused.

Maximum Dose

Apply a thin film once or twice daily; do not use continuously for more than 4 weeks without specialist review.

Clinical Focus

If applied to large body surface areas or placed under occlusion (wraps/bandages), enough drug is absorbed to suppress the adrenal glands systemically.

Bottom Line

Betamethasone is a potent topical corticosteroid for severe eczema and inflammatory dermatoses, but must not be used on the face or flexures due to skin atrophy and telangiectasia risk.

Formulation & Access

Brand Names

Diprosone, Eleuphrat, Betnovate

Topical Routes

Cream/Ointment 0.05% (Diprosone). Scalp lotion. (Diprosone OV is *Optimised Vehicle*, making it ultra-potent).

Prescribing & PBS

Authority Required (PBS). S4.

Indications & Use

Primary

PBSTGA

Severe eczema, psoriasis, lichen planus, discoid lupus.

Clinical Place

Third-line step-up. Used for thick, scaly plaques where weaker steroids cannot penetrate.

Quick reference

Class & Role

Topical Glucocorticoid — Potent topical corticosteroid.

Route / Formulation

Cream/Ointment 0.05% (Diprosone). Scalp lotion. (Diprosone OV is *Optimised Vehicle*, making it ultra-potent). (Diprosone, Eleuphrat, Betnovate)

Usual Dose & Max

Topical Apply OD to BD to the body or limbs. Apply a thin layer OD or BD for max 2 weeks.

Key Indication Doses

Severe Dermatoses / Psoriasis: Topical Apply OD to BD to the body or limbs. Scalp Psoriasis: Topical Apply scalp lotion/drops OD.

Best Uses

Betamethasone is a potent topical corticosteroid for severe eczema and inflammatory dermatoses, but must not be used on the face or flexures due to skin atrophy and telangiectasia risk.

Avoid / Cautions

Face, groin, axillae. Untreated infections. Pregnancy Category C. (Mild/moderate steroids preferred, though topical Betamethasone is often required and used cautiously).

Key Risks

Key Interactions

NONE — Significant systemic interactions are rare unless heavily abused.

Monitoring

Teach the patient to use 'pulse therapy' (e.g., use for 5 days, take 2 days off) to prevent tachyphylaxis (loss of efficacy) and skin thinning.

Clinical Pearl

Access

Authority requiredDiprosone, Eleuphrat, Betnovate

Brand: Diprosone, Eleuphrat, Betnovate
PBS status: Authority required