Halobetasol Propionate (halobetasol propionate)

For dermatologic use, topical corticosteroids are available in various dosage forms including creams, dressings (tape), foams, gels, lotions, ointments, solutions, and aerosols (suspensions). The choice of a dosage form depends on the location of the lesion and the condition being treated. Lotions are probably best for the treatment of weeping eruptions, especially in areas subject to chafing such as the axilla, foot, and groin. Lotions, gels, and aerosols may be used on hairy areas, particularly the scalp. Creams are suitable for most dermatoses, but ointments, which may also provide some occlusion, are usually used for the treatment of dry, scaly lesions. Because certain areas of the body may be more susceptible to atrophic changes than others following treatment with corticosteroids, certain topical corticosteroid preparations (e.g., betamethasone dipropionate 0.05% gel; clobetasol propionate 0.05% cream, foam, gel, lotion, solution, or shampoo; hydrocortisone valerate 0.2% cream; mometasone furoate 0.1% cream, lotion, or ointment) should not be applied to the face or intertriginous areas (e.g., axilla, groin).

Because the formulation of dermatologic corticosteroid products affects percutaneous penetration and subsequent activity of the drug, extemporaneous preparation or dilution of most commercially available products with another vehicle may result in decreased effectiveness.

The area of skin to be treated may be thoroughly cleansed before topical application of corticosteroids to reduce the risk of infection. However, some clinicians believe that, unless an occlusive dressing is used, cleansing of the treated area is unnecessary and may be irritating. Topical corticosteroids are generally applied sparingly in thin films and rubbed gently into the affected area 1-4 times daily. When a favorable response is achieved, the frequency of application or concentration of the corticosteroid is reduced to the minimum necessary to maintain control and avoid relapse and, if possible, the drug should be discontinued.

For occlusive dressing therapy, the affected area is soaked or washed to remove scales and a corticosteroid cream, lotion, or ointment is applied in a thin film or is rubbed gently into the lesion and another thin film applied. After applying the corticosteroid, the affected area is covered with a thin, pliable plastic film which is sealed to adjacent normal skin with adhesive tape or held in place by a gauze or elastic bandage. If the affected area is moist, the edges of the plastic film may be incompletely sealed or the film may be punctured to allow excess moisture to escape. For added moisture in dry lesions, the corticosteroid may be covered with a dampened cloth before the plastic film is applied or the affected area may be briefly soaked in water before application of the drug and plastic film. Thin polyethylene gloves may be used on the hands and fingers, plastic garment bags may be used on the trunk or buttocks, a tight shower cap may be used for the scalp, or whole-body suits may be used instead of plastic film to provide occlusion. Flurandrenolide tape may be used alone as an occlusive dressing for small areas.

The frequency of occlusive dressing changes depends on the condition being treated; cleansing of the skin and reapplication of the corticosteroid are essential at each dressing change. The occlusive dressing is usually left in place for 12-24 hours and therapy is repeated as needed. Some manufacturers state that the occlusive dressing may be left in place for 3-4 days at a time in resistant conditions, because theoretically the longer the occlusive dressing is left in place at one time, the more rapidly the dermatoses respond to topical corticosteroid therapy. However, most clinicians recommend intermittent use of occlusive dressings for 12 hours daily to reduce the risk of adverse effects (particularly infection) and systemic absorption and for greater convenience. For example, the corticosteroid and an occlusive dressing may be used at night, and the topical corticosteroid or a bland emollient may be used without an occlusive dressing during the day. In patients with extensive lesions, sequential occlusion of only one portion of the body at a time may be preferable to whole-body occlusion.

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There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

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There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

• Glaucoma
• Hypothalamic-pituitary insufficiency

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Less Frequent

• Folliculitis
• Purpura
• Skin and skin structure infection
• Skin atrophy

Rare or Very Rare

• Adrenocortical insufficiency
• Bullous dermatitis
• Cataracts
• Central serous chorioretinopathy
• Glaucoma
• Growth failure
• Hypothalamic-pituitary insufficiency
• Intracranial hypertension
• Ocular hypertension
• Skin hypopigmentation
• Skin striae
• Skin ulcer
• Urticaria

More Frequent

• Erythema
• Stinging of skin

Less Frequent

• Acute pain at drug application site
• Blurred vision
• Headache disorder
• Paresthesia
• Pruritus of skin
• Skin rash
• Telangiectasia
• Treatment site sequelae

Rare or Very Rare

• Acneiform eruption
• Alopecia
• Blistering skin
• Contact dermatitis
• Dry skin
• Dyschromia
• Glycosuria
• Hirsutism
• Hypercortisolism
• Hyperesthesia
• Hyperglycemia
• Miliaria
• Perioral dermatitis
• Skin irritation

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Safe use of topical corticosteroids during pregnancy has not been established. Although there are no adequate and controlled studies to date in humans, potent corticosteroids have been shown to be teratogenic in animals following topical application. Topical corticosteroids should be used during pregnancy only when the potential benefits justify the possible risks to the fetus. The drugs should not be used on extensive areas, in large amounts, or for prolonged periods in pregnant women.

It is not known whether topical corticosteroids are distributed into milk; however, systemic corticosteroids are distributed into milk. Topical corticosteroids should be used with caution in nursing women.

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