Clobetasol propionate was developed during the 1960s, with Glaxo Laboratories filing a patent for it in 1969. It was first reported in scientific literature in 1974 and received FDA approval for clinical use in the United States on December 27, 1985. Today, it remains a widely prescribed, superpotent topical corticosteroid used to treat severe inflammatory skin disorders such as psoriasis and eczema. Clobetasol propionate is a superpotent topical corticosteroid used to manage inflammatory skin disorders such as severe psoriasis, eczema, and lichen planus. It acts by decreasing inflammation, redness, and itching through its anti-inflammatory and immunosuppressive properties. Available only by prescription, this medication comes in several formulations, including creams, ointments, lotions, and foams.
BRAND NAMES
Common brand names for clobetasol propionate include Cormax, Temovate, Dermovate, Clobex, Olux, and Impoyz. These topical corticosteroids are prescribed to treat inflammatory skin conditions such as eczema, psoriasis, and lichen planus by alleviating redness, itching, and swelling.
Cormax: Available as a cream and scalp application.
Temovate: Offered as a cream, ointment, and in alternative formulations such as Temovate E.
Dermovate: A recognized brand name for clobetasol propionate in topical form.
Clobex: Supplied as a spray, lotion, and shampoo.
Olux: Formulated as an aerosol foam, with an additional E version available.
Impoyz: Provided as a cream preparation.
MECHANISM OF ACTION
Corticosteroids exert short-term effects by reducing vasodilation and capillary permeability and limiting leukocyte migration to inflamed tissues. Upon binding to glucocorticoid receptors, they alter gene expression, leading to multiple downstream effects over several hours to days. Glucocorticoids inhibit neutrophil apoptosis and promote demargination, suppress phospholipase A2 activity to decrease arachidonic acid derivative production, and block inflammatory transcription factors such as NF-κB while enhancing the expression of anti-inflammatory genes like interleukin-10.
PHARMACOKINETICS:
Absorption
Applying clobetasol foam twice daily results in a maximum plasma concentration (Cmax) of 59 ± 36 pg/mL, reached approximately 5 hours after application (Tmax). In comparison, the use of clobetasol cream shows an increase in plasma concentrations from 50.7 ± 96.0 pg/mL to 56.3 ± 104.7 pg/mL.
Distribution
After topical application, clobetasol propionate is mainly localized and distributed within the layers of the skin.
Metabolism
Although the metabolism of clobetasol propionate has not been extensively studied, it is known to induce metabolic enzymes even when applied topically. Its metabolic pathways are expected to resemble those of other corticosteroids, involving reactions such as oxidation, reduction, and conjugation with glucuronides and sulfates to produce water-soluble metabolites.
Excretion
These inactive metabolites are then primarily eliminated from the body by the kidneys (in the urine), with some also being excreted in the bile and subsequently in the feces.
PHARMACODYNAMICS
Corticosteroids exert their effects by binding to glucocorticoid receptors, suppressing pro-inflammatory pathways while enhancing anti-inflammatory ones. Clobetasol propionate is typically applied twice daily, reflecting its prolonged duration of action. These drugs possess a broad therapeutic window, as treatment often requires doses several times higher than the body’s natural corticosteroid production. Patients using corticosteroids should be advised about the potential risks of hypothalamic-pituitary-adrenal (HPA) axis suppression and heightened vulnerability to infections.
ADMINISTRATION
Clobetasol propionate is a superpotent topical corticosteroid that must be used strictly as directed by a healthcare provider, usually for short-term treatment. Before applying this medication, it is important to understand the correct method of use to maximize its effectiveness and reduce potential side effects. The following information is intended for general educational purposes and should not replace professional medical advice. Always consult your doctor for guidance specific to your condition and treatment plan.
DOSAGE AND STRENGTH
Clobetasol propionate is commonly available at a 0.05% concentration in multiple topical forms, such as cream, ointment, gel, solution, lotion, foam, and shampoo. A less frequently used 0.025% cream is also available.
DRUG INTERACTIONS
Clobetasol propionate is a potent topical corticosteroid with a low risk of systemic drug interactions, though caution is still needed. Using it alongside other corticosteroids can increase the risk of HPA axis suppression and systemic effects. Combining it with immunosuppressive drugs may heighten the chance of infections. Application during live vaccinations, especially over large areas or for prolonged periods, can reduce vaccine effectiveness or increase infection risk. Patients should always inform their healthcare provider about all medications, including over-the-counter and herbal products, before use.
FOOD INTERACTIONS
Topical clobetasol propionate is minimally absorbed into the bloodstream, so it generally does not have significant interactions with food. Unlike systemic corticosteroids, dietary intake is unlikely to affect its efficacy or safety. However, patients should still follow general guidance for corticosteroid use, such as maintaining a balanced diet and monitoring for potential side effects like increased blood sugar if used over large areas or for prolonged periods.
CONTRAINDICATIONS
Clobetasol propionate is contraindicated in individuals with a known hypersensitivity to the drug or any of its components. It should not be applied to areas with active bacterial, viral, or fungal skin infections. Use on conditions like rosacea, perioral dermatitis, or acne vulgaris is also not recommended, as it may worsen these skin problems. Caution is advised when using clobetasol in young children due to the risk of systemic side effects. The medication should always be used under medical supervision, especially on sensitive areas or for extended periods.
SIDE EFFECTS
More common
Burning or stinging at the application site
Less common
Burning sensation of the skin
dry skin
flushing or redness of the skin
itching, scaling, severe redness, soreness, or swelling of the skin
skin irritation
skin rash, encrusted, scaly and oozing
thinning of the skin with easy bruising, especially when used on the face or where the skin folds together (eg, between the fingers)
Rare
Thinning, weakness, or wasting away of the skin
OVER DOSE
Overdose of clobetasol propionate is uncommon but can occur with excessive application over large areas or prolonged use. This may lead to systemic corticosteroid effects, such as features of Cushing’s syndrome, high blood sugar, fluid retention, and suppression of the hypothalamic-pituitary-adrenal (HPA) axis. Locally, overuse can cause severe skin thinning, stretch marks, and easy bruising. Management typically involves discontinuing or reducing the medication under medical supervision, along with supportive care for any systemic effects. It is important to seek immediate medical advice if an overdose or unusual side effects are suspected.
TOXICITY
Clobetasol propionate is an ultra-potent topical corticosteroid that carries a high risk of toxicity, especially when used for extended periods, applied to large or damaged skin areas, or used under occlusive dressings. The main concern arises from systemic absorption, which can result in serious hormonal disturbances and other significant adverse effects.
