Clobetasol Propionate (Scalp Preparation)

Indications

Clobetasol Propionate scalp solution is indicated in the topical therapy of recalcitrant corticosteroid-responsive dermatoses of the scalp, including recalcitrant cases of psoriasis and seborrheic dermatitis.

Pharmacology

Clobetasol Propionate is a very potent topical corticosteroid. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It shows anti-inflammatory activity via multiple mechanisms to inhibit late phase allergic reactions. It decreases the density of mast cells, chemotaxis and activation of eosinophils. It also reduces cytokine production and inhibits the metabolism of arachidonic acid.

Dosage And Administration

Clobetasol Propionate spray: Apply required quantity of spray of once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Propionate scalp solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Propionate scalp solution for brief periods only.

Clobetasol Propionate shampoo: It should be applied to the dry (not wet) scalp once a day to the affected areas only. It should be massaged gently into the lesions and left in place for 15 minutes before lathering and rinsing. Treatment should be limited to 4 consecutive weeks. Total dosage of shampoo should not exceed 50 g per week. Under 18 years this preparation is not recommended.

Scalp Solution: Apply required quantity of spray of Clobetasol Scalp Solution once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Scalp Solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Scalp Solution for brief periods only.

Contraindications

  • Infections of the scalp
  • Hypersensitivity to the preparation
  • Use is not indicated in dermatoses in children under one year of age

Side Effects

As with other corticosteroids, prolonged use of large amounts or treatment of extensive areas, can result in sufficient systemic absorption to produce the features of hypercortisolism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. Local atrophy may occur after prolonged treatment. In rare instances, treatment of psoriasis with corticosteroids (or its withdrawal) is thought to have provoked the pustular form of the disease. If signs of hypersensitivity appear with the use of Clobetasol Propionate Scalp Solution then application should be stopped immediately.

Pregnancy And Lactation

Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development. The relevance of this finding to human beings has not been established; however, topical steroids should not used extensively in pregnancy, i.e. in large amounts for prolonged periods. The safe use of Clobetasol Propionate during lactation has not been established.

Precautions And Warnings

Care must be taken to keep the preparation away from the eyes. Long-term continuous therapy with Clobetasol Propionate scalp solution should be avoided where possible, particularly in infants and children, as adrenal suppression can occur even without occlusion. Topical corticosteroids may be hazardous in psoriasis for a number of reasons including rebound relapses, development of tolerance, risk of generalized pustular psoriasis and development of local or systemic toxicity due to impaired barrier function of the skin. If used on psoriasis, careful patient supervision is important. Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressings, and so the skin should be cleansed before a fresh dressing is applied.

Therapeutic Class

Other Topical corticosteroids

Storage Conditions

Keep below 30°C temperature, protected from light and moisture. Do not freeze. Keep out of the reach of children.