Betamethasone (Topical) (betamethasone valerate / betamethasone dipropionate — topical)
Also sold as: Betnovate, Diprovate, Betaderm, Celestoderm
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
cream 0.1% (betamethasone valerate) +4
Indications
- Moderate-to-severe eczema (atopic dermatitis)
- Psoriasis (plaque psoriasis, excluding face)
- Discoid lupus erythematosus
- Lichen planus
- Lichen simplex chronicus
- Seborrhoeic dermatitis (body — not face)
- Scalp psoriasis (lotion/scalp solution formulation)
Adult Dosing
Eczema / psoriasis (body)
Apply 0.1% cream or ointment thinly to affected area twice daily
Until controlled, then step down — avoid continuous use beyond 4 weeks on any site
Use fingertip unit (FTU) guidance: 1 FTU (~0.5g) covers palm-sized area. Ointment preferred for dry lesions; cream for weeping/flexural areas.
Scalp psoriasis
0.1% scalp solution or lotion — apply once or twice daily to scalp
Until controlled; avoid continuous use beyond 4 weeks
Shampoo hair before applying. Allow to dry before applying solution. Avoid excessive occlusion under shower caps.
Discoid lupus / lichen planus
0.1% ointment twice to three times daily to lesions
Until lesions respond — review at 4 weeks
May need higher potency formulations (betamethasone dipropionate 0.05%) for thick plaques.
Pregnancy & Lactation
Pregnancy: Category C
Topical corticosteroids are absorbed systemically in small amounts. Potent steroids (betamethasone) should be avoided on large areas, under occlusion, or in the first trimester. Use minimum effective dose for shortest duration. Prefer mild-to-moderate potency steroids in pregnancy.
Lactation: Caution
Avoid applying to breast or nipple area. Do not use under occlusive dressings while breastfeeding. Minimal systemic absorption with normal topical use; caution with extensive application.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Systemic corticosteroids | Additive HPA axis suppression if large surface area used under occlusion — monitor if concurrent systemic steroids prescribed | Moderate |
| Ritonavir, itraconazole (CYP3A4 inhibitors) | May increase systemic corticosteroid levels if significant absorption occurs — relevant mainly with extensive occlusive use | Minor |
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Side Effects
Common
- Skin thinning (atrophy) with prolonged use
- Telangiectasia (prominent blood vessels)
- Striae (stretch marks) — irreversible, especially in flexures
- Perioral dermatitis (facial use — avoid face)
- Steroid rosacea (facial use)
- Acneiform eruption
- Hypertrichosis at application site
- Hypopigmentation
Serious / Discontinue If
- HPA axis suppression (with extensive use, occlusion, or prolonged courses)
- Cushing's syndrome (systemic absorption — large area, occlusion, long duration)
- Growth retardation in children (with prolonged extensive use)
- Secondary skin infections (bacterial, fungal) — skin barrier impaired
- Glaucoma and posterior subcapsular cataracts (periocular use)
- Tachyphylaxis (reduced response with continuous use)
Contraindications
- Acne vulgaris (worsens)
- Rosacea
- Perioral dermatitis
- Fungal skin infections (unless antifungal component present)
- Viral skin infections (herpes simplex, varicella — spreads infection)
- Skin tuberculosis
- Hypersensitivity to betamethasone or any corticosteroid
- Use on face, groin, and axillae with potent formulations (0.05–0.1%)
- Children under 2 years (avoid potent steroids)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Betnovate 0.1% cream 20g | GSK (Haleon) | ₹78/20g |
| Diprovate 0.05% cream 20g | Biozone Pharmaceuticals | ₹65/20g |
| Betaderm 0.1% cream 20g | Ind-Swift Laboratories | ₹55/20g |
Monitoring Required
- Skin condition response — assess at 2–4 weeks
- Signs of skin atrophy, striae, or telangiectasia
- Growth monitoring in children using potent steroids extensively
- HPA axis function if large-area prolonged use (early-morning cortisol)
- Signs of secondary infection (bacterial, fungal) — especially under occlusion
Patient Counseling Points
- Apply only a thin layer — a little goes a long way; more does not mean better or faster results
- Use only on the affected skin — avoid normal surrounding skin
- Do NOT apply to the face, underarms, or groin unless specifically prescribed for those areas
- Do NOT use longer than 4 consecutive weeks without a review from your doctor
- Do not bandage or wrap tightly (occlude) the treated area unless your doctor instructs you to
- Betnovate-N (with gentamicin) and Lotriderm (with clotrimazole) are combination products — do not use long-term to avoid antibiotic/antifungal resistance
- If you notice your skin becoming thinner, shiny, or developing purple/red lines (striae), stop and see your doctor
- Wash hands after applying (unless treating hands)
- Store cream or ointment below 25°C — do not freeze
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Clinically reviewed by: Dr. Kavita Sharma, MD (Dermatology), FRCP, Senior Consultant Dermatologist
Last reviewed: 2026-04-01
References
- Betnovate SmPC — Haleon (GSK) India
- BAD Guidelines on Topical Corticosteroid Use 2020
- NICE CKS — Eczema (Atopic) — Topical Steroids 2023
- Coondoo A et al. Side-effects of topical steroids. Indian J Dermatol. 2014