From the FDA Drug Label
DOSAGE AND ADMINISTRATION: Apply a thin layer of clobetasol propionate gel, cream or ointment to the affected skin areas twice daily and rub in gently and completely. Clobetasol propionate gel, cream and ointment are super-high potency topical corticosteroids; therefore, treatment should be limited to 2 consecutive weeks, and amounts greater than 50 g per week should not be used.
Stronger topical corticosteroids, such as clobetasol propionate, may be used for short periods (up to 2 weeks) to treat a reddened rash on the face caused by CPAP use, but caution is advised due to potential adverse reactions.
- The use of super-high potency topical corticosteroids should be limited to 2 consecutive weeks.
- Occlusive dressings should not be used with clobetasol propionate gel, cream, or ointment.
- Monitoring for signs of adverse reactions, such as burning sensation, itching, skin atrophy, and Cushing's syndrome, is recommended 1.
- Less frequent adverse reactions may include stinging, cracking, erythema, folliculitis, numbness of fingers, skin atrophy, and telangiectasia 1.
From the Research
No, stronger topical corticosteroids are not recommended for treating a reddened rash on the face caused by CPAP use. Instead, mild corticosteroids like hydrocortisone 1% cream applied sparingly twice daily for 3-5 days is more appropriate, as suggested by the most recent and highest quality study 2. The facial skin is thinner and more sensitive than other body areas, making it more susceptible to steroid side effects like skin thinning, telangiectasia (visible blood vessels), and rebound inflammation. For CPAP-related facial rashes, addressing the underlying cause is equally important:
- Ensure proper mask fit
- Clean the mask daily with mild soap and water
- Consider using mask liners or barrier creams like petroleum jelly around pressure points
- Try different mask styles or materials if irritation persists If the rash doesn't improve with these measures and mild steroids within a week, or if it worsens, a healthcare provider should evaluate for possible allergic reactions to mask materials or other skin conditions. The use of topical corticosteroids should be guided by the principle of using the least potent steroid that is effective for the condition, as outlined in 3 and further supported by 4, 5, and 6. However, the most recent study 2 provides the most relevant and up-to-date guidance on the use of topical corticosteroids, emphasizing the importance of proper application and patient education to minimize side effects and maximize efficacy.