Clobetasol Propionate Ointment Dosage Recommendations
For most skin conditions, clobetasol propionate 0.05% ointment should be applied once daily for up to 2-4 weeks, followed by a tapering schedule to minimize side effects. 1
General Dosing Guidelines
- Clobetasol propionate is an ultrapotent (class I) topical corticosteroid that requires careful dosing to balance efficacy and safety 2
- Once daily application is sufficient for most conditions, as pharmacodynamic studies show ultrapotent corticosteroids only need once daily application 3
- Treatment should be limited to 2 consecutive weeks for most conditions, with amounts not exceeding 50 mL/week to prevent HPA axis suppression 1
- Occlusive dressings should generally be avoided unless specifically indicated for resistant conditions 1
Condition-Specific Dosing
For Lichen Sclerosus
- Apply clobetasol propionate 0.05% ointment once daily at night for 4 weeks 3
- Then apply on alternate nights for 4 weeks 3
- Finally, apply twice weekly for 4 weeks before review 3
- For maintenance, use as needed for flares (most patients require 30-60g annually) 3
For Bullous Pemphigoid
- For localized/limited disease: Apply 10-20g daily on lesional skin only 3
- For mild disease: Apply 20g daily over the entire body (10g if weight <45kg) 3
- For extensive disease: Apply 30g daily 3
- For relapse after treatment: Apply 10g daily for localized relapse, 20g daily for mild disease, or 30g daily for extensive relapse 3
For Psoriasis
- For scalp psoriasis: Apply solution twice daily for up to 2 weeks 4
- For other psoriatic lesions: Apply once daily for up to 4 weeks 5
Tapering Schedule
- After initial control of symptoms, gradually reduce frequency of application 3
- If symptoms return during tapering, increase frequency back to the effective level 3
- For maintenance therapy, use the minimum effective frequency (often twice weekly) 3, 2
Important Precautions
- Avoid use on open wounds, areas with skin cancer, or infected areas 6
- Use with caution on the face and intertriginous areas due to increased risk of side effects 2
- Monitor for local adverse effects including skin atrophy, striae, telangiectasia, and purpura 2
- Pediatric use (under 12 years) is not recommended for most indications 1
- For elderly patients (65+ years), no dosage adjustment is necessary 1
Practical Application Tips
- A fingertip unit (approximately 0.5g) covers about 2% of body surface area 7
- Hand washing after application is essential to prevent spreading medication to sensitive areas 2
- Consider using a soap substitute alongside treatment for conditions like lichen sclerosus 3
- For resistant lesions in certain conditions, weekly application under occlusive dressing may be considered under specialist supervision 8