Clobex Shampoo for Scalp Psoriasis and Seborrheic Dermatitis
Clobex (clobetasol propionate 0.05%) shampoo should be applied to affected scalp areas twice daily for a maximum of 2 consecutive weeks, with total dosage not exceeding 50 mL per week to prevent hypothalamic-pituitary-adrenal axis suppression. 1
Indications and Usage
- Clobex shampoo is FDA-approved for short-term topical treatment of inflammatory and pruritic manifestations of moderate to severe corticosteroid-responsive dermatoses of the scalp 1
- For scalp psoriasis, clobetasol propionate shampoo 0.05% is approved as a once-daily treatment 2
- Clobetasol propionate shampoo has also shown efficacy in treating seborrheic dermatitis of the scalp in pilot studies 3
Application Instructions
- Apply to affected scalp areas twice daily, once in the morning and once at night 1
- For psoriasis: Apply to wet hair, lather, leave on for 15 minutes, then rinse thoroughly 2
- For seborrheic dermatitis: Short-contact application (5-10 minutes) before rinsing has shown similar efficacy to longer application times 3
Treatment Duration and Limitations
- Treatment must be limited to 2 consecutive weeks 1
- Total dosage should not exceed 50 mL per week 1
- Not to be used with occlusive dressings 1
- Not recommended for use in pediatric patients under 12 years of age 1
Efficacy
- For psoriasis: Clobetasol propionate shampoo (ultrahigh-potency class 1) shows significant improvement within 2 weeks, with efficacy rates ranging from 58% to 92% 4
- For seborrheic dermatitis: A pilot study demonstrated that clobetasol propionate shampoo is effective with short-contact application times (5-10 minutes) 3
- Combination therapy of clobetasol propionate shampoo twice weekly alternating with ketoconazole shampoo 2% twice weekly provides significantly greater efficacy than ketoconazole alone for seborrheic dermatitis 5
Monitoring and Safety Considerations
- Monitor for local skin adverse effects including skin atrophy, striae, folliculitis, telangiectasia, and purpura 4
- Risk of hypothalamic-pituitary-adrenal axis suppression increases with prolonged use beyond recommended duration 4, 1
- After clinical improvement, gradual reduction in frequency of use is recommended to minimize risk of rebound 4
- For maintenance therapy after initial treatment:
Special Considerations
- For facial and intertriginous areas, lower potency corticosteroids should be used for shorter durations 4
- In geriatric patients (65 years or older), no dosage adjustment is necessary 1
- For women of childbearing potential, consider that topical psoriasis medications are labeled pregnancy category C 6