Recommended Dosing for Clobetasol Propionate
For most dermatological conditions, clobetasol propionate should be applied once daily for up to 2 weeks, with amounts not exceeding 50 mL/week, as it is an ultra-potent topical corticosteroid with significant risk of HPA axis suppression with prolonged use. 1
General Dosing Guidelines
- Clobetasol propionate is classified as a class 1 (ultra-high potency) topical corticosteroid requiring strict limitations on duration of use 2
- For most dermatoses, once daily application is sufficient as ultrapotent steroids only need once daily application 2
- Treatment should be limited to 2 consecutive weeks to avoid systemic absorption 1
- Total dosage should not exceed 50 mL/week due to potential HPA axis suppression 1
Condition-Specific Dosing
Bullous Pemphigoid
- For localized/limited disease: Apply clobetasol propionate 0.05% cream/ointment 10g daily to lesional skin only 3
- For mild disease: Apply clobetasol propionate 0.05% cream/ointment 20g daily (10g if weight <45kg) 3
- For extensive disease: Apply clobetasol propionate 0.05% cream/ointment 30g daily 3
- Complete epithelialization can be achieved within 4-17 days of treatment 4
Scalp Conditions
- For scalp psoriasis: Apply twice daily for up to 2 weeks 1
- For seborrheic dermatitis: Short-contact application (5-10 minutes) twice weekly has shown efficacy 5
Lichen Sclerosus
- Apply clobetasol propionate 0.05% ointment once daily for 4 weeks, then on alternate nights for 4 weeks, and finally twice weekly for 4 weeks 2
- Most patients require 30-60g annually for maintenance therapy 2
Tapering Schedule
- For bullous pemphigoid: Initial treatment should be reduced 15 days after disease control 3
- Recommended tapering schedule: daily treatment for the first month, treatment every 2 days in the second month, treatment twice weekly in the third month, and once weekly starting in the fourth month 6
- For most dermatoses: Start with once daily application for up to 2 weeks, then taper to alternate days and eventually twice weekly 2
Safety Considerations
- Clobetasol should not be used with occlusive dressings 1
- Common local adverse effects include skin atrophy, striae, folliculitis, telangiectasia, and purpura 2
- Face, intertriginous areas, and chronically treated areas are at greatest risk for developing adverse effects 2
- Transient morning plasma cortisol reductions can occur in approximately 6% of patients 7
- No dosage adjustment is recommended for geriatric patients (65 years or older) 1