Clobetasol for Scalp Psoriasis: Standard Prescribing Instructions
Apply clobetasol propionate 0.05% solution, foam, or spray to affected scalp areas twice daily for up to 2 consecutive weeks, not exceeding 50g per week total. 1
Formulation Selection for Scalp
- Solution, foam, or spray formulations are preferred for scalp psoriasis over cream or ointment, as they penetrate hair-bearing areas more effectively 2
- Shampoo formulation (0.05%) can be used as an alternative, applied to dry scalp, left on for 15 minutes, then rinsed 3
Dosing Frequency and Duration
Initial Treatment Phase:
- Apply twice daily (morning and evening) to affected scalp areas 1, 4
- Maximum treatment duration: 2 consecutive weeks 1
- Maximum weekly amount: 50g or less 2, 1
- Studies demonstrate 81% of patients achieve 50% or better clearing with twice-daily clobetasol solution after 2 weeks 2
Important Caveat: While once-daily application may be sufficient for some body areas with ultrapotent steroids 5, scalp psoriasis specifically shows superior outcomes with twice-daily application—65% response with once-daily vs. 100% with twice-daily application 4
Treatment Endpoint and Tapering
- Discontinue when control is achieved, even if before 2 weeks 1
- If no improvement after 2 weeks, reassess diagnosis 1
- Gradual tapering is recommended after clinical response: reduce to once daily, then alternate days, then twice weekly 2, 6
- Abrupt discontinuation increases rebound risk 6
Critical Safety Warnings
Do NOT:
- Use with occlusive dressings 1
- Continue beyond 2 weeks without physician reassessment 1
- Exceed 50g per week 2, 1
- Apply to face or intertriginous areas (highest risk for adverse effects) 2, 6
Monitor for:
- Skin atrophy, telangiectasia, striae, folliculitis 2, 6
- HPA axis suppression with extensive use 7
- Tachyphylaxis (loss of effectiveness) 2