Celestoderm (Betamethasone Valerate) Potency Classification
Celestoderm cream, containing betamethasone valerate 0.1%, is classified as a Class IV (mid-potency) topical corticosteroid. 1, 2
Potency Classification Details
Betamethasone valerate 0.1% consistently appears in dermatology guidelines as a Class IV (mid-potency) corticosteroid, positioned in the middle range of the seven-class potency scale where Class I represents very high potency and Class VII represents very low potency. 1
Formulation Specifications
Each gram of betamethasone valerate 0.1% cream contains 1.2 mg betamethasone valerate, which is equivalent to 1 mg of betamethasone base. 2 The cream formulation is a soft, white, hydrophilic preparation designed for dermatologic use. 2
Clinical Efficacy Evidence
For psoriasis treatment, betamethasone valerate foam (Class IV) demonstrated that 72% of patients with moderate to severe scalp psoriasis achieved improvement in Physician Global Assessment compared to 47% of placebo-treated patients after 4 weeks (P < .05). 1 In non-scalp psoriasis, 70% of patients treated with betamethasone valerate foam achieved greater than 50% improvement compared to 24% with placebo (P < .001). 1
For vitiligo treatment, betamethasone (as a potent topical steroid) used for 4 months induced 90-100% repigmentation in 6 of 23 subjects, with three showing 25-90% repigmentation. 1 However, adverse effects included hypertrichosis in two subjects and acne in three subjects. 1
Comparative Potency Context
Mid-potency (Class IV) corticosteroids like betamethasone valerate sit between:
- Higher potency options: Class III (potent) agents like fluticasone propionate 0.005% ointment, and Class II (very potent) agents like desoximetasone cream 1
- Lower potency options: Class V agents like hydrocortisone 17-butyrate 21-propionate cream 1
Safety Profile for Class IV Agents
Class IV corticosteroids have a more favorable adverse event profile compared to high and very high potency steroids, allowing for longer treatment courses. 1 The risk of skin atrophy increases with higher potency classes—in trials evaluating various potencies, abnormal skin thinning occurred in only 2 cases with moderate-potency agents versus 6 cases with potent and 16 cases with very potent corticosteroids. 3
Recommended Application
Once-daily application of potent topical corticosteroids (Class III-IV) is probably as effective as twice-daily application for treating eczema flare-ups (OR 0.97,95% CI 0.68 to 1.38). 3 Application in the late afternoon (around 1600h) may produce more extensive and prolonged activity than morning application, potentially making once-daily dosing sufficient. 4
Anatomical Site Considerations
Class IV corticosteroids are appropriate for body surfaces but should be used with caution on: