What is the maximum duration of mometasone (mometasone) cream use?

From the Guidelines

Mometasone cream should not be used for longer than 16 weeks continuously, with a recommended intermittent use of twice-weekly application for maintenance therapy to reduce disease flares and relapse, as supported by high certainty evidence 1.

Key Considerations

• The maximum duration of mometasone cream use depends on the individual's condition, the area being treated, and their overall health status.
• For most skin conditions, applying mometasone cream once or twice daily for 1-2 weeks is sufficient to see improvement.
• After the initial period, consider tapering use by decreasing frequency to every other day before stopping completely.
• Intermittent use with breaks between treatment courses is preferable to continuous long-term application for chronic conditions like eczema or psoriasis.
• Extended use of mometasone cream can lead to skin thinning (atrophy), stretch marks, increased susceptibility to infections, and systemic absorption with potential adrenal suppression.

Important Factors to Consider

• Children require more cautious use with shorter durations due to their higher skin surface area to body weight ratio.
• Always follow your healthcare provider's specific instructions, as they may recommend different durations based on your particular condition, the area being treated, and your overall health status.
• The optimal interval of scheduled intermittent use is not clear, but twice-weekly application of medium potency TCS, such as mometasone, has been shown to be effective in reducing disease flares and relapse 1.

Evidence-Based Recommendations

• A study randomized 117 adult AD patients to maintenance therapy with daily emollients and either intermittent fluticasone propionate 0.05% cream or vehicle once daily 4 days per week for 4 weeks, followed by once daily 2 days per week for 16 weeks, demonstrated that those treated with fluticasone propionate were 7.0 times less likely to have an AD relapse (95% CI: 3.0-16.7; P < .001) 1.
• Based on high certainty evidence, intermittent use of medium potency TCS, such as mometasone, as maintenance therapy (twice a week) is strongly recommended to reduce disease flares and relapse 1.

From the Research

Maximum Duration of Mometasone Cream Use

• The maximum duration of mometasone cream use is not explicitly stated in the provided studies, but its usage for various skin conditions is discussed:
  • For atopic dermatitis, mometasone 0.1% was applied once daily over 2 to 3 weeks 2.
  • For seborrhoeic dermatitis, mometasone 0.1% was used in trials lasting 4 or 6 weeks 2.
  • For scalp psoriasis and psoriasis vulgaris, mometasone 0.1% was applied once daily for 2 to 8 weeks 2.
• In comparison to other treatments, mometasone cream has been used for different durations:
  • In a study comparing mometasone cream and pimecrolimus cream for childhood localized vitiligo, patients were treated for 3 months 3.
  • Another study evaluated the effects of pimecrolimus and betamethasone on the skin barrier in patients with atopic dermatitis, with treatment lasting 3 weeks 4.
• It is essential to note that the duration of use may vary depending on the specific condition being treated and the individual patient's response to the medication.

Adverse Effects and Safety

• Mometasone cream has been associated with transient, mild to moderate, local adverse effects such as burning, stinging, folliculitis, dryness, acneiform eruptions, and signs of skin atrophy 2.
• A study comparing mometasone cream and pimecrolimus cream for childhood localized vitiligo reported atrophy, telangiectasia, and erythema in two patients (10%) in the mometasone cream group 3.
• Pimecrolimus, on the other hand, has been shown to have a good safety profile, with no evidence for an increased risk of malignancies or skin infections, and does not cause skin atrophy 5.