Topical Corticosteroids Equivalent to Clobetasol Propionate 0.05%
Clobetasol propionate 0.05% is classified as a Class I (ultra-high potency) topical corticosteroid, and other formulations in this same potency class include betamethasone dipropionate 0.05% (augmented), halobetasol propionate 0.05%, and diflorasone diacetate 0.05%. 1
Class I Ultra-High Potency Corticosteroids
The following topical corticosteroids share equivalent ultra-high potency with clobetasol propionate 0.05%:
Betamethasone dipropionate 0.05% (augmented formulation) – Available in cream, ointment, gel, and lotion forms with potency matching clobetasol 1
Halobetasol propionate 0.05% – Available in cream and ointment formulations, providing equivalent Class I potency 1
Diflorasone diacetate 0.05% – Available in ointment formulation with ultra-high potency comparable to clobetasol 1
Clinical Equivalence Considerations
While these agents share the same potency classification, practical differences exist:
Formulation matters significantly – Ointments generally deliver greater potency than creams or lotions of the same active ingredient, and foam/spray/solution formulations penetrate hair-bearing areas more effectively than cream or ointment 1, 2
Vehicle optimization – Clobetasol propionate foam achieves 74% clear or almost clear rates in scalp psoriasis with twice-daily application for 2 weeks, demonstrating how formulation impacts clinical outcomes 1
All Class I corticosteroids carry identical safety restrictions – Maximum use should not exceed 50g per week, continuous daily application should be limited to 2-4 weeks, and use beyond 4 weeks dramatically increases risk of skin atrophy, striae, telangiectasia, and HPA-axis suppression 1, 2
Critical Safety Parameters for All Ultra-High Potency Agents
High-risk anatomical sites – Face and intertriginous areas have the greatest susceptibility to adverse effects and should be avoided with all Class I corticosteroids 1, 3
Tapering protocol – After initial response (typically 2-4 weeks), all ultra-high potency agents should be tapered to alternate-day application, then twice weekly to prevent tachyphylaxis and minimize adverse effects 1, 2
Monitoring requirements – Watch for skin atrophy, telangiectasia, striae, folliculitis, and purpura regardless of which Class I agent is used 1, 2