Betamethasone dipropionate cream over the counter equivalent

2. Key facts

• Only use a steroid skin treatment if your doctor prescribes it for you. Do not use someone else's medicine.
• It's important to follow the instructions when using a steroid skin treatment. This helps to avoid side effects.
• Only use betamethasone on your face if your doctor says it's OK.
• Betamethasone will not help with skin conditions such as impetigo, rosacea and acne.
• Other betamethasone brand names include Audavate, Bettamousse, Betesil, Fucibet, Xemacort and Diprosone.

3. Who can and cannot use betamethasone for skin

Most adults aged 18 or over can use betamethasone skin treatments. Medicated plasters are suitable for adults only.

Most other betamethasone skin treatments can be used by children over the age of 1 year. Occasionally a specialist may prescribe them for a younger child. However, some betamethasone creams and foams will only be prescribed for children aged 6 years and older.

Betamethasone may not be suitable for some people. Tell a pharmacist or doctor before using it if you:

• have ever had an allergic reaction to betamethasone, any of the ingredients, or any other medicine in the past
• are trying to get pregnant, are already pregnant or you're breastfeeding
• have acne, rosacea (including rosacea around your mouth, called "perioral dermatitis") or a type of psoriasis called "plaque psoriasis"
• have a skin infection
• have broken skin, cuts or itchy skin that is not inflamed or red

4. How and when to use betamethasone for skin

Always follow the instructions from a pharmacist, doctor or the leaflet that comes with your medicine.

Betamethasone cream and ointment

Creams are better for skin that is moist and weepy. Ointments are thicker and greasier, and are better for dry or flaky areas of skin.

You will usually use betamethasone skin cream or ointment once or twice a day.

The amount of cream or ointment you need to use is sometimes measured in fingertip units. This is the amount you can squeeze onto the end of your finger.

A fingertip unit of cream is generally enough to treat an area that's twice the size of the palm of your hand.

For children, the right amount of cream or ointment depends on their age. A doctor or pharmacist can advise you.

If you are prescribed a combination cream containing betamethasone and an antibiotic, follow the instructions that come with your medicine.

How to apply cream or ointment

1. Wash and dry your hands and then squeeze out the right amount.
2. Spread the cream or ointment in a thin layer over the area of irritated skin.
3. Carefully smooth it into your skin in the direction that your hair grows.
4. Use the cream or ointment on all the irritated skin, not just the worst areas.
5. Be careful not to get the cream or ointment on broken skin or cuts.
6. Wash your hands afterwards (unless you are treating the skin on your hands).

Do not use betamethasone skin cream or ointment at the same time as any other creams or ointments, such as a moisturiser or emollient. Wait at least 30 minutes before using any other skin product after you put on betamethasone cream or ointment.

Fire warning

Skin creams can dry onto your clothes and bedding. This makes them more likely to catch fire. Avoid naked flames.

If you need to use a dressing, like a bandage or plaster, wait at least 10 minutes after putting betamethasone on.

If you're treating a child, do not cover the cream or ointment with dressings or bandages. This can cause more medicine to pass through the skin and into the bloodstream, leading to a higher chance of side effects. If your doctor has prescribed it to treat very severe nappy rash, ask them how much to use and how long to use it for.

Betamethasone lotion

Lotion is better for treating large or hairier areas of skin.

You will usually use betamethasone skin lotion once or twice a day.

Use a small amount of lotion on the affected areas of skin.

1. Wash and dry your hands.
2. Spread the lotion in a thin layer over the area of irritated skin.
3. Carefully smooth it into your skin in the direction that your hair grows.
4. Use the lotion on all the irritated skin, not just the worst areas.
5. Be careful not to get the lotion on broken skin or cuts.
6. Wash your hands afterwards (unless you are treating the skin on your hands).

Fire warning

Skin lotions can dry onto your clothes and bedding. This makes them more likely to catch fire. Avoid naked flames.

Betamethasone scalp lotion (scalp application)

You will usually use the lotion twice a day. You can use it once a day or less often when your condition improves.

If you have washed your hair, dry it properly before using the scalp lotion.

1. Wash and dry your hands.
2. Apply a thin layer of the lotion over the area of your scalp that needs to be treated. You do not have to rub the lotion in.
3. Allow your scalp to dry naturally without using a hair dryer.
4. Wash your hands afterwards.

Betamethasone scalp foam

You can use the foam up to twice a day. You can use it once a day or less often when your condition improves.

For children, the amount of foam will depend on their size.

1. Wash and dry your hands.
2. Massage a small amount of foam into your scalp. Use no more than a "golf-ball" sized amount of mousse.
3. Allow your scalp to dry naturally without using a hair dryer.
4. Wash your hands afterwards.

Betamethasone medicated plasters

Medicated plasters are for small areas of skin and thickened skin affected by psoriasis.

Do not reuse plasters. Use a new plaster on the same patch of skin every 24 hours. Wait at least 30 minutes between taking off an old plaster and putting on a new one.

Do not get the plaster wet. It's best to have a shower or bath after taking off the old plaster and before putting on a new one.

You can use up to 6 plasters on different areas of skin each day.

1. Wash and dry your skin before using the plaster.
2. Cut the plaster to fit the area that you are treating if you need to.
3. Stick the plaster on the affected skin.
4. Wash your hands afterwards.

How long will I use it for?

Most people only need to use betamethasone skin treatments for a short time. Stop as soon as your skin is better. Sometimes you only need to use the skin treatments for a few days.

Do not use the medicated plasters for more than 30 days.

If you're using the scalp foam, or are using betamethasone on your face, ask your doctor or pharmacist how long to use it for.

If you're using the cream, ointment or lotion, tell your doctor if your skin gets worse or does not improve within 2 to 4 weeks (or 5 days for a child).

Children must not use the scalp application or foam for more than 5 to 7 days (follow the instructions that come with the medicine).

What if I use too much?

Using more than the recommended amount of your betamethasone skin treatment is unlikely to harm you.

Urgent advice: Call 111 for advice now if:

• you swallow or use a large amount of betamethasone and start to feel unwell

What if I forget to put it on?

If you forget to use your betamethasone skin treatment, do not worry. Use it as soon as you remember unless it's nearly time for your next dose. In this case, skip the missed dose and apply the next one at the usual time.

5. Side effects

Betamethasone skin treatments are unlikely to cause any side effects if you follow the instructions.

You're more likely to have side effects if you use it on large areas of skin for long periods of time, or on sensitive skin areas such as the face, or under dressings or nappies.

Some people get a burning or stinging feeling for a few minutes when they put betamethasone on their skin. This stops happening after you've been using it for a few days.

Serious side effects

Serious side effects are rare. They happen to less than 1 in 10,000 people who use betamethasone skin treatments. You're more likely to have a serious side effect if you use betamethasone on a large area of skin for a long time.

Using betamethasone for a long time can make your skin thinner or cause stretch marks. Stretch marks are likely to be permanent, but they usually fade over time.

Stop using betamethasone and tell a doctor straight away if:

• your skin becomes redder or swollen, or yellow fluid is weeping from your skin – these are signs of a new skin infection or an existing one getting worse
• you get lighter or darker patches on your skin – these are a sign of changes to the pigment in your skin
• you are using betamethasone for psoriasis and you get raised bumps filled with pus under your skin
• you have a very upset stomach or you're being sick (vomiting), have very bad dizziness or fainting, muscle weakness, feel very tired, have mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems
• you feel confused, sleepy, more thirsty or hungry than usual, pee more often, have hot flushes, start breathing quickly or your breath smells of fruit – these can be signs of high blood sugar (hyperglycaemia)
• you have any new problems with your eyesight after starting to use betamethasone

Children and teenagers

In very rare cases, using betamethasone for a long time can slow the normal growth of children and teenagers.

Your child's doctor will monitor their height and weight carefully if they need to use this medicine often. This will help them to notice if your child's growth is being affected and they can change the treatment if needed.

Talk to your doctor if you're worried. They will be able to explain the benefits and risks of your child using betamethasone.

Serious allergic reaction

It happens rarely, but it is possible to have a serious allergic reaction (anaphylaxis) to betamethasone.

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you're wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of betamethasone. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

6. Pregnancy and breastfeeding

Betamethasone is not usually recommended for use when pregnant. A dermatologist (skin care specialist) may prescribe it if they feel the benefits outweigh the risks.

Small amounts of betamethasone used on small areas of skin are unlikely to cause any problems in pregnancy. There's not enough research into betamethasone to know if it's safe to use larger amounts in pregnancy.

Betamethasone and breastfeeding

Betamethasone skin treatments are generally OK to use when breastfeeding.

If you're using betamethasone cream or ointment on your breasts, wash off any medicine from your breast, then wash your hands before feeding your baby.

It's usually better to use cream rather than ointment when breastfeeding, as it's easier to wash off.

Non-urgent advice: Tell your doctor if you're:

• trying to get pregnant
• pregnant
• breastfeeding

7. Cautions with other medicines

It's very unlikely that other medicines will affect the way betamethasone skin treatments work.

If you're also using any other skin treatment, make sure you wait about 30 minutes between using betamethasone and using the other skin treatment.

Tell a pharmacist or doctor if you're taking:

• medicines used to treat HIV, such as ritonavir or cobicistat
• medicines used to treat fungal infections, such as itraconazole
• other medicines that contain steroids, such as eczema creams, asthma inhalers, tablets, injections, nasal spray, and eye or nose drops

Mixing betamethasone with herbal remedies and supplements

There's very little information about taking herbal remedies and supplements while using betamethasone. Ask a pharmacist for advice.

Medicine safety

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

8. Common questions about betamethasone

How does betamethasone work?

Betamethasone is a steroid (also called a corticosteroid). Steroids help to reduce inflammation in the skin (and other parts of your body).

Skin gets inflamed when an allergic reaction or irritation causes chemicals to be released in the skin. These make your blood vessels widen and your irritated skin becomes red, swollen, itchy and painful.

Betamethasone skin treatments work on your skin's cells to stop these chemicals being released. This reduces any swelling, redness and itching.

When will my skin get better?

Your skin should start to get better after using betamethasone for a few days.

If you're using cream, ointment or lotion, speak to your doctor if there is no improvement after 4 weeks, or if your skin gets worse at any time.

Ask your doctor how long it should take to show an improvement if you are using the scalp foam or are using betamethasone on your face. They will tell you what to do if it does not work.

How long can I use betamethasone skin treatments for?

For long-term skin problems, such as eczema or psoriasis, you may need to use the skin treatments for a week or two, or sometimes for longer.

To reduce the risk of side effects, your doctor may recommend that you only use betamethasone skin treatments for a few weeks at a time or for a day or two each week. Tell your doctor if your skin gets worse or does not improve within 2 to 4 weeks.

Once your skin is better, you can use moisturisers to keep it from becoming inflamed again.

Do not use betamethasone skin cream, ointment or lotion for more than 4 weeks without talking to your doctor. If you need treatment for a long time, they may decide you need to use a milder cream or ointment.

Talk to your doctor before stopping treatment if you've been using betamethasone for a long time. They may tell you to gradually use less of it, and use it less often, before you stop completely. This reduces the chance of your symptoms coming back.

Is it safe to use for a long time?

Using betamethasone for a long time without stopping can mean some of the medicine gets into your bloodstream. If this happens, there's a very small chance it can cause serious side effects, such as adrenal gland problems, high blood sugar (hyperglycaemia), thinning of your skin, or problems with your eyesight.

If you have been using betamethasone for a long time, your doctor may tell you to gradually reduce the amount you use before stopping completely.

Can I use betamethasone skin treatments on my face?

Do not use betamethasone skin products on your face unless a doctor has told you to.

The skin on your face is delicate, so if betamethasone skin treatments thin the skin or damage it, it's particularly noticeable.

If your doctor tells you that you can use betamethasone on your face, follow their instructions carefully.

Do not put betamethasone near your eyes or on your eyelids.

How does betamethasone compare with other steroids?

There's a range of skin treatments available that contain different steroids.

Some steroids are stronger than others and they are labelled as:

• mild
• moderate
• potent
• very potent

Most betamethasone skin treatments are potent.

Your doctor will choose a steroid skin treatment for you based on the strength you need to treat your condition. A mild or moderate strength treatment is used for most skin conditions.

Potent skin treatments are usually used for short periods of time for severe skin conditions. Usually you will have tried a lower strength steroid skin treatment first before you try betamethasone.

The stronger (or more potent) the steroid is, the better it will work. However, with stronger steroids there's also more risk of side effects. All steroids have the same side effects but you're less likely to get them with milder steroid skin products.

Can steroids make eczema worse?

Steroids like betamethasone reduce inflammation in your skin to help manage your symptoms. They do not cure the eczema.

If you feel your symptoms are getting worse after using betamethasone for 1 week, it's important to tell a doctor.

When you stop using betamethasone skin treatments, skin conditions like eczema and psoriasis can flare up again.

You can avoid this by gradually reducing the amount you put on, and how often you use it. Do this over 1 to 2 weeks before stopping it completely.

Can I still have vaccinations?

Using betamethasone does not stop you or your child having vaccinations.

But tell the doctor or nurse that you're using betamethasone skin treatments so they can give the vaccine in an untreated area of skin.

Can I drink alcohol with it?

Yes, you can drink alcohol while using betamethasone.

Is there any food or drink I need to avoid?

No. This medicine is not affected by what you eat or drink.

Will it affect my fertility?

There's no clear evidence that betamethasone affects male or female fertility.

However, speak to a pharmacist or your doctor if you're trying to get pregnant.

Can I drive or ride a bike?

Betamethasone does not make you sleepy so it's safe to drive, ride a bike or use tools or machinery when using this medicine.