Corticosteroids are widely used both systemically and topically due to their diverse effects and high efficacy when used correctly. One such product is Dermovate Cream, a topical corticosteroid. So, what is Dermovate Cream, and what conditions does it treat?
1. What is Dermovate cream?
The active ingredient in Dermovate Cream is Clobetasol Propionate 0.05% w/w, along with excipients such as Glyceryl monostearate, Cetostearyl alcohol, Chlorocresol, Sodium citrate, Citric acid, purified water, Arlacel 165, Beeswax substitute 6621, and Propylene glycol.
2. Pharmacodynamics and Pharmacokinetics of Dermovate Cream
2.1. Pharmacodynamics
The corticosteroid in Dermovate Cream acts as an anti-inflammatory by inhibiting late-phase allergic reactions. These mechanisms include:
- Reducing mast cell density.
- Decreasing chemotaxis and activation of eosinophils.
- Suppressing cytokine production from lymphocytes, monocytes, mast cells, and eosinophils.
- Inhibiting arachidonic acid metabolism.
2.2. Pharmacokinetics
Absorption: Topically applied corticosteroids can be systemically absorbed through intact skin. Absorption depends on factors such as the excipient and the integrity of the epidermal barrier.
Distribution: Blood levels of topically applied corticosteroids are typically too low to detect, making pharmacodynamic evaluation necessary.
Metabolism: Once absorbed, corticosteroids undergo metabolic processing primarily in the liver, similar to systemic corticosteroids.
Excretion: Topical corticosteroids are mainly excreted via the kidneys. Some corticosteroids and their metabolites may also be excreted in bile.
3. What does Dermovate cream treat?
Dermovate is a high-potency topical corticosteroid prescribed for adults, the elderly, and children over 12 years old to relieve inflammation and itching in skin conditions that respond to steroids, such as:
Psoriasis (excluding widespread plaque psoriasis).
Persistent and difficult-to-treat dermatitis.
Lichen planus.
Discoid lupus erythematosus.
Other skin diseases unresponsive to lower-potency steroids.
4. Dosage and Administration of Dermovate Cream
Dermovate Cream is ideal for moist or weeping skin surfaces.
4.1. Adults, Elderly, and Children Over 12 Years Old
- Apply a thin layer of Dermovate Cream to the affected area and gently rub it in until fully absorbed.
- Use once or twice daily for up to 4 weeks or until the condition improves.
- Once improved, reduce application frequency or switch to a less potent corticosteroid.
- Allow sufficient time for the cream to absorb before applying moisturizers.
- Short courses of Dermovate cream can be repeated to manage flare-ups.
For stubborn skin lesions, particularly with hyperkeratosis, the cream’s effect can be enhanced by covering the area with an occlusive dressing, such as polyethylene film. Usually, overnight occlusion is sufficient, followed by regular application without occlusion. If no improvement is observed within 2–4 weeks, reevaluate the treatment and diagnosis.
Do not use Dermovate Cream for more than 4 weeks consecutively. If further treatment is needed, switch to a lower-potency corticosteroid. Maximum dosage should not exceed 50g per week.
4.2. Atopic Dermatitis
Gradually discontinue Dermovate Cream and replace it with a suitable drug once the condition is under control. Abrupt cessation may lead to relapse.
4.3. Persistent Dermatitis
For recurrent conditions, use Dermovate Cream intermittently (once daily or twice weekly without occlusion) on previously affected areas to prevent flare-ups. Combine with daily moisturizers.
4.4. Children
Contraindicated for children under 12 years old. Children are more susceptible to local and systemic adverse effects from topical corticosteroids, so shorter treatment durations and less potent steroids are recommended for this age group.
4.5. Elderly
No significant differences in treatment response between elderly and younger patients. However, if systemic absorption occurs, the elderly may experience delayed drug clearance due to reduced liver or kidney function. Use the minimal effective amount for the shortest duration.
4.6. Patients with Liver or Kidney Failure
Prolonged use over large areas may lead to systemic absorption. In patients with impaired liver or kidney function, the metabolism and excretion of corticosteroids may be delayed, increasing the risk of systemic toxicity.
5. Contraindications of Dermovate cream
Do not use Dermovate Cream in the following cases:
- Untreated skin infections;
- Rosacea;
- Acne vulgaris;
- Itchiness without inflammation;
- Perianal or genital itching;
- Perioral dermatitis;
- Hypersensitivity to Dermovate Cream ingredients;
- Viral infections;
- Fungal infections;
- Widespread plaque psoriasis.
- Children under 12 years old, including those with dermatitis.
6. Precautions When Using Dermovate Cream
Patients with a history of local hypersensitivity to corticosteroids or other ingredients in Dermovate Cream should proceed with caution.
Long-term use can lead to secondary Cushing’s syndrome or reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, resulting in glucocorticoid deficiency. If this happens, the patient should gradually cease the medicine (lower the frequency of administration or switch to a less strong corticosteroid).
Risk Factors for Increased Systemic Effects:
- Prolonged treatment duration.
- Application to large areas.
- Use under occlusion or on skin folds.
- Damaged skin barriers or thin skin (e.g., face).
Children are at greater risk due to thinner skin and a higher surface area-to-body weight ratio.
The danger of skin infection in concealed places is increased owing to the warm, moist conditions in folds or when the skin is covered with bandages, which offer ideal circumstances for bacteria to proliferate and cause disease. As a result, users must clean the affected skin region before applying bandages.
Psoriasis: Corticosteroid use may cause rebound flare-ups, pustular psoriasis, or systemic toxicity. Careful monitoring is necessary.
Dermovate or corticosteroid creams should not be used on the face due to the danger of skin atrophy. The use of Dermovate cream on the face should be restricted to a few days.
If the drug is applied to the skin surrounding the eyelids, the patient must be careful not to allow it to enter the eyes, since this might lead to cataracts and glaucoma development if exposed for an extended period of time.
7. Side Effects of Dermovate Cream
Side effects of Dermovate cream may include:
- Increased risk of developing opportunistic infections (rare);
- Endocrine disorders: Hypothalamic-pituitary-adrenal axis suppression with manifestations similar to Cushing's syndrome (such as moon face, central obesity), slow weight gain/growth retardation in children, osteoporosis, glaucoma, hyperglycemia/glucosuria, cataracts, hypertension, decreased endogenous cortisol levels, baldness or hair loss;
- Skin itching or pain/burning on the skin. Skin atrophy, stretch marks, telangiectasia, skin thinning or wrinkling, dry skin, changes in skin color, and hirsutism are uncommon.
8. Important Notes When Using Dermovate Cream
Drug Interactions: Using Dermovate Cream simultaneously with CYP3A4 inhibitors (e.g., ritonavir, itraconazole) may lead to increased systemic corticosteroid levels due to inhibition of corticosteroid metabolism. The extent of interaction depends on the dose, route of administration of corticosteroid, and the potency of CYP3A4 inhibitor.
- Effect on Fertility: There is no available data evaluating the effects of topical corticosteroids on human fertility. In animal studies, subcutaneous administration of Clobetasol in rats did not impact fertility, although reduced fertility was observed at the highest doses.
- Pregnancy: Data on the use of Dermovate Cream in pregnant women are limited.Studies in pregnant animals using topical corticosteroids have shown abnormalities in fetal development. However, these findings have not been confirmed in humans. Dermovate Cream should only be used during pregnancy if the potential benefits outweigh the risks.
- Breastfeeding: The safety of using topical corticosteroids such as Dermovate Cream during breastfeeding has not been established. There is no evidence suggesting that topically applied corticosteroids are systemically absorbed and excreted in breast milk. However, breastfeeding mothers should carefully consider the potential risks before using Dermovate Cream. It should only be used if the benefits to the mother outweigh potential risks to the infant. Do not apply Dermovate Cream to the breast area to avoid the risk of the infant ingesting the medication.
Dermovate Cream is a potent topical corticosteroid widely used for various inflammatory skin conditions. To maximize its effectiveness and minimize side effects, it must be used as directed by a healthcare professional.
To arrange an appointment, please call … or make your reservation directly HERE. You may also download the MyVinmec app to schedule appointments faster and manage your reservations more conveniently.
