Betamethasone Topical

What is topical betamethasone?

Betamethasone belongs to the corticosteroid class of medications. This means it’s an anti-inflammatory medication.

The medication is only available with a doctor’s prescription.

The cream and ointment forms of this drug are on the World Health Organization’s list of essential medicines.¹

What is topical betamethasone used to treat?

This drug has immunosuppressive and anti-inflammatory properties. This makes it useful for treating various steroid-responsive skin conditions, including eczema, plaque psoriasis, and allergic dermatitis.

Betamethasone topical activates natural substances in the skin. This reduces the swelling, redness, dryness, crusting, scaling, and itchiness caused by these conditions. Given its higher potency, this medication is often prescribed when other anti-inflammatory drugs fail.

Note that betamethasone will not help with other skin conditions, such as impetigo, rosacea, and acne. It is not approved for use in patients under 13 years of age.

Dosage forms and strengths

Topical betamethasone is available in many forms, including ointment, cream, lotion, gel, and aerosol (spray) for use on the skin. It also comes as a foam that may be applied on the scalp.

Below are the available dosage forms and strengths.

Augmented betamethasone dipropionate

• Cream 0.05%²

• Lotion 0.05%³

• Ointment 0.05%⁴

Betamethasone dipropionate

• Cream 0.05%⁵

• Gel 0.05%⁶

• Lotion 0.05%⁷

• Ointment 0.05%⁸

• Spray 0.05%⁹

Betamethasone valerate

• Cream 0.1%¹⁰

• Aerosol foam 0.12%¹¹

• Lotion 0.1%¹²

• Ointment 0.1%¹³

Betamethasone for topical use is also available as several brand-name products, including the following:¹⁴

• Diprolene (augmented betamethasone dipropionate and betamethasone dipropionate formulations)

• Luxiq (betamethasone valerate aerosol foam)

• Beta-Val (betamethasone valerate cream)

• Sernivo (betamethasone dipropionate spray)

The right dosage for this medication will depend on several factors, including the following:

• The size of the affected area

• The medical problem being treated

• The medicine’s strength

• The time allowed between doses

Below are general dosage guidelines for betamethasone:

• For cream, gel, lotion, and ointment, a thin film is applied to the affected area 1–2 times daily.

• Sprays are sprayed onto the affected area twice daily.

• The foam is applied to the scalp twice daily.

How do you use topical betamethasone?

This drug is typically applied topically once or twice a day. This is true for all forms. It’s important to use it as directed, meaning not more or less than prescribed.

Using this medicine to treat skin conditions other than what your doctor prescribed it for is not recommended.

Be sure to ask your doctor or pharmacist to explain any instructions you don’t understand.

Betamethasone topical is applied on the affected skin of the extremities, trunk, and neck only. Don’t use it on the face, groin, or underarm areas unless directed by your doctor.

Ensure the application site is clean and dry.

Avoid using it on open wounds, scrapes, or burns.

Whether you are using foam, ointment, cream, gel, or lotion, apply a small amount of the medicine on the affected area and rub it gently. Ensure you wash your hands before and after unless they are being treated.

Seeing results

Most people only need to use this topical medication for a short time. You can expect to see improvement within 3–4 days of using betamethasone for most skin conditions. 

Talk to your doctor if your skin condition has not resolved within 1–2 weeks of using betamethasone. They may prescribe a more potent corticosteroid or recommend a different treatment.

Who should not use topical betamethasone?

Betamethasone is generally considered safe, but it may not be appropriate for some people.

Tell your doctor if:

• You’ve ever had an allergic reaction to this drug, any of its ingredients, or any other anti-inflammatory medication

• You are pregnant, breastfeeding, or trying to conceive

• You have an active infection

• You have a condition affected by steroids, like diabetes or Cushing’s syndrome

• You have broken skin, cuts, or burns

Potential side effects of topical betamethasone

Side effects in the area being treated can occur as your skin absorbs this topical medicine. 

Burning, itching, redness, dryness, and irritation at the application site are uncommon, but they have been reported. These adverse effects occur more frequently when patients place a dressing over the area being treated. As such, this should be avoided.¹⁰

Notify your doctor immediately if these symptoms develop or if your underlying skin condition worsens.

The application of topical steroids affects your immune response in the local area, making it difficult to fight off infections. You should not use this medication if you have an infection or sore in the area that requires treatment.

Though it’s rare, betamethasone may be absorbed into the bloodstream. When this happens, you may experience the generalized side effects of corticosteroids. This is more likely to occur in children, when the medication has been used for a long time, or when treating larger areas of the skin. Tell your doctor if you experience any of the following symptoms:

• Extreme tiredness

• Weight gain, especially in the abdominal area

• Headache

• Skin thinning, breaking, or scarring

• Skin color changes

• Acne-like skin eruptions

• Increased thirst/urination

• Secondary skin infection

• Vision problems

Overdose

While you shouldn’t use more than the recommended betamethasone dose, overuse is unlikely to cause systemic harm since it is applied topically.

However, with long-term overuse, the application of dressings, or treatment of large areas, the drug may be absorbed in higher amounts. This increases the risk of systemic effects. This can also occur if other steroids are taken simultaneously.

In the event of an overdose, you should speak to your doctor. You might need to gradually reduce the frequency of application or switch to a less potent corticosteroid.

This medicine is harmful if swallowed, so it should be kept out of the reach of children. An acute overdose is unlikely, but it’s still important to visit the doctor if an exposure like this occurs.

Allergy information

A serious allergic reaction to betamethasone is also rare. Seek medical help if you develop symptoms of an allergic reaction, including any of the following:

• A rash that becomes red, swollen, or blistered

• Itching

• Trouble breathing

• Severe dizziness

• Wheezing

• Vomiting

• Swelling of the mouth, lips, face, tongue, or throat

Long-term use of topical betamethasone

Long-term use of topical steroids can lead to serious side effects, such as the following:

• Thinning skin

• Skin infections

• Easy bruising

When there is increased absorption of the drug over a long period, systemic side effects may occur, such as the following:

• Increased acne

• Changes in body fat, especially on the abdomen, back, and neck

• Facial hair

• Vision problems

• Adrenal gland problems

Pregnancy category

Betamethasone has been designated by the FDA as a pregnancy category C drug. This means evidence of fetal harm has been observed in animal studies. However, there are no satisfactory studies on pregnant women, so the risk remains unknown.⁵

Betamethasone and pregnancy

This drug should only be used during pregnancy if the expected benefit outweighs the potential risks to the fetus. Be sure to apply the least quantity for the shortest time possible.

Betamethasone and breastfeeding

It is not known whether the application of topical betamethasone could result in enough absorption for the drug to be detectable in breast milk.

It is advised to apply the medication to the smallest area of the skin for the shortest possible time. It is also recommended not to apply the medication on the nipple or areola, as your baby could directly ingest the drug from your skin.

Most importantly, discuss the risks and benefits of using this medication while breastfeeding with your doctor.

Drug interactions

Betamethasone topical formulations are unlikely to interact with other drugs because they are applied on the skin. However, excessive use can increase the risk of absorption into the bloodstream. This can lead to possible interactions with other drugs and increased cortisol levels in the blood if you are taking other steroid medications.

Talk to your doctor if you are taking other medications that contain steroids, as well as medicines used to treat HIV and other viral, bacterial, and fungal infections.

Topical betamethasone does not typically interact with other topical treatments. That said, it would be best to wait at least 30 minutes before applying another skin treatment. This will increase the efficacy of both drugs.

What to discuss with your doctor before starting topical betamethasone

Before using this medication, tell your doctor your medical history. Be sure to mention any immune- or hormone-related conditions.

Your doctor should also know if you have any of the following conditions:¹⁴

• Infections

• Diabetes

• Liver disease

• Cushing’s syndrome

Let the doctor know if you are pregnant, planning to get pregnant, or breastfeeding. They should have this information to weigh the benefits of betamethasone over its potential risks.

Lastly, tell your doctor if you’re allergic to steroids, including this drug and its ingredients.

Drug approval history

1967: Betamethasone valerate was first approved by the FDA as a new active ingredient. The drug was to be sold as a topical cream under the brand name Valisone. This brand has since been discontinued, but generic versions are available.¹⁵

1975: The FDA first approved betamethasone dipropionate as a new active ingredient. The drug was to be sold as a topical cream under the brand name Diprosone. This brand has since been discontinued, but generic versions are available.¹⁶

1999: Luxiq, a brand-name foam formulation of betamethasone valerate, was approved by the FDA.¹⁷

2016: Sernivo, betamethasone dipropionate spray, was approved by the FDA. This became available as a generic medication in 2020.¹⁸ ¹⁹

Tips for using topical betamethasone

• Use as directed.

• Clean and dry the treatment site before applying the medication.

• Use only on the affected areas of the skin.

• Apply only a small amount of the medication and rub gently.

• Don’t apply on broken or infected skin or open wounds.

• Do not use a dressing over the area being treated.

• Wash your hands before and after application.

• Stop using betamethasone once your skin is better, and follow your doctor’s instructions for maintenance treatment of the condition.

• Shake betamethasone lotions before use.

• Store your topical betamethasone between 59° and 86°F (15° and 30°C).

• Call or visit your doctor if your symptoms don’t improve or worsen.

• Do not cover the treated area with a dressing or plastic film unless directed by your doctor, and avoid exposing the treated area to a heat source or open flame immediately after application. Not following these two tips may increase the amount of the drug absorbed through your skin.

Note that betamethasone topical may not work for some skin conditions, including the following:

• Acne

• Viral skin infections, like shingles or chickenpox

• Eyelid conditions

• Scabies

• Phimosis

• Perioral dermatitis

• Skin conditions caused by vaccinations, tuberculosis, or syphilis

• Recurrent skin infections

• Rosacea

Frequently asked questions

Why is topical betamethasone given by prescription only?

This drug is a potent corticosteroid. It’s restricted to prescription only to ensure safe and appropriate use. It is meant for the treatment of inflammatory skin conditions that are severe and do not respond to over-the-counter medications.

Can you use topical betamethasone on your private parts?

Although this drug is designed for topical application, it’s best to avoid using it in the genital or rectal areas unless your doctor directs you to do so. It should also not be used in and around the mouth or eye area.