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Topical Clobetasol Propionate in the Treatment of Psoriasis

A Review of Newer Formulations

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American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Ultrapotent topical corticosteroids are the mainstay of psoriasis treatment, used either alone or in combination with a topical vitamin D analog. Traditionally used in an ointment vehicle for psoriasis, clobetasol propionate 0.05% is also available in spray, foam, lotion, and shampoo formulations, which may provide for improved convenience and acceptance in many patients with similar efficacy, safety, and tolerability as the traditional ointment and cream formulations. To compare newer formulations with traditional ointment and cream formulations, we performed a systematic review of the literature. Search terms included ‘clobetasol propionate,’ in combination with ‘psoriasis,’ ‘vasoconstriction,’ ‘vasoconstrictor,’ or ‘absorption’ for each of the four vehicles (‘spray,’ ‘foam,’ ‘lotion,’ and ‘shampoo’).

While there are very few direct comparison studies between clobetasol propionate in different vehicles, the efficacy rates (with success defined as clear or almost clear of psoriasis) for more recent formulations are high, with most patients achieving success after 2–4 weeks of treatment in well controlled clinical trials, with response rates that are similar to those with the traditional clobetasol propionate ointment. Small differences in vasoconstrictor potency or cutaneous absorption have been noted among the formulations, but the clinical significance of these observations is difficult to discern. Recent research has emphasized the importance of treatment adherence in the management of psoriasis. Adherence to treatment is likely to be a far more important determinant of success than are small differences in drug delivery, especially in actual clinical use as opposed to the well controlled environment of clinical trials. For patients who prefer a less messy vehicle, adherence and outcomes are likely to be better with the more recent formulations compared with the traditionally recommended ointment.

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Acknowledgments

Writing and editorial support was provided by a medical writer, Mark P. Bowes, PhD and Medisys Health Communications. This review was supported by Galderma Laboratories, L.P.

Stephen R. Feldman, MD, PhD is a Speaker and an Advisory Board member for Galderma, Steifel, and Warner Chilcott. He receives research support from Galderma, Steifel, and Warner Chilcott. Brad A. Yentzer, MD has no financial relationships to disclose.

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  1. Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

    Steven R. Feldman & Brad A. Yentzer

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  1. Steven R. Feldman
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  2. Brad A. Yentzer
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Feldman, S.R., Yentzer, B.A. Topical Clobetasol Propionate in the Treatment of Psoriasis. AM J Clin Dermatol 10, 397–406 (2009). https://doi.org/10.2165/11311020-000000000-00000

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  • DOI: https://doi.org/10.2165/11311020-000000000-00000

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