O Increasing hydration of the stratum corneum on intertriginous areas or under occlusive dressings (in infants the nappy may act as an occlusive dressing) O Potency and formulation of topical steroid Risk factors for increased systemic effects are: Abrupt withdrawal of treatment may result in glucocorticosteroid insufficiency. If either of the above are observed, withdraw the drug gradually by reducing the frequency of application, or by substituting a less potent corticosteroid. Manifestations of hypercortisolism (Cushing's syndrome) and reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, leading to glucocorticosteroid insufficiency, can occur in some individuals as a result of increased systemic absorption of topical steroids. Local hypersensitivity reactions may resemble symptoms of the condition under treatment. Therefore the minimum quantity should be used for the shortest duration to achieve the desired clinical benefit.īetamethasone valerate should be used with caution in patients with a history of local hypersensitivity to other corticosteroids. In case of systemic absorption (when application is over a large surface area for a prolonged period) metabolism and elimination may be delayed therefore increasing the risk of systemic toxicity. Therefore the minimum quantity should be used for the shortest duration to achieve the desired clinical benefit. The greater frequency of decreased hepatic or renal function in the elderly may delay elimination if systemic absorption occurs. The condition and the benefits and risks of continued treatment must be re-evaluated on a regular basis.īetamethasone valerate is contraindicated in children under one year of age.Ĭhildren are more likely to develop local and systemic side effects of topical corticosteroids and, in general, require shorter courses and less potent agents than adults therefore, courses should be limited to five days and occlusion should not be used.Ĭare should be taken when using betamethasone valerate to ensure the amount applied is the minimum that provides therapeutic benefit.Ĭlinical studies have not identified differences in responses between the elderly and younger patients. This regimen should be combined with routine daily use of emollients. This has been shown to be helpful in reducing the frequency of relapse.Īpplication should be continued to all previously affected sites or to known sites of potential relapse.
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Once an acute episode has been treated effectively with a continuous course of topical corticosteroid, intermittent dosing (apply once a day twice a week without occlusion) may be considered. Rebound of pre-existing dermatoses can occur with abrupt discontinuation of betamethasone valerate. Therapy with betamethasone valerate should be gradually discontinued once control is achieved and an emollient continued as maintenance therapy.
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If the condition worsens or does not improve within 2-4 weeks, treatment and diagnosis should be re-evaluated. Overnight occlusion only is usually adequate to bring about a satisfactory response in such lesions thereafter, improvement can usually be maintained by regular application without occlusion. In the more resistant lesions, such as the thickened plaques of psoriasis on elbows and knees, the effect of betamethasone valerate can be enhanced, if necessary, by occluding the treatment area with polythene film.
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Creams are especially appropriate for moist or weeping surfaces.Īpply thinly and gently rub in using only enough to cover the entire affected area once or twice daily for up to 4 weeks until improvement occurs, then reduce the frequency of application or change the treatment to a less potent preparation.Īllow adequate time for absorption after each application before applying an emollient.