Temovate (clobetasol propionate) is a high-potency, Class I topical corticosteroid indicated for the short-term treatment of moderate to severe corticosteroid-responsive dermatoses. It functions as a super-high-potency vasoconstrictor, providing rapid anti-inflammatory, antipruritic, and immunosuppressive effects. This prescription medication is reserved for cases where less potent corticosteroids have proven inadequate, offering a targeted approach to managing severe skin inflammation and associated symptoms. Its formulation is optimized for enhanced epidermal penetration and sustained localized activity.

Features

• Active ingredient: Clobetasol propionate 0.05%
• Available formulations: Cream, ointment, gel, solution, and foam
• Potency classification: Group I (Super-high potency) per the US system
• Vehicle options: Optimized for different skin types and conditions (e.g., ointment for dry, lichenified areas; solution for scalp)
• Rapid onset of action with significant vasoconstrictive activity

Benefits

• Provides rapid and potent relief from inflammation, redness, and swelling associated with severe dermatoses.
• Effectively reduces intense itching (pruritus), improving patient comfort and reducing the itch-scratch cycle.
• Helps resolve scaling and plaque elevation in conditions like psoriasis and lichen planus.
• Offers targeted therapy with minimal systemic absorption when used correctly for short durations.
• Available in multiple vehicle types to suit various anatomical sites and skin conditions.

Common use

Temovate is prescribed for the short-term treatment of inflammatory and pruritic manifestations of moderate to severe corticosteroid-responsive dermatoses. Its primary applications include plaque psoriasis, particularly on elbows, knees, and torso; recalcitrant atopic dermatitis; lichen planus; lichen simplex chronicus; and severe contact dermatitis that has not responded to mid-potency steroids. It is also used for steroid-responsive dermatoses of the scalp, utilizing the solution formulation. Use is generally limited to two-week courses due to its high potency.

Dosage and direction

Apply a thin film of Temovate to the affected area(s) twice daily, gently rubbing it in. The total dosage should not exceed 50 grams per week for the cream or ointment, or 50 mL per week for the solution. Treatment should be limited to 2 consecutive weeks. The application area should not be covered with an occlusive dressing unless specifically directed by a physician, as this dramatically increases systemic absorption and the risk of adverse effects. Hands should be washed after application unless they are the treatment site. Use in children under 12 years of age is not recommended.

Precautions

Temovate can cause reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, which may manifest as hyperglycemia, glucosuria, or Cushing’s syndrome. Use with extreme caution on the face, groin, or axillae due to higher absorption rates and increased risk of skin atrophy, striae, and telangiectasia. Prolonged use can lead to tolerance (tachyphylaxis). Patients should be advised to avoid contact with eyes. Discontinuation should be gradual if used for extended periods (beyond 2 weeks is not recommended) to avoid a rebound flare of the dermatosis. Not for ophthalmic, oral, or intravaginal use.

Contraindications

Temovate is contraindicated in patients with a known hypersensitivity to clobetasol propionate, other corticosteroids, or any component of the formulation. Its use is contraindicated for the treatment of rosacea and perioral dermatitis. It should not be used on viral skin infections (e.g., herpes simplex, varicella), fungal infections, or bacterial skin infections without appropriate concomitant antimicrobial therapy. Use is contraindicated in patients with cutaneous tuberculosis.

Possible side effect

The most common side effects are localized to the application site and include burning, stinging, itching, irritation, and dryness. Less frequently, patients may experience folliculitis, hypertrichosis, acneiform eruptions, and hypopigmentation. With prolonged use or use under occlusion, more serious effects can occur, including skin atrophy, striae, telangiectasia, and miliaria. Systemic absorption can lead to HPA axis suppression, manifestations of Cushing’s syndrome, hyperglycemia, and glaucoma (if applied near the eyes).

Drug interaction

Formal drug interaction studies have not been conducted with topical clobetasol propionate. However, potential interactions exist with other drugs that suppress the immune system, potentially increasing the risk of infection. There are no known direct pharmacokinetic interactions, but the systemic effects of corticosteroids could theoretically alter the response to other medications. Caution is advised when using other topical products concurrently on the same site, as this may increase irritation or systemic absorption.

Missed dose

If a dose is missed, it should be applied as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Do not apply a double dose to compensate for a missed one. Maintaining a consistent application schedule is important for efficacy, but the short-term nature of therapy minimizes the impact of a single missed dose.

Overdose

Topically applied Temovate can be absorbed in sufficient amounts to produce systemic effects. Acute overdose is unlikely from topical application but could manifest as systemic corticosteroid effects. Chronic overdose or misuse (prolonged use, application to large body surface areas, use under occlusion) can lead to symptomatic HPA axis suppression, requiring appropriate monitoring and possibly systemic corticosteroid replacement therapy. There is no specific antidote; treatment involves discontinuation of the product and supportive management of symptoms.

Storage

Store Temovate at controlled room temperature, 20°C to 25°C (68°F to 77°F). Excursions are permitted between 15°C and 30°C (59°F and 86°F). Keep the tube or bottle tightly closed when not in use. Protect from freezing and excessive heat. Keep out of reach of children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The full prescribing information should be consulted before using this product.

Reviews

“Temovate has been a critical tool in my dermatology practice for managing severe, recalcitrant plaque psoriasis. Its potency provides rapid clearance when other options fail, but it demands respect for its potential side effects. Patient education on limited duration of use is paramount.” – Dermatologist, 15 years experience. “For my severe eczema flares that don’t respond to triamcinolone, a short 2-week course of Temovate cream is remarkably effective at breaking the cycle of inflammation and itch. I strictly follow my doctor’s instructions due to its strength.” – Patient with atopic dermatitis. “In our clinic, we reserve Temovate for the most severe cases and see excellent short-term results. However, we monitor for signs of atrophy carefully, especially in older patients. It’s a powerful but finite solution.” – Nurse Practitioner, Dermatology. “After struggling with lichen planus for months, Temovate ointment finally provided relief within a week. The key was using it sparingly and for the exact time prescribed to avoid any rebound or side effects.” – Patient with lichen planus.