Pharmacology · Corticosteroids (glucocorticoids)
Clobetasol !
A very potent corticosteroid cream or ointment for psoriasis and eczema. Used on small areas for short periods because it can thin the skin.
Updated 2026-11-01
The figure shows dexamethasone in the ligand-binding pocket of the human glucocorticoid receptor; clobetasol propionate binds the same pocket.
Mechanism of action
Clobetasol propionate is a highly potent topical glucocorticoid. In skin cells it binds the glucocorticoid receptor, which represses inflammatory genes and switches on anti-inflammatory ones. Inflammatory mediators fall, small vessels constrict and keratinocyte and fibroblast activity slows, which reduces redness, scaling and itching but, with overuse, also thins the skin. Enough can be absorbed through the skin to suppress the adrenal axis.
- Clobetasol penetrates the skin and binds the glucocorticoid receptor
- Inflammatory genes are repressed in skin cells
- Redness, scaling and itching fall; vessels constrict
Pharmacokinetics
- Absorption
- Through the skin; more with large areas, broken skin, occlusion and in children
- Metabolism
- The absorbed fraction is handled like systemic corticosteroids, in the liver
Indications
- Psoriasis, including scalp psoriasis
- Severe eczema and other corticosteroid-responsive skin diseases
Adverse effects
Common
- Burning, stinging or itching where applied
- Skin atrophy, shiny skin and stretch marks
- Acne-like bumps and rash around the mouth
- Changes in skin colour
Contraindications
- Hypersensitivity to any component
- Not recommended in children under 12
Key interactions
- Other corticosteroids (systemic, inhaled or topical)
- Adds to the total steroid load and to adrenal suppression
What is monitored
- Skin for atrophy, striae and infection
- Morning cortisol or ACTH stimulation test if large areas are treated
- Glucose in people with diabetes
Administration and safety
- A thin layer on the affected skin only; hands are washed after applying
- The area is not bandaged or wrapped unless ordered: occlusion increases absorption
- Kept away from the eyes; used for a limited time, as ordered
Nursing care
- Check the skin for thinning, stretch marks or signs of infection
- Teach a thin layer, no covering, and a limited course
- Ask about other steroid products the patient uses
- In diabetes, ask about glucose changes during treatment
Pregnancy and breastfeeding
Used in pregnancy only when the benefit justifies it, on small areas and for short periods.
Test yourself
Think of the answer, then tap the question to see it.
Why is clobetasol not used under an occlusive dressing unless ordered?
Occlusion greatly increases absorption, raising the risk of skin atrophy and of adrenal axis suppression or Cushing syndrome.
Why are children at greater risk of systemic effects from topical clobetasol?
They have a larger skin surface relative to body mass, so they absorb more drug per kilogram.
Which test checks for adrenal axis suppression after extensive topical steroid use?
ACTH stimulation test, morning plasma cortisol or urinary free cortisol.
Related drugs
← Back to the class: Corticosteroids (glucocorticoids)
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Clobetasol Topical: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2018); DailyMed - CLOBETASOL PROPIONATE cream (DailyMed (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.