A potent topical combination therapy consisting of a super-high potency corticosteroid (Clobetasol propionate) and a keratolytic agent (Salicylic Acid). It is primarily used for the treatment of severe, hyperkeratotic, and inflammatory dermatoses where scaling and thickening of the skin are prominent features. The combination provides rapid anti-inflammatory, immunosuppressive, and vasoconstrictive effects from clobetasol, while salicylic acid promotes desquamation, reduces scaling, and enhances steroid penetration.
Adult: Apply a thin film to the affected area once or twice daily. For most conditions, once-daily application is sufficient. Treatment should be limited to 2 consecutive weeks. The maximum weekly dose should not exceed 50 grams (for clobetasol).
Note: Wash and dry the affected area. Apply a thin layer and rub in gently until absorbed. Wash hands after application unless hands are being treated. Do not cover with occlusive dressings unless specifically directed by a physician. Avoid contact with eyes, mouth, nose, and mucous membranes. Do not use on broken or infected skin.
Clobetasol propionate binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus. This complex modulates gene transcription, leading to the synthesis of anti-inflammatory proteins (lipocortins) and inhibition of pro-inflammatory mediators (cytokines, leukotrienes, prostaglandins). It also causes vasoconstriction. Salicylic Acid acts as a keratolytic by disrupting intercellular cohesion in the stratum corneum, leading to desquamation of scaly skin. It also possesses mild anti-inflammatory and bacteriostatic properties.
Pregnancy: Category C (US FDA). Topical corticosteroids, especially potent ones, should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies show teratogenicity with systemic corticosteroids. Not recommended for extensive use, long duration, or under occlusion. Salicylic acid is Category C in first and second trimesters, and Category D in third trimester (risk of bleeding and premature closure of ductus arteriosus). Avoid use on large areas or for prolonged periods.
Driving: No known effects on driving ability.
| Other Topical Corticosteroids | Additive risk of local and systemic side effects, including HPA axis suppression. | Major |
| Warfarin and other Anticoagulants | Salicylic acid may potentiate anticoagulant effect, increasing risk of bleeding. | Major |
| Methotrexate | Salicylic acid may decrease renal excretion of methotrexate, increasing its toxicity. | Major |
| Oral Hypoglycemics (e.g., Sulfonylureas) | Salicylic acid may enhance hypoglycemic effect. Clobetasol may cause hyperglycemia. | Moderate |
| Diuretics (e.g., Furosemide) | Salicylates may reduce the diuretic and antihypertensive effects. | Moderate |
| Systemic Corticosteroids (e.g., Prednisolone) | Increased risk of HPA axis suppression and Cushingoid features. | Major |
| Topical Retinoids or other Keratolytics | Increased risk of severe local irritation and skin barrier damage. | Moderate |
Same composition (Clobetasol (0.05% w/w) + Salicylic Acid (6% w/w)), different brands: