Indications

This ointment, containing Clobetasol Propionate and Salicylic Acid, is indicated for the relief of inflammatory, hyperkeratotic, and dry skin conditions that are responsive to corticosteroids. These include:

• Psoriasis
• Chronic atopic dermatitis
• Neurodermatitis (Lichen Simplex, Chronicus)
• Lichen planus
• Eczema (including nummular eczema, hand eczema, and eczematous dermatitis)
• Seborrheic dermatitis of the scalp
• Ichthyosis vulgaris and other ichthyotic conditions

Pharmacology

• Clobetasol Propionate: This is a high-potency corticosteroid. It works by decreasing inflammation through various mechanisms, such as stabilizing cell membranes, inhibiting the accumulation of inflammatory cells, and reducing capillary permeability, thereby reducing swelling.
• Salicylic Acid: This acts as a potent keratolytic agent, meaning it softens and breaks down the outer layer of the skin (stratum corneum). This helps to remove scales and thick skin, which allows the Clobetasol Propionate to penetrate more effectively. It also has mild antiseptic properties.

Dosage & Administration

• Adults: Apply a thin layer of the ointment to the affected skin areas twice daily, rubbing it in gently and completely. Treatment should be discontinued once the condition is under control.
• If no improvement is seen after 2 weeks, a reassessment of the diagnosis may be necessary.
• Do not use with an occlusive dressing. Treatment should not exceed 2 consecutive weeks or a total of 50 gm per week due to the risk of systemic absorption.
• Children: Use in patients under 12 years of age is not recommended.

Interaction

• There are no known interactions with the Clobetasol Propionate component.
• Salicylic Acid may increase the absorption of other topical medications applied to the same area. Therefore, concomitant use should be avoided.

Contraindications

This ointment is contraindicated in patients with a known hypersensitivity to Clobetasol Propionate, Salicylic Acid, or any other ingredients. It should not be used for:

• Primary bacterial or fungal skin infections (unless an anti-infective is also used).
• Primary cutaneous viral infections (e.g., herpes simplex, chickenpox).
• Tuberculous skin lesions.
• Dermatoses in children under one year of age, including diaper rash.

Side Effects

Prolonged use, especially on large areas or with occlusive dressings, can lead to systemic absorption and the features of hypercortisolism. This is more likely to occur in infants and children. Local side effects can include skin thinning and stretch marks. Pustular psoriasis may be triggered in some cases. Hypersensitivity reactions, drying, and irritation may also occur.

Pregnancy & Lactation

The safe use of this ointment during pregnancy and lactation has not been established. It should only be used if the potential benefit to the mother outweighs the possible risk to the fetus. It should not be used extensively or for prolonged periods during pregnancy.

Precautions & Warnings

• Use with caution on lesions near the eyes to prevent the preparation from entering them.
• Prolonged use over large areas may lead to adrenal suppression, especially in children, who are more susceptible.
• Use with caution in psoriasis, as it may lead to complications like rebound relapses.
• If a skin infection is present, an appropriate anti-microbial therapy should be used.
• Avoid contact with broken or inflamed skin. Salicylate toxicity may occur if applied to large areas or to neonates.

Overdose Effects

Acute overdose is very unlikely. However, chronic overuse or misuse can lead to the symptoms of hypercortisolism, in which case the topical steroid should be gradually discontinued under medical supervision. Salicylate poisoning is unlikely with proper use but could occur if large amounts are applied or ingested, leading to symptoms like tinnitus, dizziness, and deafness.

Therapeutic Class

This ointment is classified as a Clobetasol/Clobetasone & Combined Preparation.

Storage Conditions

Store in a cool and dry place, protected from light.