Clobex: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on Feb 13, 2024.

1. How it works

• Clobex is a brand (trade) name for clobetasol propionate which is a super-high potency topical corticosteroid formulation that may be used to treat inflammation and itching caused by plaque psoriasis or skin conditions that respond to topical steroids.
• Experts aren't sure exactly how clobetasol propionate, the active ingredient in Clobex, works, but they believe it may be inducing phospholipase A2 inhibitory proteins, collectively called lipocortins. These proteins are thought to control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
• Clobex belongs to the class of medicines known as topical steroids.

2. Upsides

• Clobex may be used to treat moderate to severe plaque psoriasis that affects up to 20% of the body surface area (BSA) in people aged 18 years of age and older. It may also be used to treat skin conditions that respond to topical steroids.
• Available as a convenient-to-use 0.05% topical spray.
• Treats inflammation and itching.
• Clobex is available as a generic under the name clobetasol propionate spray.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Burning, itching, swelling, or irritation of the treated skin; dry or cracking skin; redness or crusting around the hair follicles; spider veins; stretch marks, thinning skin; rash or hives; acne; or temporary hair loss are the most common side effects reported.
• Other side effects reported (usually only after excessive use) include headache, nausea, dizziness, blurred vision, tunnel vision, eye pain, or seeing halos around lights.
• Clobex may increase the risk of developing an infection. See your doctor if you develop redness, warmth, swelling, oozing, or severe irritation of any treated skin. In people with a pre-existing infection, consider the concomitant administration of an appropriate antifungal or antibacterial agent. If no improvement is seen or the infection worsens, discontinue Clobex until the infection has been adequately controlled.
• Allergic contact dermatitis, manifesting as irritation can develop and Clobex should be discontinued and appropriate therapy is given. Symptoms usually include a failure of the skin to heal rather than an exacerbation of psoriasis.
• Clobex spray is flammable and people using Clobex should not smoke or expose themselves to a flame or heat source during and immediately after application.
• Rarely, Clobex may cause an allergic reaction. Seek emergency medical help if you develop hives; difficulty breathing; or swelling of your face, lips, tongue, or throat.
• Doctors should monitor people administering Clobex for possible signs of absorption through their skin. Symptoms may include weight gain in the face and shoulders, slow wound healing, skin discoloration, thinning skin, increased body hair, tiredness, mood changes, menstrual changes, and sexual changes.
• Clobex spray should not be used in children and adolescents younger than 18 years of age because children can absorb larger amounts of this medicine through the skin and there is a high risk of hypothalamic-pituitary-adrenal (HPA) axis suppression.
• Only use for the minimum time possible and no more than 4 consecutive weeks. The total dosage should not exceed 50 g (59 mL or 2 fl. oz.) per week. Do not use more than 26 sprays per application or 52 sprays per day. If complete disease control is not achieved after 4 weeks of treatment a less potent topical steroid may be substituted. If no improvement is seen reassess the diagnosis.
• Clobex may not be suitable for people with any type of skin infection, a history of skin reactions to steroid medications, liver disease, or an adrenal gland disorder.
• Clobex may increase levels of blood glucose (sugar) in the blood or urine. People with diabetes may need to monitor their blood sugar levels more carefully. Symptoms include increased thirst, increased urination, dry mouth, or fruity breath odor.
• There is not enough data to know whether using Clobex on the skin will harm an unborn baby. Women who are pregnant should only use Clobex if the risks outweigh the benefits and only under a doctor's advice.
• It may not be safe to breastfeed while using this medicine. If breastfeeding and your doctor has advised you to use Clobex do not apply it to any areas of the chest likely to come into contact with the baby's mouth.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Clobex is a topical, super high-potency steroid spray that may be used to treat plaque psoriasis that affects less than 20% of the body surface area of people aged 18 and older. It should be used strictly as directed, no more than 50g applied each week, and used for no longer than four consecutive weeks. Clobex spray is flammable and people who have applied Clobex spray to their bodies should keep away from a heat source or a fire, and should not smoke while they are applying Clobex and immediately after application.

5. Tips

• Apply Clobex spray directly to the affected area, if possible. Use exactly as directed and only to the areas of your body affected by plaque psoriasis. Do not spray Clobex on your face, groin, or armpits, and do not take it by mouth. If the spray accidentally gets into your eyes or mouth, rinse them thoroughly with water.
• Once you have applied the spray, rub it in gently and completely. Do not apply Clobex to broken or infected skin and avoid applying it to open wounds. Always wash your hands thoroughly after applying Clobex.
• Do not cover the treated area with plastic film or a dressing unless your doctor tells you to because this may increase how much of the product is absorbed through your skin.
• Do not apply more than 50 g (59 mL or 2 fl. oz.) of spray per week. Do not use more than 26 sprays per application or 52 sprays per day. Do not use it for longer than 4 consecutive weeks. If your condition clears up before 4 weeks, then stop using Clobex. Excessive use of Clobex can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.
• Call your doctor if you develop an infection or redness, if your symptoms do not improve, or if they get worse.
• Do not apply any other topical steroid medications to the same areas that you are treating with Clobex unless your doctor tells you to.
• Do not use Clobex on your face. Clobex is classed as a super potent topical corticosteroid and lower potency corticosteroids, such as hydrocortisone are more appropriate to use on the face if one is deemed necessary. You should always use the lowest potency corticosteroid that is effective for your skin condition for the shortest possible time.
• Clobex should not be used to treat acne; bacterial, fungal, or viral skin infections (such as herpes simplex, shingles, or chickenpox); bites or stings; eyelid conditions; mild dermatitis; perioral dermatitis; phimosis (a tight foreskin of the penis); rosacea; scabies; skin conditions caused by vaccinations, tuberculosis, or syphilis.
• Using more shampoo than recommended, or applying Clobex for longer than four weeks can lead to side effects such as skin thinning, growth retardation in children, cataracts, glaucoma, or suppression of the hypothalamic-pituitary-adrenal axis.
• If you have surgery scheduled, tell your doctor you are using Clobex.
• Store at room temperature 68° to 77°F (20° - 25°C) as much as possible; however, occasional lower or higher temperatures are permitted between 59° and 86°F (15° - 30°C).
• Clobex spray may increase your risk of glaucoma or cataracts. Report any visual symptoms to your doctor who may refer you to an ophthalmologist for evaluation.
• Do not smoke after applying Clobex spray as the foam is flammable and your hair or areas of skin could catch fire. Do not go near a heat source or open flame during or immediately following application.
• Tell your doctor if you are pregnant, plan to become pregnant, or breastfeeding as Clobex may not be suitable for you.

6. Response and effectiveness

• Some improvement in symptoms of plaque psoriasis such as inflammation (redness) and itching, should be noticed within one to two weeks. Other symptoms, such as dryness, crusting, or scaling may take a bit longer to resolve.
• Research has shown that after two weeks, 0% to 2% of people reported completely clear skin, and 47% to 53% reported almost clear skin. After 4 weeks, 25% to 30% reported completely clear skin, with 52% to 53% reporting almost clear skin.
• Treatment with Clobex should not exceed four weeks and no more than 50 g of the spray should be used per week.
• Clobex is not effective against other types of skin rashes caused by fungi, viruses, scabies, acne, rosacea, or other conditions.

7. Interactions

Clobex is unlikely to interact with any other drugs that are taken orally because it is applied topically to the skin. However, excessive use of Clobex may increase the risk of absorption of Clobex, and possible interactions.

The product information for Clobex lists only minor interactions. These include:

• acid suppressants, such as famotidine, or omeprazole (corticosteroids can increase irritation of the stomach)
• diabetic medications, such as insulin, glyburide, glimepiride, or glipizide (Clobex may increase blood sugar levels)
• oral or topical corticosteroids, such as prednisone (may increase the risk of HPA suppression).

Note that this list is not all-inclusive and includes only common medications that may interact with Clobex. You should refer to the prescribing information for Clobex for a complete list of interactions. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

References

• Clobex (clobetasol propionate) [Product information]. Updated 11/2023. Cerner Multum Inc.. https://www.drugs.com/mtm/clobex.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Clobex only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2024 Drugs.com. Revision date: February 13, 2024.

Medical Disclaimer