Halobetasol vs. clobetasol - How do they compare?

Halobetasol and clobetasol are both classified as super high-potency or high-potency topical corticosteroid (“steroid”) creams used on the skin. They are both FDA-approved to treat plaque psoriasis and skin conditions such as dermatitis and eczema (atopic dermatitis). They lessen skin redness and pain, itching, dryness and scaling.

Topical corticosteroids work by preventing the release of substances in the body that cause inflammation and pain, redness, and itching. They help to relieve crusting, dryness and scaling often seen with plaque psoriasis.

They can be used for more serious skin allergies, insect bites or rashes, if needed. They may be absorbed through the skin and lead to dangerous side effects if not used as directed.

How do halobetasol and clobetasol come?

Halobetasol

Halobetasol is available as a topical cream, lotion, ointment or aerosol foam. Generic options are available for the cream, ointment, and aerosol foam products; however, the lotion does not have a generic option available yet.

Halobetasol is approved to treat plaque psoriasis in adults as well as corticosteroid-responsive dermatoses. It was first approved by the FDA in 1990.

Brand names of halobetasol include:

• Bryhali 0.01% (lotion)
• Lexette 0.05% (aerosol foam)
• Ultravate 0.05% (lotion)

Halobetasol is also available in a combination lotion product with tazarotene (Duobrii), approved for use in plaque psoriasis in adults.

Clobetasol

Compared to halobetasol, clobetasol is available in many more types of formulations. It can be found as a topical cream, ointment, lotion, solution, gel, spray, shampoo, or topical foam. All of these dosage forms are available as generic options.

Like halobetasol, clobetasol is also approved to treat plaque psoriasis in adults as well as corticosteroid-responsive dermatoses. It was first approved in 1985.

Brand names of clobetasol include:

• Clobex 0.05% (lotion, shampoo, spray)
• Cormax 0.05% (cream)
• Embeline 0.05% (gel, ointment, solution)
• Impoyz 0.025% (cream)

Where can I apply a topical corticosteroid?

Most products come in special dosage forms that are specific to the area being treated; for example, products used for scalp psoriasis would come in topical shampoos or solutions.

The best areas to apply certain topical corticosteroids:

• Most dosage forms can be used for hairy areas like the scalp, with exception of ointments, which can be quite messy and have greater absorption.
• Areas without hair or with thick skin respond best to ointments, creams and foams.
• The palms and soles of the feet respond well to ointments, creams and foams.
• Skin areas that are infected can be usually treated with most dosage forms, if indicated, except ointments, which have greater penetration. Solution, foams, and lotions are acceptable. Note that steroids can increase the risk of infection so only apply to an infected area if directed by your doctor.
• Areas between skin folds and areas that are moist or broken down respond to most dosage forms, except ointment or gels. Gels contain alcohol and may sting in areas with open skin.

Only use topical steroids on your face, groin, or axillae (armpit) if directed by your doctor. Avoid using bandages or occlusive dressings unless directed by your doctor to do so. Side effects are more likely to occur if the area is covered with an occlusive dressing (wrap) or with extensive or prolonged use of high strength medicines.

How do the side effects compare between halobetasol and clobetasol?

Potent topical steroids like halobetasol and clobetasol can be absorbed through the skin and cause serious side effects, so it’s important to follow your doctor’s order exactly.

If you experience any irritation or side effect with the use of a topical corticosteroid, contact your doctor immediately.

Because halobetasol and clobetasol fall in the same therapeutic category and potency, side effects are expected to be similar and include:

• Skin irritation, itching, burning, contact dermatitis, skin thinning or striae, folliculitis, or changes in skin color.
• Cushing's syndrome
• Sugar in the urine (glycosuria)
• Decline in growth (children)
• HPA-axis suppression, adrenal crisis
• High blood sugar (hyperglycemia).
• Skin infections

Side effects are more likely to occur if the area is covered with an occlusive dressing (wrap or bandage) or with extensive or prolonged use of high-strength medicines. Only use this medicine on your face, groin, or axillae (armpit) if directed by your doctor.

This is not a complete list of side effects or warnings. Review the full halobetasol or clobetasol warnings or side effects and discuss this information with your doctor.

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How do drug interactions compare between halobetasol and clobetasol?

Most drug interactions with topical corticosteroids are considered minor. However, you should always have your doctor and pharmacist review any medications you take for drug interactions, including prescription drugs, over-the-counter (OTC) medications, vitamins and herbal supplements.

If you use multiple topical skin preparations, ask your doctor if they can be applied within a certain time frame.

See drug interactions here:

• Clobetasol drug interactions
• Halobetasol drug interactions

Which is more expensive, halobetasol or clobetasol?

Prices of these products vary, depending upon if you are getting the brand or generic option, have insurance coverage and a copay, or if you are paying cash and using an online coupon.

• Clobetasol is available generically in all of its approved dosage forms, including: aerosol, cream, gel, lotion, ointment, shampoo, spray, and solution which can help to lower the cost of these topical medications.
• Halobetasol is available generically in a cream and an ointment. The lotion is not yet available as a generic option.

If a generic is available, it will usually be the lower cost option and more likely to be covered by your insurance. It may be worthwhile to check different pharmacies to compare prices. Look for an online discount coupon if needed. If you prefer generics, tell your doctor before they write your prescription.

Drugs.com Price Guide: You can view more prices and find a discount coupon here.

• Topical clobetasol Price Guide
• Topical halobetasol Price Guide

Costs are approximate if you are paying cash with an online coupon, for both generic and brand products. Prices may vary based on location, coupon type and pharmacy.

Bottom Line

• Halobetasol and clobetasol are both classified as super high-potency or high-potency topical corticosteroid (“steroid”) skin creams used to treat plaque psoriasis and skin conditions that are responsive to topical corticosteroids, such as eczema (atopic dermatitis).
• The side effects between these two drugs are similar, and include: skin irritation or burning, skin thinning (atrophy), folliculitis, high blood or urine sugars, HPA-axis suppression, and adrenal crisis, among others.
• Halobetasol and clobetasol are available in many different kinds of formulation, such as creams, lotions, ointments and topical solutions. The form you use is often selected based on where your skin condition is on your body.
• Both generic and brand names products are on the U.S. market and generic forms or online coupons can save you money.

This is not all the information you need to know about halobetasol or clobetasol for safe and effective use and does not replace your healthcare provider's instructions. Review the full monograph information here for both halobetasol and clobetasol, and discuss this information with your doctor or other health care provider.