DEFOSALIC LOTION 30ML

Indications

Approved Uses

Steroid-responsive inflammatory scalp dermatoses with hyperkeratosis/scaling (e.g., scalp psoriasis and seborrheic dermatitis) where a potent topical corticosteroid plus keratolytic is appropriate.

Dosage & Administration

Dosing by Condition

Scalp psoriasis / scaly steroid-responsive scalp dermatoses: apply a small amount (few drops) to affected scalp once or twice daily; reassess if not improved within ~2-4 weeks and avoid prolonged continuous use without medical review.

Initial Dose

Apply a thin layer to the affected area twice daily (morning and evening).

Maintenance Dose

As the condition improves, the frequency may be reduced to once daily or less frequent application.

Maximum Dose

Apply a thin film once to twice daily; limit duration to the shortest effective course (typically up to 2-4 weeks) and avoid large-area/occlusive use; do not exceed ~50-60 g/week of potent topical steroid equivalent.

Children's Dosage

Not recommended for children under 12 years. In children 12 years and older, use with caution, apply sparingly, and limit duration due to higher risk of systemic absorption.

Dose Adjustment Notes

Use the minimum effective amount for the shortest duration; once controlled, reduce frequency (e.g., to once daily or intermittent use) and avoid large areas, broken skin, and occlusion to limit systemic absorption and local adverse effects.

How to Take

For scalp use: part the hair, apply a small amount (a few drops) of the scalp solution directly onto the affected scalp skin (not the hair), massage gently, allow to dry/leave on, wash hands after application, and avoid contact with eyes/face; do not use under occlusion unless specifically instructed.

Side Effects

Common Side Effects

Application-site burning/stinging, pruritus, irritation/erythema, dryness, folliculitis; may also cause peeling due to the salicylic acid keratolytic effect.

Side Effect Frequency

Common: local burning/stinging, pruritus, irritation, dryness, erythema; Uncommon/Infrequent: folliculitis, acneiform eruptions, hypertrichosis, hypopigmentation, contact dermatitis, maceration, secondary infection, skin atrophy/striae/telangiectasia, miliaria; Rare: HPA-axis suppression/Cushingoid effects, hyperglycemia, and (with excessive/prolonged/large-area use) systemic salicylate toxicity.

Safety & Warnings

Contraindications

Hypersensitivity to betamethasone dipropionate, salicylic acid, or excipients; untreated bacterial/fungal/viral skin infections (e.g., herpes simplex, varicella); rosacea; perioral dermatitis; acne vulgaris; avoid use on face/genitals unless specifically directed.

Warnings & Precautions

External use only; avoid eyes/mucosa; avoid face/groin/axillae unless directed; do not use under occlusion unless prescribed; use short courses and small areas (extra caution in children); stop and treat if infection develops; discontinue if significant irritation/sensitization occurs; risk of systemic absorption (HPA suppression) and salicylism with extensive/prolonged use.

Age Restriction

Avoid routine use in children <12 years; if specialist-directed use is necessary, use the smallest amount for the shortest duration with close monitoring.

Driving Warning

Safe

Drug Interactions

Drug Interactions

No clinically significant interactions expected with appropriate limited topical use; avoid concurrent application of other topical irritants/keratolytics on the same area, and be cautious with extensive use alongside systemic salicylates/anticoagulants due to theoretical salicylate absorption.

Food Interaction

No restriction

Alcohol Interaction

Safe

Special Populations

Pregnancy

Caution

Breastfeeding

Caution

Children

Not recommended for children under 12 years. In children 12 years and older, use with caution, apply sparingly, and limit duration due to higher risk of systemic absorption.

Elderly

Use with caution; elderly patients may have thinner, more fragile skin with increased risk of atrophy and systemic absorption. Apply sparingly and for the shortest duration necessary.

Kidney Impairment

No dose adjustment needed for topical use; avoid extensive/prolonged application in significant renal impairment due to theoretical salicylate accumulation.

Liver Impairment

No dose adjustment needed for topical use.

Storage & Patient Advice

Missed Dose

Apply when remembered; if close to the next scheduled application, skip the missed dose and continue as usual-do not apply extra to make up for it.

Stopping the Medicine

If used for prolonged periods, on large areas, under occlusion, or with high-potency effect, taper by reducing frequency/amount rather than stopping abruptly to minimize rebound; short courses on limited areas may be discontinued once controlled as directed by the prescriber.

Overdose

Excessive/prolonged use may cause systemic corticosteroid effects (HPA-axis suppression/Cushingoid features) and salicylism (e.g., tinnitus, nausea/vomiting, hyperventilation/metabolic acidosis) especially with large areas/occlusion; management is stopping or tapering steroid as appropriate, washing off, supportive care, and urgent medical evaluation if salicylate toxicity is suspected.

Patient Counseling

Apply a thin layer to affected scalp areas only as prescribed; avoid eyes/face/mucosa and broken skin; wash hands after use; do not use under occlusion/tight coverings unless directed; limit duration and area (seek review if not improving or if prolonged use is needed); stop and seek care for severe irritation, signs of infection, or steroid adverse effects (skin thinning/striae/telangiectasia); keep away from flames/heat sources until dry if the vehicle is alcohol-based; inform clinician if pregnant/breastfeeding or using on children.

Monitoring Requirements

No routine labs for short courses on limited scalp areas; for prolonged/high-dose/large-area use (or in children), monitor for local adverse effects (atrophy, striae, telangiectasia, secondary infection) and consider HPA-axis suppression risk (clinical features; cortisol testing only if clinically indicated).

Pharmacology

Mechanism of Action

Betamethasone dipropionate activates glucocorticoid receptors to reduce inflammatory mediator production and vasodilation/pruritus; salicylic acid is keratolytic, reducing corneocyte cohesion to promote desquamation and enhance corticosteroid penetration through scale.

Bioavailability

Percutaneous absorption is variable and increases with inflammation, damaged skin, large surface area, prolonged use, and occlusion; salicylic acid can increase corticosteroid penetration; do not cite a fixed % absorption for betamethasone dipropionate on the scalp.

Metabolism

If systemically absorbed: betamethasone dipropionate is hydrolyzed to active betamethasone and further metabolized mainly in the liver; salicylic acid undergoes hepatic conjugation (glycine and glucuronide pathways).

Protein Binding

Salicylic acid is ~50-80% protein-bound (concentration-dependent); corticosteroids (including betamethasone) are variably protein-bound-avoid asserting a single definitive % for betamethasone dipropionate specific to this topical product.

Product Information

Available Dosage Forms

Scalp solution (lotion) in a bottle (30 mL).

Composition per Dose

Each 1ml of lotion contains: 0.5mg Betamethasone (as 0.64mg Betamethasone Dipropionate) and 20mg Salicylic Acid.

OTC Alternatives

OTC options for mild scalp scaling include salicylic acid-containing shampoos/solutions and other anti-dandruff shampoos (e.g., ketoconazole 1%, selenium sulfide, zinc pyrithione); there is no true OTC equivalent to the prescription combination of betamethasone dipropionate + salicylic acid scalp solution.

Skin Condition

Psoriasis, Eczema, Seborrheic Dermatitis

Steroid Potency

Potent

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