Dermovate Ointment for Dry Skin and Chronic Inflammation: Uses and Application Guide
What Is Dermovate Ointment?
Dermovate ointment contains clobetasol propionate 0.05% in an anhydrous (water-free), paraffin-based ointment vehicle. It is classified as a very potent (Class 4) topical corticosteroid — the highest tier of topical steroid potency available in the UK — and is a prescription-only medicine (POM) under UK law. It is manufactured by GlaxoSmithKline and licensed under the brand name Dermovate; generic clobetasol propionate 0.05% ointments are also available by prescription.
The ointment formulation is the format of choice when the skin is dry, thickened, scaly, or lichenified — that is, when the outer layers of skin have become toughened and hardened through chronic inflammation or persistent scratching. In these circumstances, a grease-based vehicle is both a more effective drug-delivery system and a therapeutic tool in its own right: it restores moisture to a compromised skin barrier and slows evaporation of the active ingredient, improving penetration of clobetasol propionate through the thickened stratum corneum.
Dermovate also comes as a cream (for moist or weeping presentations) and a scalp application. This guide is strictly about the ointment. For guidance on the cream formulation, see Dermovate cream for weeping or moist eczema.
What Makes the Ointment Base Different from Cream?
The fundamental difference between a topical ointment and a cream lies in the vehicle — the inert base that carries the active ingredient. Dermovate cream is an oil-in-water emulsion: it contains water, emulsifiers, and preservatives that allow it to spread easily and feel light on the skin. Dermovate ointment, by contrast, is anhydrous — it contains no water at all. The base is predominantly white soft paraffin (petrolatum), a semi-solid hydrocarbon mixture that does not evaporate, does not absorb into the skin, and forms a physical barrier on the skin surface.
This difference in composition has significant clinical consequences:
- Occlusion and hydration — the paraffin base forms a semi-impermeable film that prevents transepidermal water loss (TEWL). In dry eczema and psoriasis, TEWL is substantially elevated; the ointment directly counteracts this by trapping moisture within the stratum corneum.
- Enhanced drug penetration — occlusion raises the local temperature and hydration of the skin surface, both of which increase the penetration of clobetasol propionate through thickened or lichenified skin that would limit absorption from a cream.
- Longer skin contact time — because the base does not evaporate or absorb, the active ingredient remains in contact with the skin for a longer period than a cream formulation, particularly relevant overnight.
- No preservatives or sensitisers — the anhydrous base requires no preservatives (which can irritate sensitised skin) and contains no propylene glycol or other potential allergens found in some cream formulations.
- Greasy residue — the practical trade-off is cosmetic: the ointment leaves a greasy feel on the skin and may transfer to clothing and bedding. It is generally better suited to evening and nighttime use for this reason.
Greater occlusion means greater systemic absorption. The ointment base, precisely because it is more occlusive than the cream, increases the proportion of clobetasol propionate absorbed through the skin into the bloodstream. This makes careful adherence to the 50 g per week maximum and the four-week duration limit especially important with the ointment formulation.
Conditions Best Suited to Dermovate Ointment
Dermovate ointment is licensed for the treatment of severe inflammatory skin conditions where the presentation is characterised by dryness, scaling, thickening, or lichenification rather than by weeping or acute moisture. The following conditions are those for which the ointment is the preferred formulation:
Chronic atopic eczema with lichenification
Repeated scratching causes the skin to thicken and develop a leathery, grid-like texture known as lichenification. This hardened skin barrier limits absorption from the cream; the ointment’s occlusive base restores moisture and drives the active ingredient through the thickened stratum corneum.
Plaque psoriasis (body, elbows, knees, palms, soles)
Well-demarcated, dry, silver-scaled plaques with a significantly thickened epidermal layer. The ointment softens the overlying scale and enhances clobetasol propionate penetration. Must not be used on facial or flexural psoriasis.
Lichen simplex chronicus
A localised area of chronically itchy, intensely thickened skin resulting from habitual scratching. The itch-scratch cycle perpetuates the condition; the ointment’s anti-inflammatory action combined with its penetration advantage is the preferred approach.
Discoid eczema (chronic/dry phase)
Coin-shaped eczema plaques that have transitioned from the acute weeping phase to a dry, scaly, crusted presentation. At this stage the ointment is the more effective formulation.
Palmoplantar eczema
Eczema affecting the exceptionally thick skin of the palms and soles. Cream penetration through palmar or plantar skin is minimal; the ointment is strongly preferred for these sites.
Hyperkeratotic skin conditions
Conditions such as hyperkeratotic hand eczema where abnormal keratin thickening creates a physical barrier to drug absorption. Only an occlusive, anhydrous vehicle can reliably deliver a very potent corticosteroid through this level of thickening.
How Dermovate Works
Clobetasol propionate binds to intracellular glucocorticoid receptors, triggering a cascade of anti-inflammatory, vasoconstrictive, and antiproliferative effects that suppress the immune responses driving eczema, psoriasis, and related conditions. For a full explanation of the mechanism of action, the evidence on potency, and the complete safety and side-effect profile, see our detailed guide: how clobetasol propionate (Dermovate) works.
Cream vs Ointment: Which Should You Use?
The choice between Dermovate cream and Dermovate ointment is driven primarily by the nature of the skin at the affected site — specifically whether it is dry and thickened or moist and inflamed. The table below summarises the key decision factors:
| Factor | Dermovate Ointment | Dermovate Cream |
|---|---|---|
| Skin presentation | Dry, scaly, thickened, lichenified | Moist, weeping, acutely inflamed |
| Base type | Anhydrous (paraffin — no water) | Oil-in-water emulsion (contains water) |
| Occlusion | High — forms physical barrier on skin | Low — absorbs and dries on skin |
| Drug penetration | Enhanced through thickened skin | Adequate for normal or mildly thickened skin |
| Hydration effect | Locks moisture in; prevents TEWL | Light hydration; evaporates over time |
| Preservatives | None required (anhydrous) | Required to prevent microbial growth |
| Feel on skin | Greasy — practical for evening/night use | Light, non-greasy — suitable for daytime |
| Best used for | Lichenified eczema, plaque psoriasis, palmoplantar eczema, lichen simplex, chronic discoid eczema | Acute eczema flares, moist or weeping dermatitis, intertriginous (skin-fold) areas |
| Avoid if | Skin is wet, weeping, or infected | Skin is dry, cracked, or heavily lichenified |
If you are uncertain which formulation is right for your skin, your prescriber will advise. Some patients use both — the cream for acute flares and the ointment for the chronic dry phase of the same condition — but always count both toward the 50 g per week maximum. If your skin has not responded adequately to the cream, switching to the ointment is often the appropriate next step before considering alternative treatments. For a full guide to the cream formulation, see Dermovate cream for eczema.
Step-by-Step Application of Dermovate Ointment
The most common errors with ointment formulations are applying too thick a layer, spreading onto unaffected surrounding skin, and failing to observe the limits on duration and quantity.
1
Wash hands thoroughly before applying
Clean hands prevent transferring bacteria or other contaminants onto already-compromised skin. If you are using an emollient as part of your skin care routine, apply it first and wait at least 30 minutes before applying Dermovate ointment to prevent dilution of the active ingredient.
2
Ensure the skin is clean and dry
Gently cleanse the affected area with a non-soap wash or plain water and pat dry with a soft towel. Do not apply Dermovate ointment to visibly wet, weeping, crusted, or infected skin. If the area appears infected — signs include increasing redness, warmth, swelling, pus, or crusting — contact your prescriber before applying.
3
Apply a thin smear to the affected area only
Squeeze a small amount onto your fingertip — use the fingertip unit (FTU) method described in the next section — and apply a very thin smear to the affected skin only. The warmth of your fingers will soften the ointment slightly and help it spread. Avoid spreading onto surrounding healthy skin. Ointments feel more occlusive than creams, so less genuinely does more: a thin, barely visible layer is correct.
4
Smooth gently in the direction of hair growth
Work the ointment in with gentle strokes in the direction of hair follicles, not against them. This reduces the risk of folliculitis (follicular plugging or infection), which can occasionally occur when greasy preparations are applied against the direction of hair growth.
5
Apply once or twice daily as directed
Follow your prescriber’s instructions. Dermovate ointment is typically prescribed once or twice daily. Once daily in the evening is common practice, as this avoids the cosmetically inconvenient greasy residue during the day and provides prolonged skin contact during sleep. Do not apply more frequently than directed — increasing frequency does not improve outcomes and increases the risk of side effects.
6
Wash hands after application
Wash your hands thoroughly after applying Dermovate ointment, unless your hands are the area being treated. This prevents inadvertent transfer to the face, eyes, or other sensitive areas. Take particular care not to touch your eyes after handling the ointment.
Do not use under occlusive dressings or wraps unless explicitly instructed by a specialist. Covering Dermovate ointment — which already has an inherently occlusive base — with clingfilm, bandages, or waterproof dressings dramatically increases systemic absorption and the risk of adrenal suppression, skin atrophy, and striae.
The Fingertip Unit and Ointment
The fingertip unit (FTU) is a standardised measure for topical preparations that helps patients apply a consistent and appropriate quantity. One FTU is the amount of preparation squeezed from the tip of a tube to the first crease of an adult index finger — approximately 0.5 g. One FTU is enough to cover roughly twice the area of an adult palm (approximately 2% of body surface area).
For ointments, the quantity-to-coverage relationship works the same way as for creams. One practical difference: because ointments feel more occlusive and spread less easily, patients tend to over-apply. The greasy feel can prompt adding more until the skin looks “coated” — this is incorrect. A barely visible, thin smear is the target. The warmth of the fingertip will soften the paraffin base sufficiently to spread one FTU across the correct area with gentle strokes.
Approximate FTU guidance for adult body regions:
| Body Area | Approximate FTUs per Application | Approximate Weight per Application |
|---|---|---|
| One hand (palm and fingers) | 1 FTU | 0.5 g |
| One foot (sole and toes) | 2 FTUs | 1.0 g |
| One forearm | 3 FTUs | 1.5 g |
| Both elbows (localised plaques) | 1 FTU each | 1.0 g total |
| Both knees (localised plaques) | 2 FTUs each | 2.0 g total |
These figures show that for a single small patch the 50 g/week limit is easily observed, but it can be reached quickly when multiple sites or larger areas are being treated. Always count usage across all affected sites and all Dermovate formulations combined.
Lichen Simplex, Plaque Psoriasis, and Discoid Eczema in Detail
Lichen Simplex Chronicus
Lichen simplex chronicus (LSC) is a condition defined by intense, chronic itch in a localised patch of skin, perpetuated by an itch-scratch cycle. The scratching itself causes the skin to thicken, harden, and develop a characteristic coarse, grid-like surface texture — the same lichenification seen in chronic atopic eczema. Common sites include the nape of the neck, the lower legs, the wrists, the ankles, and the anogenital region.
Dermovate ointment is well suited to LSC on appropriate body sites (excluding the face, anogenital area, and skin folds) because the thickened skin necessitates a formulation that can penetrate through the abnormal stratum corneum. The anti-inflammatory and antipruritic effects of clobetasol propionate help break the itch-scratch cycle. Treatment is typically combined with advice on avoiding scratching and, in some cases, occlusive dressings applied under specialist supervision. Response to a short course of Dermovate ointment is usually good, but the underlying itch habit must also be addressed to prevent relapse.
Plaque Psoriasis
Plaque psoriasis causes well-defined, raised patches of skin covered by a silvery-white scale. The epidermal turnover rate is greatly accelerated — up to ten times faster than normal — producing the characteristic thick, layered scale. This thickened epidermis is precisely why the ointment formulation is preferred: cream penetration through psoriatic scale is limited, and the ointment’s occlusive base both softens the scale and enhances drug delivery to the actively inflamed layers beneath.
Dermovate ointment is appropriate for localised plaque psoriasis on the trunk, elbows, knees, and hands or feet (palmoplantar psoriasis). Important restrictions apply:
- Do not apply to the face, scalp (the scalp application formulation exists for this), skin folds (flexures), or genitals — skin at these sites is thinner and more permeable, substantially increasing systemic absorption and the risk of skin atrophy.
- Do not use for widespread plaque psoriasis — the cumulative surface area would lead to excessive systemic absorption and breach the 50 g/week maximum.
- Be aware of the rebound risk: abrupt discontinuation of potent topical steroids in psoriasis can precipitate a rebound flare, or in some cases a transition to more unstable forms of psoriasis (such as pustular psoriasis). Always taper use as directed by your prescriber and do not stop suddenly after prolonged courses.
- NICE CKS and British Association of Dermatologists guidance supports the use of very potent topical corticosteroids for short courses in localised plaque psoriasis as part of a broader management strategy that may include vitamin D analogues, coal tar preparations, and specialist referral for resistant disease.
Discoid Eczema (Nummular Eczema)
Discoid eczema produces distinctive round or oval eczema plaques on the limbs and trunk. The condition often cycles between an acute weeping phase and a chronic dry, crusted, scaly phase. Dermovate ointment is particularly useful for the chronic, dry phase of discoid eczema, when plaques have become thick and do not respond adequately to lighter-potency creams. In the acute weeping phase, the cream formulation is preferable — a greasy ointment applied to a weeping plaque can trap exudate and increase the risk of secondary infection.
Safety, Duration, and Monitoring
50 g
Maximum per week — all Dermovate formulations combined
4 wks
Maximum continuous treatment course without prescriber review
1–2×
Daily applications — do not exceed without advice
Signs of Skin Thinning (Cutaneous Atrophy)
The most common local side effect of prolonged use of potent topical corticosteroids is skin thinning, also called cutaneous atrophy. This manifests as skin that appears visibly thinner, more fragile, or semi-transparent; small, visible blood vessels near the surface (telangiectasia); stretch marks (striae) in areas subject to tension; and a tendency for the skin to bruise or tear easily. Skin atrophy is more likely:
- At sites with naturally thinner skin — face, eyelids, axillae, groin, and anogenital region
- Under occlusion
- With prolonged use beyond the recommended four-week limit
- In elderly patients or young children, whose skin is more susceptible
If you notice any of these changes, stop using Dermovate ointment and contact your prescriber promptly. The skin may partially recover after discontinuation, but striae are generally permanent.
Infected Skin — an Absolute Contraindication
Dermovate ointment must not be applied to skin that is infected. Topical corticosteroids suppress the local immune response and will worsen bacterial, viral, or fungal skin infections. Common infections that can mimic or complicate eczema include bacterial impetigo (Staphylococcus aureus), herpes simplex (eczema herpeticum, which is a medical emergency), and dermatophyte (ringworm/tinea) infections. If you see signs of infection — increasing pain, warmth, swelling, pus, honey-coloured crusting, or fever — stop the ointment and seek medical advice before resuming.
Systemic Effects and HPA Axis Suppression
Although rare with correctly dosed short courses applied to localised areas, systemic absorption of clobetasol propionate can suppress the hypothalamic-pituitary-adrenal (HPA) axis, potentially causing Cushing’s syndrome features (weight gain, central adiposity, moon face, hypertension) or, on withdrawal after prolonged use, secondary adrenal insufficiency. Risk factors include treating large body surface areas, using occlusion, prolonged use beyond four weeks, and use in children. Children are at substantially higher risk of systemic effects per unit area because of their higher surface area-to-body weight ratio; Dermovate ointment is not recommended in children under one year and should be used with particular caution in all paediatric patients.
When to Contact Your Prescriber
- If your skin has not shown meaningful improvement after two to four weeks of correct use
- If you notice signs of skin thinning, telangiectasia, or striae
- If any sign of skin infection develops during treatment
- If you experience any systemic symptoms (unusual weight gain, fatigue, or signs of Cushingoid change)
- Before using Dermovate ointment on any new body site not previously discussed with your prescriber
- If you need to use Dermovate ointment for longer than four weeks or more frequently than prescribed
Get Dermovate Ointment Online via Access Doctor
Access Doctor is a GPhC-registered online pharmacy (registration #9011198). Complete a short, clinically validated consultation and our pharmacist independent prescribers will assess your suitability for Dermovate ointment. If appropriate, your prescription will be issued and dispensed for discreet next-day delivery.
Get Dermovate Ointment Online →Getting Dermovate Ointment Online via Access Doctor
Dermovate ointment is a prescription-only medicine in the UK and cannot legally be supplied without a valid prescription. Access Doctor operates as a fully regulated online pharmacy and prescribing service under GPhC registration #9011198. All prescriptions are issued by GPhC-registered pharmacist independent prescribers following a clinical consultation that assesses the appropriateness of treatment for your individual circumstances.
The process is straightforward: complete the online consultation form detailing your skin condition, its history, and any previous treatments; a prescriber reviews your submission and either issues the prescription or contacts you for further information. If the prescription is approved, your Dermovate ointment is dispensed and despatched the same day (subject to order cut-off times) in discreet packaging with next-day delivery. You can request a specific tube size — Dermovate ointment is available in 30 g and 100 g presentations — and repeat prescriptions can be issued following reassessment.
Prescription Treatment
Dermovate Ointment
Clobetasol propionate 0.05% in an anhydrous paraffin base. For dry, scaly, lichenified, or hyperkeratotic inflammatory skin. Issued following clinical consultation.
View treatment →Prescription Treatment
Dermovate Cream
Clobetasol propionate 0.05% cream. Preferred for moist, weeping, or acutely inflamed eczema presentations. Issued following clinical consultation.
View treatment →Frequently Asked Questions about Dermovate Ointment
What is Dermovate ointment used for?
Dermovate ointment is used to treat severe, resistant inflammatory skin conditions characterised by dryness, scaling, thickening, or lichenification. These include chronic atopic eczema with lichenification, lichen simplex chronicus, plaque psoriasis on the body, discoid (nummular) eczema in its chronic dry phase, and palmoplantar eczema affecting the palms or soles. It is a prescription-only very potent (Class 4) topical corticosteroid and should only be used under medical supervision.
Is Dermovate ointment stronger than the cream?
Both formulations contain the same concentration of clobetasol propionate — 0.05% — so the active ingredient is identical. However, the ointment’s anhydrous, occlusive base increases the proportion of clobetasol propionate absorbed through the skin compared with the cream. In practice this means the ointment can be more effective on thick or lichenified skin, but the same strict dosing limits (50 g per week, maximum four weeks) apply to both formulations.
When should I use Dermovate ointment instead of cream?
Choose the ointment when the affected skin is dry, scaly, thickened, or lichenified — characteristic of chronic eczema, plaque psoriasis, lichen simplex, palmoplantar eczema, or discoid eczema in its dry phase. The cream is better suited to moist, weeping, or acutely inflamed skin presentations. If your skin has not responded adequately to the cream, the ointment is often the next appropriate step. Your prescriber will advise which is best for your specific presentation.
How do I apply Dermovate ointment correctly?
Wash your hands, then ensure the affected skin is clean and dry. Apply a very thin smear to the affected area only using the fingertip unit (FTU) method — one FTU covers roughly twice the area of an adult palm. Smooth gently in the direction of hair growth. Apply once or twice daily as directed by your prescriber. Wash hands thoroughly after. Do not cover with occlusive dressings unless directed by a specialist, and do not exceed 50 g per week in total.
How long can I use Dermovate ointment?
Dermovate ointment should not be used for more than four consecutive weeks. The maximum total amount is 50 g per week across all Dermovate formulations combined. If your condition has not adequately improved after four weeks of correct use, contact your prescriber for a clinical review rather than continuing the treatment independently. Prolonged use without review increases the risk of skin thinning and systemic side effects.
Can I use Dermovate ointment on psoriasis?
Yes. Dermovate ointment is commonly prescribed for localised plaque psoriasis on the trunk, elbows, knees, palms, and soles (palmoplantar psoriasis). It must not be applied to the face, skin folds, or genitals, and is not appropriate for widespread plaque psoriasis due to systemic absorption concerns. Be aware that abrupt discontinuation after a prolonged course carries a risk of rebound flare; always follow your prescriber’s guidance when stopping Dermovate ointment in psoriasis.
Can I use Dermovate ointment under clothing or wraps?
No — unless a specialist has specifically instructed this as part of a supervised treatment plan. Covering Dermovate ointment with occlusive dressings, clingfilm, bandages, or tight-fitting clothing significantly increases the absorption of clobetasol propionate through the skin. Because the ointment base is already occlusive, any additional occlusion has a pronounced amplifying effect on systemic absorption, raising the risk of adrenal suppression and local skin atrophy. Clinician-supervised wet wrap therapy is a different and specialised technique that must not be self-administered.
What are the risks of using Dermovate ointment long-term?
Prolonged or excessive use of Dermovate ointment can cause local skin thinning (cutaneous atrophy), stretch marks (striae), visible surface blood vessels (telangiectasia), and increased susceptibility to skin infections. On a systemic level, suppression of the hypothalamic-pituitary-adrenal (HPA) axis is possible with large-area application, occlusion, or extended duration of use — particularly in children. Using the smallest effective amount for the shortest duration necessary, and ensuring prescriber review before any course exceeds four weeks, minimises these risks.
References
- Electronic Medicines Compendium (EMC). Dermovate Ointment 0.05% Summary of Product Characteristics. https://www.medicines.org.uk/emc/product/1145
- British National Formulary (BNF). Clobetasol propionate. NICE. https://bnf.nice.org.uk/drugs/clobetasol-propionate/
- NICE Clinical Knowledge Summary. Psoriasis. Updated 2023. https://cks.nice.org.uk/topics/psoriasis/
- NICE Clinical Knowledge Summary. Eczema — atopic. Updated 2023. https://cks.nice.org.uk/topics/eczema-atopic/
- NHS. Topical corticosteroids. NHS.uk. https://www.nhs.uk/conditions/topical-corticosteroids/
- DermNet NZ. Lichen simplex chronicus. https://dermnetnz.org/topics/lichen-simplex/
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Dermovate ointment is a prescription-only medicine (POM) in the UK. Do not start, stop, or change your treatment without consulting a qualified healthcare professional. If you experience a medical emergency, call 999 immediately.