Enstilar Foam: How to Use It, How Long to Leave It On and Side Effects
A practical guide to Enstilar cutaneous foam: application, limits, long-term use, strength and side effects.
Part of our psoriasis guide.
Get urgent help first. Call 999 or go to A&E if your skin suddenly becomes red and inflamed over most of your body, or you have widespread pus-filled spots, especially with a fever, chills or feeling very unwell. These can be signs of erythrodermic or generalised pustular psoriasis, which are emergencies. See a GP soon if you have painful, swollen joints. Online treatment isn't suitable in these situations.
Key fact: Enstilar combines calcipotriol (vitamin D) and betamethasone (a potent steroid). It's sprayed on once a day for up to 4 weeks and left on, with no more than 15g a day on no more than 30% of the body.
Adults only online, and not in pregnancy or breastfeeding. Access Doctor's online psoriasis service is for adults aged 18 and over, and can't supply treatment if you're pregnant or breastfeeding: your GP or midwife can help. Children with psoriasis should see their GP.
What is Enstilar foam?
Enstilar is a cutaneous foam that contains two medicines: calcipotriol (50 micrograms per gram), a form of vitamin D that slows down skin cell growth (see our calcipotriol guide), and betamethasone dipropionate (0.5 mg per gram), a potent steroid that calms inflammation. It's licensed for plaque psoriasis (psoriasis vulgaris) in adults. It comes as a 60g spray can and is prescription-only.
Enstilar contains the same two medicines as Dovobet gel, but as a foam that sprays on and spreads easily over larger areas. The foam form helps the medicines soak into the skin.
How to use Enstilar foam
1
Shake the can
Shake for a few seconds before each use.
2
Spray from about 3cm away
Hold the can at least 3cm from the skin and spray directly onto the plaques. The can can be held in any position except on its side. For the scalp or hard-to-reach areas, spray into your hand first, then apply.
3
Rub in gently
Spread the foam over the plaque and a little beyond the edge.
4
Wash your hands
Unless you're treating your hands, wash them afterwards so you don't spread it to your face or eyes.
5
Once a day
Use it once a day, at the same time each day, for up to 4 weeks.
Flammable: the foam contains flammable propellants. Don't use it near a naked flame or while smoking, and keep the can away from heat.
How long to leave Enstilar on
Leave it on: Enstilar is not washed off. Apply it after a bath or shower, when the skin is dry, and let it soak in. If you're using it on the scalp, wait until the next day to wash your hair, and avoid showering or bathing straight after applying it so the medicines have time to work.
How much to use, and for how long
| Rule | Limit (from the product information) |
|---|---|
| How often | Once a day |
| Course length | Up to 4 weeks |
| Maximum a day | 15g (one 60g can lasts at least 4 days at the maximum) |
| Maximum area | No more than 30% of your body |
| Long-term use | Twice a week on two non-consecutive days, after a 4-week course that worked |
| Where not to use it | Not on the face, genitals or skin folds; avoid the eyes |
Can you use Enstilar long term?
Yes, in a specific way. If psoriasis has cleared after 4 weeks of daily use, the product information allows long-term maintenance twice a week, on two days that aren't next to each other (for example Monday and Thursday), with 2 to 3 days without treatment in between. This is applied to areas that have had psoriasis before, to help stop it coming back. If psoriasis flares again, go back to once-daily use for up to 4 weeks, then review with a prescriber.
Is Enstilar a strong steroid?
The steroid in Enstilar, betamethasone dipropionate, is a potent steroid: the third of the four UK strengths (mild, moderate, potent, very potent). It's stronger than hydrocortisone and Eumovate, and weaker than Dermovate. That's why Enstilar isn't used on the face or skin folds and has a maximum daily dose. The calcipotriol in it isn't a steroid. See our steroid cream strengths guide.
Enstilar vs Dovobet gel
| Enstilar foam | Dovobet gel | |
|---|---|---|
| Medicines | Calcipotriol + betamethasone dipropionate | The same, at the same strengths |
| Form | Spray foam | Gel |
| Licensed for | Plaque psoriasis on the body and scalp, in adults | Scalp psoriasis, and mild to moderate plaque psoriasis on the body, in adults |
| Best for | Larger areas of body psoriasis; easy to spread | The scalp and smaller areas |
| Course length (licence) | Up to 4 weeks | Up to 4 weeks on the scalp; up to 8 weeks on the body |
| Long-term maintenance | Twice a week, licensed | Not licensed for twice-weekly use |
Our Dovobet gel guide covers how to use Dovobet, especially on the scalp.
Side effects
- Common: itching or irritation where it's applied.
- Less common: burning, rash, worsening psoriasis, skin infection, changes in skin colour.
- With long or heavy use (the steroid): skin thinning, stretch marks, visible small blood vessels and, rarely, effects on the body's own steroid hormones.
- With too much (the calcipotriol): raised calcium levels in the blood, which is why the 15g daily limit matters.
- After stopping: psoriasis can flare. Tell a prescriber if it comes back worse than before.
Who shouldn't use Enstilar
- People under 18
- Anyone pregnant or breastfeeding (not supplied by our online service)
- Erythrodermic or pustular psoriasis
- Skin infections, ulcers or wounds in the treated area
- People with kidney or liver problems, or calcium disorders, without specialist advice
Diagnosed with plaque psoriasis?
Our GPhC-registered pharmacist independent prescribers can assess you online and, if suitable, prescribe Enstilar foam. Adults 18 and over. Dispensed from our UK pharmacy. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose.
Start Psoriasis Consultation →How our online service supplies psoriasis treatment: adults 18 and over, not for the face, genitals or skin folds. Enstilar, Dovobet and other psoriasis-only treatments need psoriasis already diagnosed by a GP or dermatologist. Enstilar and Dovobet: one pack per order, supplied as a course of up to 4 weeks, on no more than 30% of the body. Betnovate and Elocon: up to 3 × 30g or 1 × 100g, for a 4-week course followed by a 4-week break. Dermovate only if you have been prescribed it before. Widespread psoriasis, joint pain or psoriasis that hasn't responded to treatment is referred to your GP.
UK safety and reporting side effects
Prescription psoriasis treatments are only supplied after a GPhC-registered pharmacist independent prescriber reviews your consultation, including where your psoriasis is, how much skin it covers and what you have used before. Always read the patient information leaflet. Since 2024, UK steroid packs show their strength on the front (mild, moderate, strong or very strong). The MHRA advises using topical steroids for the shortest time needed, and to tell a healthcare professional if your skin flares badly after you stop a steroid you have used for a long time, which can be a topical steroid withdrawal reaction.
If you think you've had a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme.
Enstilar and other psoriasis treatments from Access Doctor
Following an online consultation, our prescribers can supply Enstilar where suitable, as part of our psoriasis treatment service.
Vitamin D + potent steroid · Rx
Enstilar Foam
Calcipotriol with betamethasone in a spray foam, once a day for up to 4 weeks. For diagnosed plaque psoriasis.
View product →Vitamin D + potent steroid · Rx
Dovobet Gel
Calcipotriol with betamethasone, for the scalp and for mild to moderate plaque psoriasis on the body.
View product →Frequently Asked Questions
How long do you leave Enstilar foam on?
Leave it on: Enstilar isn't washed off. Apply it to dry skin and let it soak in. If you use it on your scalp, wait until the next day to wash your hair.
Can you use Enstilar long term?
Yes, but only in a set way. After a 4-week daily course that has cleared your psoriasis, it can be used twice a week on two non-consecutive days to help stop psoriasis coming back. If psoriasis flares, go back to daily use for up to 4 weeks.
Is Enstilar a strong steroid?
Enstilar contains betamethasone dipropionate, a potent steroid, the third of the four UK strengths. It's weaker than Dermovate but stronger than hydrocortisone, so it isn't used on the face or skin folds.
Can Enstilar get rid of psoriasis?
It can clear plaques in many people within 4 weeks, but it doesn't cure psoriasis, which can return. Twice-weekly maintenance and daily emollients help keep it away for longer.
How long does a can of Enstilar last?
It depends on how much skin you treat. At the maximum of 15g a day, a 60g can lasts at least 4 days; treating a few small plaques, it can last the whole 4-week course.
Can I use Enstilar on my face?
No. The product information says not to use it on the face or genitals, because the skin there is thin and sensitive to steroids, and calcipotriol can irritate it.
References
- Enstilar 50 micrograms/g + 0.5 mg/g cutaneous foam: summary of product characteristics. medicines.org.uk
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
- Joint Formulary Committee. British National Formulary: psoriasis (treatment summary). bnf.nice.org.uk
- MHRA. Topical corticosteroids: information on the risk of topical steroid withdrawal reactions. Drug Safety Update, September 2021. gov.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Prescription psoriasis treatments need a clinical consultation before they can be supplied. If your skin is red all over, you have widespread pus spots, a fever or you feel unwell, seek medical advice the same day. In a medical emergency, call 999.