Steroid Creams for Psoriasis: Betnovate, Elocon, Dermovate and How Long to Use Them
How steroid creams and ointments are used for psoriasis, which strength suits which area, and how to avoid 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: potent steroids such as Betnovate and Elocon are the usual choice for psoriasis on the body. NICE's first step uses them for up to 4 weeks, with a break of about 4 weeks between courses, and they aren't used on the face or skin folds.
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.
Why steroids are used for psoriasis
Topical steroids reduce the inflammation that makes psoriasis plaques red, thick and itchy. They work quickly, often within 1 to 2 weeks, and they're part of the first step NICE recommends for plaque psoriasis, alongside a vitamin D treatment. Used correctly, at the right strength, on the right area and for a set time, they're safe and effective.
Which strength for psoriasis?
| UK strength | Examples | Used for psoriasis on |
|---|---|---|
| Mild | Hydrocortisone 1% | Face and skin folds, short courses |
| Moderate | Clobetasone butyrate (Eumovate) | Face, ears and skin folds, short courses |
| Potent | Betamethasone valerate (Betnovate), mometasone (Elocon) | Body, arms, legs and scalp: the usual choice |
| Very potent | Clobetasol propionate (Dermovate) | Thick, stubborn plaques, hands, feet and scalp, short courses, usually with specialist advice |
Since 2024, UK steroid packs show the strength on the front as mild, moderate, strong or very strong. Our steroid cream strengths guide explains the potency ladder in full, and our guide to the best cream for psoriasis in the UK compares steroids with over-the-counter creams.
Betnovate for psoriasis
Betnovate (betamethasone valerate 0.1%) is a potent steroid licensed for psoriasis, except widespread plaque psoriasis, as well as eczema and other inflamed skin conditions. For body plaques it's usually applied once a day for up to 4 weeks. The ointment suits thick, dry, scaly plaques; the cream suits areas you don't want greasy. Our Betnovate uses guide covers it in more detail.
Elocon for psoriasis
Elocon (mometasone furoate 0.1%) is a potent steroid licensed for psoriasis, except widespread plaque psoriasis, and atopic eczema. It's applied once a day, which many people find easier. See our Elocon guide.
Dermovate for psoriasis
Dermovate (clobetasol propionate 0.05%) is the strongest topical steroid. It's licensed for psoriasis (except widespread plaque psoriasis), but the BNF advises that very potent steroids should be used for psoriasis only under specialist supervision, apart from short courses on the scalp. It's used for thick plaques, the palms and soles, and stubborn scalp psoriasis, for short courses of no more than 50g a week. Our online service supplies it only if you've been prescribed it before. See how Dermovate works.
How to use a steroid for psoriasis
1
Apply once a day
Most potent steroids are applied once a day. Use them on the plaques only, not the surrounding skin.
2
Use the right amount
One fingertip unit (a line squeezed from the tip of an adult finger to the first crease) covers an area about the size of two adult palms.
3
4
Keep using emollients
Apply emollients separately, ideally 30 minutes before or after the steroid.
5
Stop after the course
A first course is usually up to 4 weeks. NICE advises aiming for a 4-week break before another course of a potent or very potent steroid.
How long to use a steroid for psoriasis, and breaks
NICE's first step for body plaques uses a potent steroid for up to 4 weeks, alongside vitamin D. NICE also sets a safety ceiling: don't use a potent steroid continuously on the same area for more than 8 weeks, or a very potent steroid for more than 4 weeks, and aim for a 4-week break between courses.
Access Doctor service rule: we supply Betnovate and Elocon for psoriasis as a 4-week course, followed by a 4-week break, and review before another course. This is our service criterion, set within NICE guidance.
Very potent steroids are used for shorter courses. Breaks lower the risk of skin thinning and other side effects. During the break, a vitamin D treatment such as calcipotriol or coal tar can keep the psoriasis under control.
Where not to use a potent steroid: the face, genitals, skin folds (armpits, groin, under the breasts) and broken or infected skin. These areas need a mild or moderate steroid for no more than 2 weeks. See psoriasis on the face and inverse psoriasis.
Side effects and rebound
- Skin thinning, stretch marks and easy bruising with long or heavy use, especially on thin skin.
- Visible small blood vessels and changes in skin colour.
- Rebound flare: psoriasis can come back worse when a strong steroid is stopped suddenly, or turn into a more unstable form. This is one reason steroids are combined with vitamin D and used in planned courses.
- Topical steroid withdrawal: rarely, after long-term use, the skin becomes red, burning and sore when the steroid is stopped. Tell a prescriber if this happens.
- Absorption into the body: very rare with sensible use, but possible with large amounts of very potent steroids over large areas.
Need a steroid for psoriasis on your body?
Our GPhC-registered pharmacist independent prescribers can assess your psoriasis online and, if suitable, prescribe Betnovate, Elocon or another treatment. 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.
Steroids for psoriasis from Access Doctor
Following an online consultation, our prescribers can supply the steroids below where suitable, as part of our psoriasis treatment service.
Potent steroid · Rx
Betnovate Cream
Betamethasone 0.1%. A 4-week course for body plaques, then a 4-week break.
View product →Potent steroid · Rx
Betnovate Ointment
The greasier form, better for thick, dry or scaly plaques.
View product →Potent steroid · Rx
Elocon Cream
Mometasone 0.1%, applied once a day.
View product →Potent steroid · Rx
Elocon Ointment
Once-daily mometasone in an ointment base, for dry, thick plaques.
View product →Very potent steroid · Rx
Dermovate Cream
Clobetasol 0.05%, only if you have been prescribed it before for psoriasis.
View product →Very potent steroid · Rx
Dermovate Ointment
Clobetasol in an ointment base, only if previously prescribed.
View product →Frequently Asked Questions
Is Betnovate good for psoriasis?
Yes. Betnovate is a potent steroid licensed for psoriasis, except widespread plaque psoriasis. It's used once a day for up to 4 weeks on body plaques, usually alongside a vitamin D treatment, then stopped for a break of about 4 weeks.
Is Elocon good for psoriasis?
Yes. Elocon (mometasone) is a potent steroid licensed for psoriasis and atopic eczema. It's applied once a day, which makes it easy to use, and follows the same 4-week course and 4-week break.
Can I use Dermovate for psoriasis?
Dermovate is licensed for psoriasis but is very potent, so it's used only for short courses on thick, stubborn plaques, the palms and soles or the scalp, usually with specialist advice. Our online service supplies it only if you've been prescribed it before.
What is the strongest steroid cream for psoriasis?
Clobetasol propionate (Dermovate) is the strongest, rated very potent. Most psoriasis on the body is treated with a potent steroid such as Betnovate or Elocon, and the strongest steroid is kept for short courses on stubborn areas.
Why do I need a break from steroid creams?
NICE advises aiming for a 4-week break between courses of potent steroids, and not using one continuously on the same area for more than 8 weeks. Breaks lower the risk of skin thinning, rebound flares and other side effects. A vitamin D treatment or coal tar can be used during the break.
Can I use a steroid cream on psoriasis on my face?
Only a mild or moderate steroid, such as hydrocortisone or Eumovate, for no more than 2 weeks, on a prescriber's advice. Potent steroids like Betnovate and Elocon aren't used on the face.
References
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
- Joint Formulary Committee. British National Formulary: psoriasis (treatment summary). bnf.nice.org.uk
- Joint Formulary Committee. British National Formulary: topical corticosteroids. bnf.nice.org.uk
- MHRA. Topical steroids: introduction of new labelling and a reminder of the possibility of severe side effects, including topical steroid withdrawal reactions. Drug Safety Update, May 2024. gov.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.