Steroid Scalp Lotions Compared: Betacap, Betnovate, Elocon and Dermovate
How the UK's steroid scalp applications compare on strength, ingredients and use, Betacap vs Betnovate Scalp, how to apply them, how long to use them, and the alternatives.
Part of our scalp psoriasis health guides.
Key fact: A potent steroid scalp application once a day for up to 4 weeks is NICE's first treatment for scalp psoriasis in adults. Betacap and Betnovate Scalp contain the same steroid at the same strength; Dermovate Scalp is very potent and kept for when potent steroids haven't worked.
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See scalp psoriasis treatments →What is a steroid scalp lotion?
A steroid scalp lotion (also called a scalp application or scalp solution) is a topical corticosteroid in a thin liquid, made to reach the skin through hair. You apply a few drops to the patches and leave it on. It reduces inflammation, which eases itching, redness and scale.
In the UK, topical steroids are grouped by strength as mild, moderate, potent or very potent. Scalp lotions for psoriasis are potent or very potent, so they're prescription-only.
Steroid scalp lotions compared
| Medicine | Steroid | Strength | Good to know | Price from |
|---|---|---|---|---|
| Betacap Scalp Application 0.1% | Betamethasone valerate | Potent | NICE first step; licensed for scalp psoriasis and seborrhoeic dermatitis; contains a coconut-derived emollient | £12.99 |
| Betnovate Scalp Application 0.1% | Betamethasone valerate | Potent | Same steroid and strength as Betacap, in a different liquid; licensed for steroid-responsive scalp conditions | £18.99 |
| Elocon Scalp Lotion 0.1% | Mometasone furoate | Potent | Once a day; licensed for scalp psoriasis and seborrhoeic dermatitis | £19.99 |
| Dermovate Scalp Application 0.05% | Clobetasol propionate | Very potent | Adults only; short courses; through our service, only if it's been prescribed for you before | £16.99 |
| Etrivex Shampoo | Clobetasol propionate 0.05% | Very potent | A shampoo, left on for 15 minutes; adults only; needs a diagnosis | £24.99 |
| Diprosalic Scalp Application | Betamethasone dipropionate with salicylic acid | Potent | Also lifts scale; not yet available through our online service | — |
| Bettamousse | Betamethasone valerate foam | Potent | A foam rather than a liquid; not yet available through our online service | — |
Prices are the starting prices on our product pages. All of these are prescription-only, and a pharmacist prescriber decides which suits you. Through our service you can order up to 3 bottles of Betacap, Betnovate Scalp, Elocon or Dermovate Scalp at a time. Alcohol-based scalp applications, including Betacap and Betnovate Scalp, are flammable: keep them away from flames and cigarettes, and don't use a hairdryer until your scalp is dry.
Betacap vs Betnovate Scalp
Betacap and Betnovate Scalp Application both contain betamethasone valerate 0.1%, a potent steroid, so they work in the same way and at the same strength. The differences are in the liquid they're made in, the bottle and the price:
- Same steroid, same strength: neither is stronger than the other
- Different bases: both are alcohol-based, but Betacap also contains a coconut-derived emollient (macrogolglycerol cocoates) to reduce the drying effect of the alcohol
- Both are flammable: keep them away from flames and cigarettes, and don't use a hairdryer on the treated scalp
- Price: Betacap has the lower starting price on our site
Both product licences say to apply them night and morning until the scalp improves, then less often; NICE frames the first course as once a day for up to 4 weeks. Follow the instructions your prescriber gives you. If one has worked well for you before, it's usually sensible to stay with it. Read more in our Betacap guide and Betnovate Scalp Application guide.
Elocon scalp lotion (mometasone)
Elocon Scalp Lotion contains mometasone furoate 0.1%, another potent steroid, used once a day. It's licensed for scalp psoriasis and seborrhoeic dermatitis of the scalp. It's an alternative if a betamethasone product hasn't suited you.
Dermovate Scalp and clobetasol
Dermovate Scalp Application contains clobetasol propionate 0.05%, a very potent steroid and the strongest type of steroid scalp lotion. NICE keeps very potent steroids for adults whose scalp psoriasis hasn't responded to the earlier steps, as a short course (up to twice a day for 2 weeks). Etrivex shampoo contains the same steroid in a shampoo that's rinsed off after 15 minutes.
Through our service, Dermovate Scalp is supplied only to adults who've been prescribed it before, and Etrivex only to adults whose scalp psoriasis a doctor has diagnosed.
How to apply a steroid scalp lotion
1
Start with a clean scalp
If the scale is thick, soften and wash it out first so the lotion reaches the skin (see our guide to removing scale).
2
Part your hair
Part your hair over each patch so you can apply the lotion to the skin, not the hair.
3
Apply a few drops
Put a small amount onto the patches and gently massage it in. You don't need to cover the whole scalp.
4
Leave it on
Don't wash it out. Let it dry naturally, and keep flammable lotions away from flames and hairdryers.
5
Wash your hands
Keep it away from your eyes and face, and wash your hands afterwards.
Use it as often as your prescriber and the leaflet say. NICE advises once a day for a potent steroid on the scalp.
How long can you use one?
4 weeks
First course of a potent scalp steroid, then review (NICE)
8 weeks
Longest continuous use of a potent steroid (NICE)
4 weeks
Longest continuous use of a very potent steroid (NICE)
NICE also suggests aiming for a break of about 4 weeks between courses. If your scalp hasn't improved after 4 weeks, the next step is a different form of steroid, descaling first, or Dovobet gel, rather than simply carrying on. If you've used a steroid for a while, don't stop suddenly without advice, because psoriasis can flare back.
Alternatives, including calcipotriol scalp solution
- Dovobet gel: calcipotriol (a vitamin D analogue) with betamethasone, once a day for up to 4 weeks on the scalp. See our Dovobet gel guide
- Calcipotriol scalp solution: vitamin D without a steroid. NICE suggests a vitamin D treatment alone for mild to moderate scalp psoriasis in people who can't use a steroid on the scalp. Not yet available through our online service
- Coal tar: shampoos and ointments such as Psoriderm and Cocois. See our psoriasis shampoo guide
- Specialist treatment: light therapy, tablets or injections, if topical treatments don't work
For every option side by side, see our scalp treatment options guide.
Side effects and who shouldn't use them
Used as directed for short courses, steroid scalp lotions are usually well tolerated. Possible side effects include stinging or burning when you apply them, inflamed hair follicles (folliculitis) and, with long or heavy use, thinning of the skin and, rarely, effects on the body's own steroid hormones. Hair loss is uncommon or very rare (see our guide to scalp psoriasis and hair loss). See a doctor if your vision becomes blurred.
Don't use a steroid scalp lotion on skin that's infected, weeping or has cold sores, or on your face or eyelids unless a prescriber has told you to. Through our service, steroid scalp treatments are for adults 18 and over, and we don't supply them in pregnancy or while breastfeeding.
Report any side effects through the MHRA Yellow Card scheme.
Frequently asked questions
Is Betacap the same as Betnovate scalp application?
They contain the same steroid, betamethasone valerate, at the same strength (0.1%), so they work in the same way. They're made in slightly different alcohol-based liquids: Betacap also contains a coconut-derived emollient to make it less drying. Both are flammable. Betacap has the lower starting price on our site.
Which is stronger, Betacap or Dermovate scalp?
Dermovate Scalp Application is stronger. It contains clobetasol propionate, a very potent steroid, while Betacap contains betamethasone valerate, a potent steroid. NICE uses a potent steroid first and keeps very potent steroids for adults whose scalp psoriasis hasn't responded, as short courses.
What is the strongest steroid scalp lotion in the UK?
Clobetasol propionate 0.05%, found in Dermovate Scalp Application and Etrivex shampoo, is the strongest. It's a very potent steroid, used by adults only, for short courses.
Can I use a steroid scalp lotion every day?
Yes, for a set course. NICE advises a potent steroid on the scalp once a day for up to 4 weeks, then a review. Potent steroids shouldn't be used continuously for more than 8 weeks, or very potent steroids for more than 4 weeks, and a break of about 4 weeks between courses is advised.
Do I wash out a steroid scalp lotion?
No. Steroid scalp lotions and applications are leave-on treatments: apply a few drops to the patches and let them dry. Etrivex is different, because it's a shampoo that's rinsed off after 15 minutes.
Can I use a hair dryer after a steroid scalp lotion?
Not if the lotion is alcohol-based. Betacap and Betnovate Scalp are both flammable, and their product information says to let the scalp dry naturally and keep away from flames and heat, including a hairdryer. Check the leaflet for your product.
What is an alternative to calcipotriol scalp solution?
Dovobet gel contains calcipotriol with a steroid and is licensed for scalp psoriasis in adults, used once a day for up to 4 weeks. Steroid scalp lotions and coal tar are other options. Which suits you depends on what you've tried and whether you can use a steroid.
Do I need a prescription for a steroid scalp lotion?
Yes. Steroid scalp lotions for psoriasis are potent or very potent, so they're prescription-only. You can get one from your GP or online after a consultation with a pharmacist prescriber.
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Start Scalp Psoriasis Consultation →References
- NICE. Psoriasis: assessment and management (CG153), recommendations 1.3.1 and 1.3.4 (scalp psoriasis). nice.org.uk/guidance/cg153
- Betacap Scalp Application: summary of product characteristics. medicines.org.uk/emc
- Betnovate Scalp Application: summary of product characteristics. medicines.org.uk/emc
- Etrivex 500 micrograms/g Shampoo: summary of product characteristics. medicines.org.uk/emc
- Dovobet 50 microgram/g + 0.5 mg/g gel: summary of product characteristics. medicines.org.uk/emc
- NICE Clinical Knowledge Summaries. Psoriasis. cks.nice.org.uk/topics/psoriasis
- MHRA Yellow Card scheme. yellowcard.mhra.gov.uk
Medical disclaimer: This page is for information only and isn't a substitute for medical advice. Steroid scalp treatments, Etrivex and Dovobet are prescription-only, so a clinical consultation is needed before they can be supplied. Always follow your prescriber's advice and the leaflet. In a medical emergency, call 999.