Etrivex Shampoo (Clobetasol Propionate)

Etrivex Shampoo is a prescription-only treatment for scalp psoriasis of moderate intensity in adults. It contains a very strong steroid called clobetasol propionate. In the UK, topical steroids are graded from mild to very potent; clobetasol sits at the very top. This shampoo is designed to work directly on your scalp, reducing the redness, flaking, thickness and itching that make scalp psoriasis so uncomfortable.

Think of it as a targeted treatment – not a regular shampoo you use every day, but a short-course medicine you use exactly as your doctor tells you.

Scalp psoriasis happens when your skin cells are produced much faster than normal, causing them to pile up into red, scaly patches. The immune system in your skin is overactive. Clobetasol propionate calms that overactivity. It enters the skin cells on your scalp and changes how they behave – they stop sending out so many inflammatory signals. The blood vessels narrow, which reduces redness. The itch signals drop. And the excessive skin cell production slows down.

Because this is a very potent steroid, it works quickly – often within a week or two – but that same potency means you must be careful to use it exactly as prescribed.

You apply Etrivex to dry hair and scalp, not wet. Here is the correct method, step by step:

1. Make sure your hair and scalp are completely dry before you start. If you have just washed your hair, wait until it is fully dry.

2. Apply the shampoo directly to your dry scalp once a day. Use the nozzle to apply it to the areas where you have psoriasis.

3. Use the right amount. About half a tablespoon (roughly 7.5 ml) is usually enough to cover the whole scalp. Do not use more – extra shampoo will not work better, but it will increase the risk of side effects.

4. Massage it in gently with your fingertips. Make sure you cover all the affected patches.

5. Leave it on for 15 minutes. This is important – the steroid needs time to absorb into the skin. Do not cover your head with a shower cap, a towel or anything else during this time.

6. Rinse it out thoroughly with water. You can use a small amount of your regular shampoo afterwards if you find that helps.

7. Dry your hair as normal.

8. Wash your hands thoroughly after applying the shampoo, and again after you have finished your routine. This stops you accidentally spreading the steroid to your face or eyes.

If you have used Etrivex exactly as directed for four weeks and there is no improvement at all, you should stop and speak to your doctor. This could mean a few things: the diagnosis might be wrong (it might not be psoriasis at all), or you might need a different type of treatment, such as a vitamin D analogue or a systemic medicine. Do not continue using Etrivex for longer than 4 weeks without a medical review.

Yes – repeated short courses can be used to control flare-ups, provided you are under regular medical supervision. If your scalp psoriasis settles down and then comes back weeks or months later, your doctor can prescribe another 4-week course. However, you should not keep re-using it without seeing your doctor first. Long-term or repeated unsupervised use increases the risk of side effects such as skin thinning and adrenal suppression.

There is limited safety information on using very potent steroid shampoos like Etrivex during pregnancy and breastfeeding. As a result, Etrivex should not be used during pregnancy unless your doctor decides it is clearly necessary. Similarly, it should be avoided while breastfeeding if possible.

If your doctor does prescribe it for you during pregnancy or breastfeeding, they will tell you to use it for the shortest possible time, on the smallest possible area, and – if you are breastfeeding – not to apply it to your breasts or anywhere that could come into contact with your baby's mouth.

Always speak to your doctor or midwife before using Etrivex if you are pregnant, planning to become pregnant, or breastfeeding.

Etrivex contains alcohol (ethanol), which can sometimes affect hair colour, especially if your hair has been bleached, permed, or colour-treated. The manufacturer advises that you should rinse your hair thoroughly after using Etrivex to help avoid any interaction with hair colour dye and prevent unwanted colour changes. If you are planning to dye your hair, it is sensible to finish your course of Etrivex first, or to leave a gap of several washes with a regular shampoo before colouring.

Store Etrivex at room temperature – below 25°C – in a dry place, away from direct sunlight and heat. Keep the bottle out of the sight and reach of children. Do not freeze it. Check the expiry date on the bottle before use and do not use it after that date. Any leftover or expired medicine should be taken to your local pharmacy for safe disposal – do not pour it down the sink or throw it in household waste.