Betamethasone and neomycin cream and ointment used to be marketed under the brand name Betnovate N cream and ointment. However, this product has been discontinued and the cream and ointment are now only available generically (ie without a brand name). Both contain two active ingredients, betamethasone valerate and neomycin.
Betamethasone valerate is a type of medicine called a topical corticosteroid.
Corticosteroids are medicines used for reducing inflammation. Inflammation of the skin happens as a result of allergy or irritation of the skin, and is caused by the release of various substances that are important in the immune system. These substances cause blood vessels to widen and result in the irritated area becoming red, swollen, itchy and painful, such as is seen in dermatitis or eczema.
When betamethasone is applied to the skin it works by acting inside the cells to decrease the release of these inflammatory substances. This reduces swelling, redness and itch. Betamethasone is a potent corticosteroid.
Neomycin is an antibiotic of the aminoglycoside type and is used to treat infections with bacteria. It works by affecting the bacteria's production of certain proteins that are necessary for their survival. It causes the bacteria to produce abnormal and faulty proteins. This ultimately kills the bacteria. Neomycin is included in this preparation to treat the bacteria that sometimes infect inflammatory skin diseases.
The combination of betamethasone and neomycin is used to treat inflammatory skin disorders that are either already infected, or your doctor thinks are likely to become infected, for example because you are using airtight dressings. Dressings can create a warm, moist environment where bacteria and fungi can grow easily.
The cream is more suitable for moist, weeping areas of skin, while the thicker, more greasy ointment is more suitable for dry, scaly areas of skin.
This cream and ointment are used in short courses to treat inflammatory skin conditions such as those listed below, when milder corticosteroids have not been effective and when the condition is either already infected or likely to become infected.
- Eczema of various types.
- Skin inflammation due to allergies or irritants (allergic contact dermatitis or irritant contact dermatitis).
- Inflammatory skin condition with greasy, red and scaly areas (seborrhoeic dermatitis).
- Thickened skin rash caused by excessive scratching to relieve itching (neurodermatitis, eg lichen simplex).
- An eruption of hard nodules in the skin accompanied by intense itching (prurigo nodularis).
- Skin disorder causing a flat, itchy, violet rash, usually on the wrists, shins, lower back and genitals (lichen planus).
- Inflammatory skin disease known as discoid lupus erythematosus (DLE).
- Intense and widespread reddening of the skin (generalised erythroderma) in combination with oral or injected corticosteroids.
- Reactions to insect bites and stings.
- The cream or ointment should be applied thinly to the affected areas of skin once or twice a day, as directed by your doctor. Click here to see how much cream or ointment to use.
- If your doctor has advised you to use dressings with this medicine, the skin should be cleansed before applying the cream or ointment under a fresh dressing.
- Wash your hands thoroughly after applying this medicine, unless the hands are the area being treated.
- As this medicine also contains an antimicrobial it should not normally be used for longer than a week, as longer term use may increase the chances of micro-organisms becoming resistant to the medicine. If the infection does not seem to be clearing up within a few days of using this medicine you should consult your doctor.
- Don't use this medicine more often or for longer than advised by your doctor.
- You should not dilute this medicine with moisturisers or any other products. If you are using other medicines or moisturisers on the same area of skin it is recommended that you leave at least 30 minutes between applying each product. This is to allow each product time to be absorbed and avoid them mixing on the skin.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Skin irritation, eg redness, rash, itching or burning on application, or allergic inflammation of the skin (contact dermatitis). Stop using this medicine and consult your doctor if you think you have experienced a reaction or your skin condition appears to be getting worse.
- Spreading and worsening of infection. Tell your doctor if you think the infection is getting worse.
- Thinning of the skin.
- Reduced skin pigmentation.
- Stretch marks (striae).
- Groupings of fine blood vessels becoming prominent under the skin (telangiectasia).
- Excessive hair growth (hypertrichosis).
- Prolonged use of this medicine on extensive areas of skin, broken or raw skin, skin folds or underneath airtight dressings may on very rare occasions result in enough corticosteroid being absorbed to have side effects on other parts of the body, for example a decrease in the production of natural hormones by the adrenal glands, or symptoms of Cushing's syndrome - see warning section above.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
- This medicine is for external use on the affected areas of skin only.
- You should never use this medicine as a moisturiser.
- Avoid getting this medicine in the eyes, or inside the mouth or nose. Rinse with cold water if accidental contact occurs.
- If corticosteroids are used long term, on large areas of skin, raw skin, skin folds, or under airtight dressings (including nappies) they are absorbed into the body more. This increases the risk of local side effects such as skin thinning, and those on other parts of the body, such as a decrease in the production of natural hormones by the adrenal glands. For this reason, continuous, long-term use of this medicine should be avoided wherever possible, particularly in children and on large areas of skin. You should only use airtight dressings over the affected area if instructed by your doctor.
- Do not use this medicine for longer than instructed by your doctor, or for recurrent infections without consulting your doctor, as this may cause the skin to become over-sensitive or allergic to the medicine.
- If this medicine is used on the face, wherever possible it should not be used for longer than five days. You should not use airtight dressings to cover the area treated.
- If used in children, wherever possible this medicine should not be used for longer than five days, or on the face. You should not use airtight dressings to cover the area treated. Be aware that children's nappies can also act as an airtight dressing and can increase the absorption of the medicine. Children being treated with this medicine should be reviewed by the doctor at least once a week.
Use with caution in:
- Children (see above).
- Elderly people.
- Decreased kidney function.
- Psoriasis. If you have been prescribed this medicine to treat psoriasis you should have regular check-ups with your doctor. This is because although corticosteroids may be useful for psoriasis in the short-term, they can sometimes make psoriasis worse, and may cause the condition to relapse into generalised pustular psoriasis
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