Topical Steroid Selection Tool
Find Your Best Topical Steroid Option
Answer a few questions about your skin condition to get personalized recommendations based on current medical guidelines.
Recommended Topical Steroid
Important: Always consult your dermatologist before starting or changing steroid therapy. This tool provides general guidance only.
When you’re dealing with stubborn skin conditions like psoriasis or severe eczema, the choice of a topical steroid can make or break your treatment journey. Tenovate (Clobetasol Propionate) is a super‑potent, prescription‑only corticosteroid that’s often the go‑to for thick plaques and resistant lesions. But it’s not the only player on the market. Below we break down how Tenovate stacks up against other high‑potency options, so you can decide whether it truly is the best fit for your skin.
Key Takeaways
- Clobetasol Propionate is the most potent topical steroid currently approved in the U.S. and EU.
- Alternatives like Betamethasone dipropionate and Halobetasol provide similar strength with slightly different safety profiles.
- Cost, formulation (cream vs. ointment), and specific skin condition dictate which steroid is optimal.
- Long‑term use of any high‑potency steroid carries risks of skin thinning, hypothalamic‑pituitary‑adrenal (HPA) axis suppression, and secondary infections.
- Consult a dermatologist before swapping or combining steroids, especially for facial or intertriginous areas.
How Clobetasol Propionate Works
Clobetasol Propionate belongs to the class of super‑potent (class I) topical corticosteroids. It binds to glucocorticoid receptors in skin cells, reducing inflammation, suppressing immune responses, and narrowing blood vessels. This triple action shrinks redness, scaling, and itching within days.
Its 0.05% concentration is typically delivered as an ointment, cream, or scalp solution. Because it penetrates deeply, it’s effective for thick plaques but also more likely to cause side effects if used improperly.
Decision Criteria When Comparing Steroids
Before diving into alternatives, lay out the factors that matter most to you:
- Potency level - Class I (super‑potent) vs. Class II (potent).
- Formulation - Ointment, cream, lotion, or foam influences absorption and cosmetic feel.
- Indication - Some steroids are better for scalp psoriasis, others for psoriasis on scalp or extremities.
- Safety profile - Risk of skin atrophy, HPA axis suppression, and perioral dermatitis.
- Cost & insurance coverage - Generic options can be dramatically cheaper.
- Availability - Prescription‑only vs. over‑the‑counter (OTC) strength.
Comparison Table: Tenovate and Common Alternatives
| Brand / Generic | Active Ingredient | Potency (US class) | Common Formulations | Typical Indications | Key Side‑Effects | Average Monthly Cost (USD) |
|---|---|---|---|---|---|---|
| Tenovate | Clobetasol Propionate | I (Super‑potent) | Ointment, cream, scalp solution | Psoriasis, lichen planus, severe eczema | Skin thinning, HPA suppression, acneiform eruption | $70-$120 |
| Betnovate Dipropionate | Betamethasone Dipropionate | I (Super‑potent) | Ointment, cream, lotion | Psoriasis, dermatitis, eczema | Similar to clobetasol but slightly lower systemic absorption | $55-$95 |
| Ultravate | Halobetasol Propionate | I (Super‑potent) | Ointment, cream | Psoriasis, severe plaque eczema | Potential for skin atrophy; less HPA impact than clobetasol in short courses | $80-$130 |
| Elocon | Mometasone Furoate | II (Potent) | Cream, lotion, ointment | Atopic dermatitis, psoriasis (moderate) | Lower risk of systemic effects; still can cause skin thinning with prolonged use | $30-$60 |
| Cortizone‑10 | Desonide | III (Mild to moderate) | Cream, lotion | Minor eczema, contact dermatitis | Very low systemic risk; may be insufficient for thick plaques | $15-$35 |
Deep Dive into Each Alternative
Betamethasone Dipropionate
Betamethasone dipropionate is a synthetic glucocorticoid that offers near‑identical potency to clobetasol but usually comes at a lower price point. Its cream formulation feels less greasy than Tenovate ointment, making it a favorite for patients who dislike heavy ointments. Some studies suggest slightly reduced systemic absorption, which could be reassuring for long‑term intermittent use.
However, the trade‑off is a marginally slower onset of action-patients often report visible improvement after 5‑7 days rather than 3‑4 days with clobetasol.
Halobetasol Propionate (Ultravate)
Halobetasol is another class I steroid, approved in 2022 for adult plaque psoriasis. It penetrates the epidermis efficiently and is available as a cream and ointment. Clinical trials show comparable PASI (Psoriasis Area and Severity Index) score reductions to clobetasol within four weeks.
Its side‑effect profile is slightly more favorable for short bursts (≤2 weeks) because it appears to cause less HPA axis suppression, though skin atrophy still remains a concern with prolonged use.
Mometasone Furoate (Elocon)
Mometasone is a class II steroid, meaning it’s potent but not as intense as class I agents. It’s ideal for treating moderately severe eczema, especially on sensitive areas like the face or genital skin where super‑potent steroids risk severe irritation.
Because of its lower potency, it’s often used as a maintenance therapy after an initial “burst” of a stronger steroid such as clobetasol or betamethasone.
Desonide (Cortizone‑10)
Desonide sits in the mild‑to‑moderate range. It’s OTC in many countries and works well for acute flares of contact dermatitis or mild atopic eczema. While it won’t shrink thick psoriasis plaques, it’s a safe option for children and for areas where high potency is contraindicated.
Pros and Cons of Tenovate (Clobetasol Propionate)
Pros:
- Highest FDA‑approved potency for topical use.
- Fastest clinical response-often noticeable within 2‑3 days.
- Multiple formulations cover scalp, body, and intertriginous zones.
Cons:
- Higher cost, especially without insurance coverage.
- Greater risk of skin atrophy, telangiectasia, and systemic cortisol suppression.
- Not recommended for use on the face, neck, or groin for more than a few days.
How to Choose the Right Steroid for Your Situation
Start by categorizing the severity and location of your skin condition:
- Very thick plaques (psoriasis) - Consider a short‑term course of Tenovate or Halobetasol.
- Moderate plaques or areas where irritation is a concern - Betamethasone dipropionate or Mometasone.
- Sensitive skin (face, intertriginous zones) - Switch to Mometasone or Desonide after an initial 1‑2 week burst of a stronger steroid.
- Budget constraints - Generic Betamethasone dipropionate offers similar results at a lower price.
Always discuss tapering schedules with a dermatologist; abrupt discontinuation of a high‑potency steroid can trigger rebound flares.
Frequently Asked Questions
Can I use Tenovate on my face?
No. The skin on the face is thin and absorbs steroids quickly, so using a super‑potent steroid like clobetasol can cause severe atrophy and permanent discoloration. Opt for a lower‑potency option such as mometasone if facial treatment is required.
How long is it safe to stay on Tenovate?
Most dermatologists limit continuous use to 2 weeks, followed by a break of at least 2 weeks. For chronic conditions, a pulse‑therapy approach (e.g., 5 days on, 10 days off) helps minimize side‑effects.
Is there a generic version of Tenovate?
Yes, clobetasol propionate is available as a generic ointment or cream, often at a lower price point. Verify that the concentration (0.05%) matches the brand product.
What are the signs of HPA axis suppression?
Symptoms include persistent fatigue, dizziness, nausea, and low blood pressure. If you notice these while using a high‑potency steroid, contact your doctor for a cortisol test.
Can I combine Tenovate with moisturizers?
Yes. Applying a fragrance‑free moisturizer after the steroid has absorbed (usually 15‑20 minutes) helps restore the skin barrier and reduces irritation.
Bottom Line
If you need the fastest, most powerful punch against severe plaques, Clobetasol Propionate remains the gold standard. But the higher cost and side‑effect risk mean it isn’t always the smartest first‑line choice. Betamethasone dipropionate offers a near‑identical efficacy at a friendlier price, while halobetasol gives a slightly better safety window for short bursts. For moderate disease or sensitive locations, step down to mometasone or desonide.
Ultimately, the best steroid is the one that clears your skin quickly, stays affordable, and doesn’t leave lasting damage. Talk to a dermatologist, weigh the factors above, and you’ll land on the right option for your unique situation.
14 Responses
Clobetasol isn't the gold standard-it's the nuclear option. If you're using it without a dermatologist breathing down your neck, you're not managing your skin, you're playing Russian roulette with your epidermis.
And don't even get me started on the 'gentle alternatives' crowd. Betamethasone doesn't 'feel less greasy'-it just takes longer to fail.
I’ve been thinking a lot about the metaphysics of skin. When we apply steroids, are we healing or merely silencing the body’s protest? The skin remembers. It doesn’t forget the burn, the thinning, the silence after the flare fades.
Maybe what we need isn’t a stronger steroid-but a deeper relationship with our own biology. What if the plaques are messages? Not enemies to crush, but signals to listen to?
Look I’ve been on clobetasol for 18 months and it’s the only thing that works
My dermatologist said 2 weeks max but I’m not dying so I keep going
My skin looks normal now and I’m not gonna stop because some article says I should
Also I use it on my elbows and knees and it’s fine
Y’all are overthinking this
It’s important to emphasize that while clobetasol is effective, the risks are real and documented. Skin atrophy isn’t just a side effect-it’s irreversible damage. Many patients don’t realize they’re developing telangiectasias until it’s too late.
Always pair steroid use with barrier repair moisturizers. Ceramides, niacinamide, and even plain petrolatum can significantly reduce dependency and damage. Small steps matter.
I’m from the Philippines and we use clobetasol like it’s Advil here. No prescription needed at the local sari-sari store. My abuela used it for everything-rashes, bug bites, even her knee pain.
But honestly? I stopped using it after I saw my cousin’s skin turn translucent on her inner thighs. Never again. Now I use coconut oil and prayer. Works better than you think.
Oh wow. A 1200-word essay on how to weaponize your skin with pharmaceutical-grade corticosteroids. How very 2025. You people treat your eczema like it’s a Netflix subscription-you want the premium version with extra side effects.
Let me guess-you also buy ‘natural’ essential oil blends from Instagram influencers who think tea tree oil is a cure-all. Please. Your skin isn’t a spa day. It’s an organ. Treat it like one-or don’t. I’m not your dermatologist.
America’s healthcare system is broken. You need a $300 specialist visit just to get a steroid that should cost $15. Meanwhile, in Russia, they use cheap topical antiseptics and get better results. Why? Because they don’t over-medicalize everything.
Stop paying Big Pharma to sell you fear. Your skin will heal if you stop touching it so much.
Bro clobetasol is fire but u need to be smart
I use it 3x a week max on my scalp
And I wash it off after 4 hours
Also I take turmeric capsules
And drink lemon water
And sleep 8 hrs
And my psoriasis is 90% gone
😂
The real question isn’t which steroid is stronger-it’s why we’ve normalized the idea that our bodies need chemical suppression to function. We don’t treat depression with cocaine because it ‘works fast.’ So why do we treat skin inflammation with clobetasol like it’s a weekend getaway?
Maybe the problem isn’t your skin. Maybe it’s your life. Stress. Diet. Sleep. Trauma. These are the real plaques.
I tried everything. Even that expensive cream with the weird name. Then I just used hydrocortisone from the drugstore and it worked fine. Why pay more? My skin doesn’t care if it’s brand name or generic. It just wants to stop itching.
For those considering alternatives, it’s worth noting that halobetasol’s pharmacokinetic profile demonstrates a 22% lower systemic absorption than clobetasol in Phase IV trials (JAMA Derm 2024). The cream formulation also has a higher occlusive index, which enhances epidermal penetration without increasing dermal toxicity.
For maintenance, consider combining a low-dose calcineurin inhibitor (tacrolimus 0.03%) with intermittent steroid pulses-this reduces flares by 40% over 12 months in real-world cohorts.
i used tenovate for like 3 weeks and my skin got super thin like paper
now i just use vaseline and pray
also i think the article is kinda long
but thanks for the info
I’ve been using betamethasone for my scalp psoriasis for 6 months. It works. Not perfect, but better than nothing. I don’t stress about the side effects. I just use it when I need it. Skin is resilient. We give it too much credit sometimes.
It’s critical to understand that potency does not equal efficacy in the long term. While clobetasol delivers rapid symptom relief, the rebound phenomenon following discontinuation is well-documented in longitudinal studies-often exceeding baseline severity. A pulsed regimen, combined with phototherapy and microbiome-targeted topicals (e.g., Roseomonas mucosa), has shown superior durability in clinical practice. Also, always apply steroids to damp skin; this increases absorption by 30–50% without increasing risk. And yes-moisturize after. Always.