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Halobetasol cream is a medication used in the management and treatment of psoriasis. It is in the topical corticosteroid class of drugs. This activity outlines the indications, action, and contraindications for halobetasol as a valuable agent in managing psoriasis (and other disorders when applicable). This activity will highlight the mechanism of action, adverse event profile, and other key factors pertinent to interprofessional team members in the care of patients with psoriasis and related conditions. Objectives: Review the mechanism of action of halobetasol cream. Describe the possible adverse effects of halobetasol cream. Outline the appropriate indications for using halobetasol cream. Explain some interprofessional team strategies for improving care coordination and communication to advance halobetasol cream and improve outcomes. Access free multiple choice questions on this topic.

Topical corticosteroids, including halobetasol cream, are commonly prescribed by dermatologists for the treatment and management of many inflammatory and pruritic conditions of the skin. They provide rapid relief to patients for a plethora of conditions, and therefore, prescriptions for these agents are very common. However, proper counseling by the physician and pharmacist is not always adequately provided to the patient. Misuse of steroids can lead to clinically serious systemic and/or local effects.[10] It is crucial to give patients the correct dosage form when prescribing topical corticosteroids. Solutions, foams, gels, lotions, creams, and ointments all have appropriate clinical applications. The proper frequency, amount, and duration of treatment should also be emphasized to patients to avoid overtreating an area, leading to adverse effects, or undertreating an area, leading to poor therapeutic outcomes.[10] Intertriginous regions should not have treatment with ointments, for example, and very rarely should a topical steroid be applied to a particular area more than twice a day.[6] Additionally, glucocorticoid potency is an essential pharmacologic factor to take into account. Sometimes it is better to prescribe a more potent steroid to provide rapid control of the disease and stop treatment quickly, rather than use a less potent steroid for an extended period, especially in cases of self-limited conditions such as acute irritant dermatitis, panderous dermatitis, etc.[10] However, in other situations, using a less potent formulation (such as halobetasol 0.01% lotion) can offer the same results as a more potent formulation (halobetasol 0.05% cream), in which case the less potent option should be the choice to decrease the possibility of overtreatment and adverse drug effects.[11] Generally, the least potent steroid should be used for the shortest time while still maintaining therapeutic effectiveness.[1]

Additionally, glucocorticoid potency is an essential pharmacologic factor to take into account. Sometimes it is better to prescribe a more potent steroid to provide rapid control of the disease and stop treatment quickly, rather than use a less potent steroid for an extended period, especially in cases of self-limited conditions such as acute irritant dermatitis, panderous dermatitis, etc.[10] However, in other situations, using a less potent formulation (such as halobetasol 0.01% lotion) can offer the same results as a more potent formulation (halobetasol 0.05% cream), in which case the less potent option should be the choice to decrease the possibility of overtreatment and adverse drug effects.[11] Generally, the least potent steroid should be used for the shortest time while still maintaining therapeutic effectiveness.[1] Additionally, patients may have concerns about prescribed topical steroids that lead to nonadherence due to fear of harming themselves. This factor leads to a significant proportion of patients that do not receive adequate treatment. Therefore, patient education is also important to dispel fears and false notions and ensure the safe use of topical corticosteroids.[6] Nursing and pharmacy can both offer patient counsel on proper administration and alert the patient of specific signs of toxicity to watch for so they can inform their prescriber promptly. The pharmacist should also check for potential interactions, verify that dosing is appropriate, and notify the prescriber of any concerns. These are but a few examples of interprofessional teamwork that can improve patient outcomes and minimize adverse events. Therapy with halobetasol requires an interprofessional team approach, including physicians, specialty-trained nurses, and pharmacists, collaborating across disciplines to achieve optimal patient outcomes. [Level 5]