Clobetasol, neomycin and nystatin cream/ointment
How does it work?
Clobetasol, neomycin and nystatin cream and ointment used to be marketed under the brand name Dermovate-NN 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 three active ingredients, clobetasol propionate, neomycin sulfate and nystatin.
Clobetasol propionate is a type of medicine called a topical corticosteroid.
Corticosteroids are medicines used for reducing inflammation. Inflammation of the skin happens due to 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 clobetasol is applied to the skin it works by acting inside the skin cells to decrease the release of these inflammatory substances. This reduces swelling, redness and itch.
There is a range of potencies of corticosteroids applied to the skin. Clobetasol propionate is classed as a very potent corticosteroid. It is prescribed to treat severe inflammatory skin disorders such as eczema and psoriasis that have not responded to weaker corticosteroids.
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.
Nystatin is an antifungal medicine that kills fungi and yeasts by interfering with their cell membranes. It works by binding to a substance called ergosterol, which is a component of fungal cell membranes. Binding to ergosterol disrupts the cell membrane and causes holes to appear. The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. As nystatin causes holes to appear in the cell membranes, essential constituents of the fungal cells can leak out. This kills the fungi.
The combination of clobetasol, neomycin and nystatin is used to treat severe 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.
What is it used for?
- This cream and ointment are used in short courses to treat severe inflammatory skin conditions such as eczema, dermatitis or psoriasis that are infected or likely to become infected. This medicine should only be used when other milder topical corticosteroids have not been effective.
How do I use it?
- 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 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 antimicrobials 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. If your doctor thinks a longer course of this medicine is necessary, treatment should not be continued for longer than four weeks without being reviewed by 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.
- This cream and ointment are for external use on the affected areas of skin only.
- You should never use this medicine as a moisturiser.
- Avoid getting the cream or ointment 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 or broken skin, skin folds, or under airtight dressings 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 after the treatment is stopped.
Not to be used in
- Children under two years old.
- Inflammatory skin disorders infected with pseudomonas or proteus species of bacteria.
- Primary bacterial skin infections, such as impetigo.
- Primary fungal skin infections, eg athlete's foot, ringworm, candida skin infections.
- Viral skin infections, such as chickenpox, shingles, cold sores or herpes simplex.
- Acne vulgaris.
- Acne rosacea.
- Inflammatory rash around the mouth (perioral dermatitis).
- Itchy skin around the genitals or back passage.
- Nappy rash.
- Widespread plaque psoriasis.
- Inflammation in the ear canal (otitis externa) if you have a perforated ear drum.
This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine during pregnancy and breastfeeding is not established. It is not recommended for use during pregnancy or breastfeeding. Consult your doctor for further advice.
- This medication is to be spread thinly and sparingly 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.
- Changes in 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 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. It may also cause the skin to become sensitive to the antibiotic. 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.
How can this medicine affect other medicines?
This medicine is not known to affect other medicines. However, as with all medicines, it is important to tell your doctor or pharmacist what medicines you are already using, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before using any new medicines while using this one, to make sure that the combination is safe.
If you are using other topical 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.
If you apply moisturisers shortly before or after applying this medicine these can dilute the corticosteroid and potentially make it less effective. Try to apply your moisturisers at a different time of day, or at least 30 minutes before or after this one.
Other medicines containing the same active ingredients
Clobetasol, neomycin and nystatin cream and ointment used to be marketed under the brand name Dermovate-NN cream and ointment. However, this product has been discontinued and the cream and ointment are now only available generically (ie without a brand name).