Betamethasone Valerate Cream 0.1% 30g for Phimosis

Apply a thin layer of Betamethasone Valerate Cream to the tight band of foreskin twice a day, or as directed by your prescriber, for the length of treatment prescribed.

To apply the phimosis treatment cream:

• Wash your hands before applying treatment

• Wash the penis gently and dry the area first

• Identify the tight ring of skin at the tip of the foreskin

• Apply a small, thin smear of cream directly to this tight band only

• Gently rub the cream in using your fingers until absorbed

• Wash your hands afterwards

Apply the cream to the tight ring only. Do not spread it over the whole penis or deliberately apply it to the glans unless your clinician has specifically told you to do so.

How and when do I do phimosis stretching exercises?

Your prescriber may advise you to gently stretch back your foreskin once the skin has begun to soften, often starting one week into treatment.

Stretching isn’t something everyone needs to do. The British Association of Urological Surgeons (BAUS) specifically cautions against stretching a diseased or scarred foreskin, so do not start stretching unless your prescriber has advised that it is suitable for you (3).

If stretching has been recommended:

• Gently retract the foreskin only as far as is comfortable

• Hold the stretch without forcing the foreskin backwards

• Stretch as often and for as long as your doctor recommends

• Stop if stretching is painful or causes bleeding or tearing

• Never force the foreskin back. Small tears scar when they heal and make the foreskin tighter.

How long does phimosis treatment last?

Betamethasone cream for phimosis is usually prescribed for a maximum of 12 weeks.

Continue using the cream for the full course prescribed by your doctor, even if you notice an improvement sooner. Stopping early may mean the medicine has not had enough time to work fully.

If the foreskin is still very tight at the end of the treatment course, do not continue using the cream, as it can increase the risk of side effects like skin thinning and make the treated skin more vulnerable to infection (1,2). Contact our clinical team instead.

What if Betamethasone cream does not work?

If your foreskin is still too tight to pull back after completing your full treatment course, contact our team for a review. We can assess your phimosis again, try to figure out why treatment didn’t work, and discuss what to do next. Next steps may include (2,3):

• Another short treatment course with Betamethasone cream

• Prescribing antibiotic or antifungal creams if there is an active infection

• Referral for assessment for a surgical treatment such as circumcision

The most common side effects of Betamethasone cream, affecting up to 1 in 10 people, include (1,7):

• Itching where the cream is applied

• Local burning or pain

These effects are usually limited to the application area. If irritation is persistent, getting worse or making treatment difficult to continue, contact us for advice.

Very rare skin reactions have also been reported, such as (1,7):

• Thinning or wrinkling of the skin

• Dry skin

• Stretch marks or changes in skin colour

• Visible small blood vessels

• Redness, rashes or hives

• Skin allergy reactions

• Skin infections

Blurred vision and topical steroid withdrawal reactions have been reported (1). Speak to a doctor if you develop blurred vision or another visual disturbance while using betamethasone.

Many of these side effects are more likely if the cream is used for longer than recommended, which is why you shouldn’t use Betamethasone cream for longer than prescribed by your doctor. Applying too much cream can also make some side effects worse (1).

For a full list of side effects, refer to the Patient Information Leaflet for Betamethasone Cream (7).

When should I stop using the cream and seek advice?

Stop using the steroid cream and contact a clinician if:

• You have signs of an allergic reaction, such as a rash or itching

• The treated area becomes more irritated, painful or infected

• Your symptoms get worse during treatment instead of getting better

If an infection develops or spreads during treatment, you may need treatment for the infection and your steroid cream may need to be stopped (1). Let your prescriber know if this happens.

This page does not list every possible side effect. Read the Patient Information Leaflet for Betamethasone Valerate Cream for the full list of side effects, warnings and precautions (7).

Advisory information

Allergies: Do not use Betamethasone Valerate Cream if you are allergic to Betamethasone Valerate or any of its ingredients. Tell your prescriber if you have previously had an allergic reaction to another steroid cream. An allergic skin reaction can sometimes look like your symptoms are getting worse (1).

Infections: If you develop signs of an infection while using the cream, such as increasing redness, swelling, soreness or discharge, contact a doctor. You may need treatment for the infection and may need to stop using the steroid cream until the infection has cleared up (1).

Other medicines: Tell your prescriber about any medicines you use. Some medicines, including Ritonavir (used to treat HIV) and Itraconazole (used to treat fungal infections), can increase the amount of corticosteroid in your body and may increase the risk of side effects (1).

Ingredients: Betamethasone Valerate 0.1% Cream contains chlorocresol, which can cause allergic reactions, and cetostearyl alcohol, which can cause local skin reactions such as contact dermatitis. Stop using the cream and speak to a doctor if you think you are having a reaction (1).

Fire risk: The cream contains paraffin, which can soak into clothing, bedding and other fabrics and make them catch fire and burn more easily. Do not smoke or go near naked flames while using the cream. Washing fabrics may reduce product build-up but may not remove it completely. (1,7)