Betamethasone Valerate 0.1% Ointment 30g for Phimosis

Use Betamethasone ointment for phimosis exactly as your doctor prescribed. Usually, you will need to apply it directly to the tight band on the foreskin twice daily.

Unless your prescriber has given you different instructions:

• Wash your hands and gently clean and dry the penis

• Identify the tight ring of foreskin at the opening of the penis

• Apply a thin smear of ointment directly to this tight band only

• Gently smooth the ointment into the skin

• Wash your hands after applying the ointment

Do not spread the phimosis treatment ointment over the head of the penis or the shaft. Only a small amount is needed to specifically cover the tighter area of skin.

The ointment is greasy and may mark your underwear, so allow time for it to absorb properly before getting dressed. Do not cover the treated area with gauze or a dressing to protect your underwear unless your clinician has specifically advised you to. Covering Betamethasone ointment can increase absorption of the steroid and may increase the risk of side effects (1).

How and when do I do phimosis stretching exercises?

Phimosis stretching may be introduced after the ointment has started to soften the skin, often around one week into treatment. Your clinician will tell you whether it's suitable and when you should start.

Phimosis stretching exercises should not hurt. The idea is to gently move the foreskin back until you feel a mild stretch, without causing pain. Hold the stretch briefly and repeat for a few minutes. Always return the foreskin to cover the head of the penis once finished.

A few things to remember:

• Only stretch if your clinician has told you to. Stretching may be suitable for a tight but otherwise healthy foreskin, but scarred or diseased foreskin should not be stretched (3).

• Never force the foreskin backwards. Stop stretching if you experience pain, bleeding or tearing, as damage to the skin can cause further scarring (3).

• A foreskin that becomes trapped behind the head of the penis is a medical emergency. This is called paraphimosis. If you cannot pull the foreskin forwards, go to A&E (3,4).

How long does phimosis treatment last?

A course of Betamethasone ointment for phimosis is typically prescribed for a maximum of 12 weeks. You should complete the full course, even if you notice improvements sooner.

Do not use Betamethasone for longer than prescribed or decide to self-treat indefinitely without speaking to your clinician. Genital skin absorbs topical corticosteroids easily, and prolonged use of prescription-strength steroids increases the risk of local side effects like skin thinning (1,8).

What should I do if Betamethasone ointment does not work?

Contact our clinical team if your foreskin is still tight after completing the prescribed course of phimosis treatment ointment.

We can reassess the cause and severity of the phimosis, investigate why treatment was unsuccessful, and discuss what to do next. Depending on your circumstances, further treatment or referral for a surgical option such as circumcision may be suggested (2-4).

Betamethasone Valerate 0.1% ointment can cause side effects, but they are less likely when you apply a small amount to the intended area for a short, prescribed course.

The most common side effects, affecting up to 1 in 10 people, are itching, burning or painful sensations at the application site. Other skin reactions are very rare, affecting fewer than 1 in 10,000 people. These include (1,8):

• Allergic skin reactions or contact dermatitis

• Redness, rash or hives

• Skin thinning or wrinkling

• Stretch marks

• Changes in skin colour

• Skin infection

• Worsening of symptoms

This page does not list every possible side effect. For a full list of side effects, refer to the Patient Information Leaflet for Betamethasone Ointment (8).

When should I stop using Betamethasone ointment and seek advice?

Stop using the steroid ointment for phimosis and speak to your doctor if (1,8):

• The treated skin becomes increasingly irritated, or your symptoms get worse

• You develop a rash or other signs of an allergic reaction

• You develop signs of an infection (redness, swelling, soreness or discharge)

Long-term use of topical steroids can cause a withdrawal reaction after treatment is stopped, which can cause redness, burning or stinging, itching, peeling or oozing skin. It’s more likely after prolonged use, which is another reason not to take Betamethasone ointment longer than prescribed (1).

Blurred vision has also been reported with topical corticosteroids. Speak to a doctor if you develop blurred vision or another change in your vision while using Betamethasone (1).

Advisory information

Fire risk: The ointment contains a paraffin base, which can transfer to underwear or bedding and make these fabrics highly flammable. You can reduce paraffin build-up by washing fabrics, but some residue can remain. Do not smoke or go near naked flames while using the ointment (1,8).

Allergic reactions: Do not use Betamethasone Valerate Ointment if you are allergic to Betamethasone Valerate, liquid paraffin or white soft paraffin. Tell your prescriber if you have previously reacted to another topical corticosteroid (1).

Infections: Betamethasone Ointment should not be used while you have a skin infection. If you develop signs of an infection after starting the treatment course, the steroid may need to be stopped while the infection is treated (1). Talk to your doctor for advice if this happens.

Other medicines: Medicines that inhibit CYP3A4, including Ritonavir and Itraconazole, can increase exposure to corticosteroids and may increase the risk of side effects (1). Tell your prescriber about any other medicines you take or use so they can make sure there are no interactions.