Temovate (Clobetasol) vs Alternatives: What Works Best for Skin Conditions

Temovate (clobetasol propionate) is one of the strongest topical corticosteroids available by prescription. It’s often prescribed for stubborn skin conditions like severe eczema, psoriasis, and lichen planus. But it’s not the only option-and for many people, it’s not the best long-term choice. If you’ve been using Temovate and are wondering if there’s something safer, cheaper, or just as effective, you’re not alone.

What Temovate Actually Does

Temovate contains clobetasol propionate, a Class I corticosteroid-the strongest category approved for topical use in the UK and US. It works by suppressing the immune response in the skin, reducing redness, swelling, itching, and scaling. For some, it’s a miracle worker: flare-ups clear up in days. But that power comes with risks.

Using Temovate for more than two weeks straight can thin your skin, cause stretch marks, or even lead to adrenal suppression. It’s not meant for the face, groin, or armpits unless a doctor specifically says so. And it won’t fix the root cause of your skin condition-it just puts out the fire.

Why People Look for Alternatives

Many patients switch from Temovate because:

• They’ve used it too long and their skin got worse
• They’re tired of the side effects-burning, stinging, or visible thinning
• They need something for daily use, not just emergencies
• They’re pregnant, breastfeeding, or treating a child
• They can’t afford it or it’s not covered by their insurance

It’s not about avoiding steroids altogether. It’s about using the right tool for the job-and knowing when to step down.

Top Alternatives to Temovate

There are several options that work well depending on your condition, skin type, and how long you need treatment. Here are the most common alternatives, ranked by strength and use case.

1. Betamethasone Valerate (Diprosone)

Betamethasone valerate is a Class II steroid-slightly weaker than clobetasol but still potent. It’s often used for moderate to severe psoriasis and eczema. Many dermatologists prefer it for long-term maintenance because it’s less likely to cause skin atrophy than Temovate. It comes in cream, ointment, and scalp solution forms, making it versatile.

2. Mometasone Furoate (Elocon)

Mometasone is a Class II steroid with a strong safety profile. It’s approved for use in children as young as two and is often recommended for facial eczema. Unlike Temovate, it doesn’t typically cause visible skin thinning even with daily use over several weeks. It’s also less irritating, which makes it a good choice for sensitive skin.

3. Hydrocortisone Butyrate (Locoid)

This is a Class III steroid-noticeably milder than Temovate but still effective for many cases of mild-to-moderate eczema. It’s often prescribed as a step-down option after initial control with stronger steroids. Locoid is less likely to cause rebound flares when discontinued, making it a smart choice for chronic conditions.

4. Calcineurin Inhibitors (Tacrolimus, Pimecrolimus)

These aren’t steroids at all. Tacrolimus (Protopic) and pimecrolimus (Elidel) work by blocking the immune cells that trigger inflammation. They’re FDA and NICE-approved for atopic dermatitis and are especially useful on the face and neck where steroid use is risky.

They don’t cause skin thinning, but they can cause a temporary burning sensation when first applied. Studies show they’re as effective as mid-strength steroids for maintenance. Many patients use them daily after a steroid course to prevent relapse.

5. Crisaborole (Eucrisa)

Crisaborole is a non-steroidal, PDE4 inhibitor approved for mild-to-moderate eczema in adults and children over two. It’s a topical ointment applied twice daily. Unlike steroids, it doesn’t suppress the immune system broadly-it targets a specific inflammation pathway. Side effects are minimal: mild stinging in a small percentage of users.

It’s more expensive than most steroids, but it’s safe for long-term use and doesn’t carry the same risks. It’s becoming a go-to for parents of kids with chronic eczema.

6. Coal Tar and Emollient-Based Treatments

For psoriasis, coal tar (in shampoos, creams, or baths) has been used for over a century. It slows skin cell growth and reduces scaling. While it smells strong and can stain clothes, it’s safe for long-term use and works well alongside other treatments.

Emollients (moisturisers) like Cetraben, E45, or Aqueous Cream aren’t treatments on their own-but they’re essential. Dry skin worsens eczema and psoriasis. Using a thick emollient twice daily can cut flare-ups by up to 40%, according to the British Association of Dermatologists.

Comparison Table: Temovate vs Key Alternatives

When to Use Each Option

There’s no one-size-fits-all. Your choice depends on your condition, skin area, and treatment goals.

• For sudden, severe flare-ups: Temovate or betamethasone for 7-14 days, then step down.
• For face or folds (armpits, groin): Mometasone, tacrolimus, or crisaborole.
• For children: Mometasone, crisaborole, or emollients. Avoid Temovate unless absolutely necessary.
• For maintenance after flare-up: Tacrolimus or crisaborole 2-3 times a week.
• For psoriasis plaques: Coal tar + emollient + occasional steroid pulse therapy.

Many dermatologists use a ‘stepping ladder’ approach: start strong, then reduce strength and frequency over time. This prevents dependency and minimises side effects.

What Doesn’t Work

Some people try OTC hydrocortisone 1% for severe eczema or psoriasis. It’s too weak. Others use natural oils like coconut or tea tree oil. These might soothe dry skin but won’t reduce inflammation like a prescription treatment. And never mix steroids with other topical treatments without checking with your doctor-some combinations can irritate or reduce effectiveness.

What to Do If Temovate Stops Working

If you’ve been using Temovate for weeks and your skin isn’t improving-or it’s getting worse-you might be dealing with:

• Topical steroid withdrawal (red burning skin after stopping)
• Resistance (rare, but possible with long-term misuse)
• An underlying infection (like fungal or bacterial)

Stop using it and see your GP or dermatologist. They may switch you to a non-steroidal option or prescribe an oral medication like methotrexate or ciclosporin for severe cases.

Final Thoughts

Temovate is powerful, but it’s not the endgame. It’s a tool for short-term control, not lifelong management. The best outcomes come from combining the right medication with good skincare habits: moisturising daily, avoiding triggers (like harsh soaps or stress), and knowing when to switch to safer long-term options.

Don’t be afraid to ask your doctor about alternatives. There’s no shame in needing something gentler-or more sustainable. Your skin will thank you.