The potential for hypothalamic-pituitary adrenal (HPA) suppression was evaluated in a study of 20 adult subjects with moderate to severe plaque psoriasis. A mean dose of grams halobetasol lotion was applied twice daily for two weeks and produced HPA axis suppression in 5 of 20 (25%) patients. In this study, the criteria for HPA-axis suppression was a serum cortisol level of less than or equal to 18 micrograms per deciliter 30 minutes after stimulation with cosyntropin (adrenocorticotropic hormone). These effects were reversible as recovery of HPA axis function was generally prompt with the discontinuation of treatment [see Warnings and Precautions ()].
Apply a thin layer of halobetasol propionate cream to the affected skin once or twice daily, as directed by your physician, and rub in gently and completely. Halobetasol propionate cream is a super-high potency topical corticosteroid; therefore, treatment should be limited to two weeks, and amounts greater than 50 g/wk should not be used. As with other corticosteroids, therapy should be discontinued when control is achieved. If no improvement is seen within two weeks, reassessment of diagnosis may be necessary. Halobetasol propionate cream should not be used with occlusive dressings.