Ultravate narrows the blood vessels in the skin to prevent the overactive immune response that causes inflammation, while also reducing inflammation. With the use of Ultravate, a protein called lipocortin is released to block the production of chemicals that are responsible for the inflammatory response that causes red and itchy skin.

Halobetasol is known as a strong medication characterized as a Class I topical corticosteroid. This means that small doses of this medication are able to produce strong effects. 

It comes in ointment, lotion, cream, and foam to apply to the skin.

What Is Ultravate Used For?

The Food and Drug Administration (FDA) approved Ultravate to treat plaque psoriasis in people 18 years and older. However, it is also used for other conditions such as eczema (atopic dermatitis) and skin rashes. 

Brand Name(s): Ultravate

Drug Availability: Prescription

Therapeutic Classification: Corticosteroid 

Available Generically: Yes 

Controlled Substance: N/A

Administration Route: Topical 

Active Ingredient: Halobetasol propionate

Dosage Form(s): Lotion, cream

Plaque psoriasis is a is characterized by inflamed and scaly patches on the skin. Although the cause of plaque psoriasis is not fully known, it is believed to be due to your immune system mistakenly attacking healthy cells. Frequent cell damage can cause new skin cells to grow faster than normal, forming thick and scaly patches.

Unfortunately, plaque psoriasis is not curable. However, medications such as Ultravate can help manage your symptoms and slow the growth of skin cells.

How to Use Ultravate

It is important to know that Ultravate is a strong topical medication. Always use this medication as directed by your healthcare provider. Do not use it on any open wounds or damaged areas of the skin. Also, do not share this medication with other people.

Ultravate comes in 0.01% (lotion) and 0.05% (foam, lotion) doses. It is typically applied as a thin layer to affected areas once or twice daily for up to two weeks. If you are pregnant or breastfeeding, you may need to take extra caution when using this medication. Corticosteroids are generally safe in pregnancy at low doses but may have certain risks that should be discussed with your healthcare provider.

Wash your hands before and after using Ultravate. Unless your healthcare provider advises you, do not apply it on the face, scalp, underarms, or crotch area.

Storage

Store Ultravate at room temperature (around 77 degrees Fahrenheit) in a dry place. Short excursions in temperatures ranging from 59 to 86 degrees are permitted.

Do not store Ultravate in the bathroom or kitchen. Containers should be closed tightly and kept away from direct sunlight. Keep this medication in a safe place out of the reach of children and pets. 

Off-Label Uses

There are instances in which Ultravate may be prescribed for reasons other than what has been approved by the FDA. However, there are currently no recommended off-label uses of this medication. 

What Are the Side Effects of Ultravate?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effects of Ultravate are application site reactions like small, visible blood vessels, thinning of the skin (atrophy), and headache.

Other side effects not mentioned here may occur. Contact your healthcare provider for any further advice or concerns about side effects. 

Severe Side Effects

Life-threatening side effects from Ultravate are rare. However, some symptoms are severe and should not be taken lightly. Seek medical help right away if you experience:

Signs of high blood sugar, such as hunger, increased thirst, or fatigue Weight gain in the upper back, belly, or face (similar to Cushing’s syndrome)  Changes in eyesight, such as blurred vision or general pain (It is extremely important to avoid contact with the eyes. ) Thinning of the skin  Dizziness  Mood changes  Extreme upset stomach 

Although rare, call your healthcare provider right away if you experience any of these serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. 

Long-Term Side Effects

Long-term use of Ultravate should only be at the approval of your healthcare provider. High doses or long-term use of this medication can lead to side effects such as thinning skin, bruising, or discoloration. Proper and routine follow-up as recommended by your healthcare provider is important to monitor any unwanted side effects and ensure the medication is working.

Dosage: How Much Ultravate Should I Use?

Modifications

Due to the possible effects of this medication, there may be changes to how it is used.

If you experience a serious side effect, you or your provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For topical dosage forms (cream or ointment): For redness, itching, and swelling of the skin: Adults and children 12 years of age and older—Apply to the affected area of the skin 1 or 2 times a day. Children younger than 12 years of age—Use is not recommended. For topical dosage form (foam or lotion): For plaque psoriasis: Adults and children 12 years of age and older—Apply to the affected area of the skin 2 times a day for up to 2 weeks. Children younger than 12 years of age—Use is not recommended.

Adults Age 65 and Older

As you get older, your skin changes. Corticosteroids should be used carefully and appropriately in older adults. Use of Ultravate must be under the recommendation and supervision of your healthcare provider. 

Children

The absorption of corticosteroids can be increased in young children, which may increase the potential for unwanted side effects. Please use as directed by your healthcare provider and always express any concerns that you may have. 

Pregnancy

Corticosteroid use is typically safe in pregnancy. Always use as directed by your healthcare provider, especially regarding where and how often to apply the medication. 

Breastfeeding

Generally, corticosteroid use is safe for breastfeeding people. However, it is recommended to avoid application to the nipple area until you are no longer breastfeeding.

Missed Dose

If you miss a dose of Ultravate, apply it to the skin as soon as you think about it. If it is almost time for your next dose, skip the missed dose and continue your recommended schedule. Do not apply extra doses or multiple doses at the same time.  

Overdose: What Happens If I Use Too Much Ultravate?

Systemic absorption (absorption throughout the body) of halobetasol can occur if too much Ultravate is applied to the skin.

Overdosing on Ultravate can lead to systemic absorption with adverse effects such as:

Bruising and thinning of the skin (atrophy)Weight gainIncreased acneCushing’s syndromeHypothalamic-pituitary-adrenal (HPA) suppressionHyperglycemia (high blood sugar)

Always take as directed by your healthcare provider. If you experience any of these symptoms or may have used too much Ultravate. Contact your provider or go to the emergency room.

Precautions

What Are Reasons I Shouldn’t Use Ultravate?

Ultravate may not be the right medication for you.

If someone collapses or isn’t breathing after using Ultravate, call 911 immediately.

If your or your child’s symptoms do not improve within a few days or weeks, or if they become worse, check with your doctor.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. The risk is greater for children and patients who use large amounts for a long time. Talk to your doctor right away if you or your child have blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness.

Halobetasol lotion may cause serious skin reactions, which may occur if you cover the treated skin area or use the medicine for a long time. Check with your doctor right away if you or your child have thinning of the skin with easy bruising, reddish purple lines on the arms, face, legs, trunk, or groin areas, acne or pimples, darkening or lightening of skin color, blistering, burning, crusting, dryness, flaking of the skin, or itching, scaling, severe redness, soreness, or swelling of the skin.

Check with your doctor right away if you or your child have a skin rash, burning, stinging, swelling, or irritation on the skin.

Check with your doctor right away if blurred vision, difficulty with reading, or any other change in vision occurs during or after treatment. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor).

Do not use cosmetics or other skin care products on the treated areas.

You should not use Ultravate if: 

You have hypersensitivity to its ingredients (allergic reaction): Signs of an allergic reaction include hives, fever, and swelling.   You have had an allergic reaction to other corticosteroids: Although an allergic reaction to one corticosteroid may not guarantee a reaction to another, there is the possibility of it occurring. It is important to tell your healthcare provider about your medication allergies so they can find the best options for you.

What Other Medications Interact With Ultravate?

There is the potential that the use of other medications with Ultravate can have adverse treatment outcomes.

For example, corticosteroids should not be used with Proleukin (aldesleukin), an anticancer medication. When used together, Ultravate can prevent this medication from working correctly.

What Medications Are Similar?

Other commonly used topical corticosteroids are listed below. These medications are strong topical medications just like Ultravate:

Diprolene (augmented betamethasone dipropionate) Temovate (clobetasol propionate) Vanos (fluocinonide)

This is a list of drugs that are similar to Ultravate. It is not necessarily a list of alternative drugs for plaque psoriasis. It is not recommended to take these medications with Ultravate. Discuss any questions with your healthcare provider.

How Can I Stay Healthy While Taking Ultravate?

As a chronic condition, plaque psoriasis can be both physically and emotionally taxing to live with. Symptoms can be uncomfortable and topical steroids are a common treatment choice for managing symptoms. Often, your healthcare provider will determine the right therapeutic option for you based on your individual needs.

It is important to avoid applying to the skin more often than needed or directed.

Follow your healthcare provider’s instructions carefully when using topical corticosteroids like Ultravate. While effective, these treatments can sometimes cause unwanted side effects if used more than prescribed.

You can also try to track psoriatic disease flares over time to help identify any triggers. Triggers can include specific medication use, infections, injury to the skin, and stress. In addition to your prescribed treatments, you can also try lifestyle changes and home remedies to help relieve symptom discomfort.

The author would like to recognize and thank Faith Awoniyi for contributing to this article.