Desonide 0.05% Cream 15gm
It is used to treat skin rashes and other skin irritation.
Drug Class
Topical Corticosteroid
Pharmacologic Class
Corticosteroid, Anti-inflammatory
Pregnancy Category
Category C
FDA Approved
Aug 1978
DEA Schedule
Not Controlled
Overview
What is this medicine?
Desonide cream is a mild corticosteroid medication applied to the skin to reduce redness, swelling, and itching caused by various skin conditions like eczema or dermatitis. It works by calming down the immune response in the skin.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Continue using the medication as directed, even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, as directed by your doctor. Do not take it by mouth.
Avoid getting the medication in your mouth, nose, or eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean the affected area before applying the medication and dry it thoroughly.
Apply a thin layer of the medication to the affected skin and gently rub it in.
Do not cover the treated area with bandages or dressings unless your doctor instructs you to do so.
Unless directed by your doctor, do not apply the medication to your face, underarms, or groin area.
Storage and Disposal
Store the medication at room temperature and do not freeze it.
Keep all medications in a safe place, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of medications, and consider participating in local drug take-back programs.
Missed Dose
If you miss a dose, apply it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
Do not apply two doses at the same time or use extra doses to make up for a missed dose.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Continue using the medication as directed, even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, as directed by your doctor. Do not take it by mouth.
Avoid getting the medication in your mouth, nose, or eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean the affected area before applying the medication and dry it thoroughly.
Apply a thin layer of the medication to the affected skin and gently rub it in.
Do not cover the treated area with bandages or dressings unless your doctor instructs you to do so.
Unless directed by your doctor, do not apply the medication to your face, underarms, or groin area.
Storage and Disposal
Store the medication at room temperature and do not freeze it.
Keep all medications in a safe place, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of medications, and consider participating in local drug take-back programs.
Missed Dose
If you miss a dose, apply it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
Do not apply two doses at the same time or use extra doses to make up for a missed dose.
Lifestyle & Tips
- Apply a thin layer of cream to the affected area as directed by your doctor, usually two to three times a day.
- Wash your hands before and after applying the cream.
- Do not cover the treated area with bandages or dressings unless specifically instructed by your doctor, as this can increase absorption and side effects.
- Avoid applying the cream to your eyes, mouth, or other mucous membranes.
- Do not use this cream for longer than prescribed, especially on the face, groin, or armpits, or in children, as prolonged use can lead to skin thinning or other side effects.
- Inform your doctor if your condition does not improve or worsens after a few days of treatment.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin film to the affected skin areas two to three times daily.
Condition-Specific Dosing:
atopicDermatitis:
Apply a thin film to the affected skin areas two to three times daily.
psoriasis:
Apply a thin film to the affected skin areas two to three times daily.
Pediatric Dosing
Neonatal:
Not established
Infant:
Apply a thin film to the affected skin areas two to three times daily. Use with caution, especially on large surface areas or under occlusion, due to increased risk of systemic absorption.
Child:
Apply a thin film to the affected skin areas two to three times daily. Use with caution, especially on large surface areas or under occlusion, due to increased risk of systemic absorption.
Adolescent:
Apply a thin film to the affected skin areas two to three times daily.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed due to minimal systemic absorption.
Moderate:
No adjustment needed due to minimal systemic absorption.
Severe:
No adjustment needed due to minimal systemic absorption.
Dialysis:
No specific considerations due to minimal systemic absorption.
Hepatic Impairment:
Mild:
No adjustment needed due to minimal systemic absorption.
Moderate:
No adjustment needed due to minimal systemic absorption.
Severe:
No adjustment needed due to minimal systemic absorption.
Pharmacology
Mechanism of Action
Desonide is a low-potency corticosteroid. Corticosteroids exert their anti-inflammatory actions by inducing phospholipase A2 inhibitory proteins, lipocortins. These proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. Corticosteroids also suppress the migration of polymorphonuclear leukocytes and reverse increased capillary permeability.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption (typically <1%) through intact skin; increased with inflammation, skin damage, occlusion, or application to large surface areas.
Tmax:
Not precisely quantified for topical application due to minimal systemic absorption; local effect is rapid.
FoodEffect:
Not applicable for topical formulation.
Distribution:
Vd:
Not precisely quantified for topical application due to minimal systemic absorption.
ProteinBinding:
Systemically absorbed corticosteroids are extensively bound to plasma proteins, primarily corticosteroid-binding globulin and albumin.
CnssPenetration:
Limited (only if significant systemic absorption occurs).
Elimination:
HalfLife:
Not precisely quantified for topical application due to minimal systemic absorption; systemically absorbed corticosteroids have variable half-lives (e.g., 2-4 hours for hydrocortisone).
Clearance:
Not precisely quantified for topical application.
ExcretionRoute:
Primarily renal excretion of metabolites; some biliary excretion.
Unchanged:
Minimal
Pharmacodynamics
OnsetOfAction:
Within hours (local anti-inflammatory effect).
PeakEffect:
Within days of consistent application.
DurationOfAction:
Varies, typically requires twice or thrice daily application for sustained effect.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Skin irritation
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Changes in eyesight, eye pain, or severe eye irritation
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:
Burning or stinging
Dry skin
* Signs of a common cold
This is not an exhaustive list of all possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Skin irritation
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Changes in eyesight, eye pain, or severe eye irritation
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:
Burning or stinging
Dry skin
* Signs of a common cold
This is not an exhaustive list of all possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Increased redness, itching, or irritation at the application site
- Signs of skin infection (e.g., pus, spreading redness, fever)
- Skin thinning, easy bruising, or stretch marks (striae) in the treated area
- Acne-like breakouts
- Excessive hair growth in the treated area
- Changes in skin color (lightening or darkening)
- If used extensively or for prolonged periods, watch for signs of systemic effects like unusual fatigue, weight gain, or swelling (rare with desonide).
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
The presence of an infection at the site where this medication will be applied.
* Any areas of thinning skin where you plan to apply this medication.
This list is not exhaustive, and it is crucial to discuss all your medications (including prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine whether it is safe to take this medication in conjunction with your other treatments and health issues. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
The presence of an infection at the site where this medication will be applied.
* Any areas of thinning skin where you plan to apply this medication.
This list is not exhaustive, and it is crucial to discuss all your medications (including prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine whether it is safe to take this medication in conjunction with your other treatments and health issues. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Before using any other medications or skin products, such as soaps, consult with your doctor to ensure safe use.
When applying this medication, avoid using tight-fitting diapers or plastic pants if the treated area is in the diaper region, as this can increase the amount of medication absorbed into the body. Do not apply this medication to cuts, scrapes, or damaged skin. If you need to use this medication on a large area of skin, exercise caution and discuss this with your doctor.
Use this medication only for the duration prescribed by your doctor. Do not exceed the recommended treatment period. Be aware that this medication may increase the risk of developing cataracts or glaucoma, so it is crucial to discuss this with your doctor.
If the patient is a child, use this medication with caution, as the risk of certain side effects may be higher in children. In some cases, this medication can affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor to discuss this potential risk.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor, as you will need to discuss the benefits and risks of using this medication to both you and your baby. If you are breastfeeding and apply this medication to your breast or nipple, be sure to wash the area thoroughly before breastfeeding your child.
When applying this medication, avoid using tight-fitting diapers or plastic pants if the treated area is in the diaper region, as this can increase the amount of medication absorbed into the body. Do not apply this medication to cuts, scrapes, or damaged skin. If you need to use this medication on a large area of skin, exercise caution and discuss this with your doctor.
Use this medication only for the duration prescribed by your doctor. Do not exceed the recommended treatment period. Be aware that this medication may increase the risk of developing cataracts or glaucoma, so it is crucial to discuss this with your doctor.
If the patient is a child, use this medication with caution, as the risk of certain side effects may be higher in children. In some cases, this medication can affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor to discuss this potential risk.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor, as you will need to discuss the benefits and risks of using this medication to both you and your baby. If you are breastfeeding and apply this medication to your breast or nipple, be sure to wash the area thoroughly before breastfeeding your child.
Overdose Information
Overdose Symptoms:
- Prolonged or excessive use of topical corticosteroids can lead to systemic effects, including suppression of the hypothalamic-pituitary-adrenal (HPA) axis, Cushing's syndrome, hyperglycemia, and glucosuria. These are rare with desonide due to its low potency and minimal systemic absorption, but risk increases with large surface area application, prolonged use, occlusion, or in pediatric patients.
- Local symptoms may include severe skin irritation, burning, or worsening of skin condition.
What to Do:
Discontinue the medication gradually under medical supervision. Symptomatic and supportive treatment. For accidental ingestion, call a poison control center immediately (1-800-222-1222 in the US).
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify any contraindications (e.g., active infection).
Timing: Prior to initiation of therapy.
Routine Monitoring
Clinical response (reduction in inflammation, pruritus)
Frequency: Regularly, at follow-up visits (e.g., weekly to bi-weekly initially, then as needed).
Target: Improvement in symptoms and appearance of affected skin.
Action Threshold: Lack of improvement or worsening of symptoms may indicate need for re-evaluation, change in therapy, or diagnosis of underlying infection.
Local adverse effects (skin atrophy, striae, telangiectasias, folliculitis, perioral dermatitis, hypertrichosis)
Frequency: At each follow-up visit, especially with prolonged use or on sensitive skin areas.
Target: Absence of or minimal adverse effects.
Action Threshold: Presence of significant adverse effects warrants reduction in frequency, discontinuation, or change to a lower potency steroid.
Signs of HPA axis suppression (rare with desonide, but possible with extensive/prolonged use, especially in children or with occlusion)
Frequency: Consider if large body surface area is treated, prolonged use, or in pediatric patients. May involve plasma cortisol levels or ACTH stimulation test.
Target: Normal HPA axis function.
Action Threshold: Evidence of HPA axis suppression requires gradual withdrawal of the steroid or reduction in potency/frequency.
Symptom Monitoring
- Burning
- Itching
- Irritation
- Dryness
- Folliculitis
- Hypertrichosis
- Acneiform eruptions
- Hypopigmentation
- Perioral dermatitis
- Allergic contact dermatitis
- Maceration of the skin
- Secondary infection
- Skin atrophy
- Striae
- Miliaria
Special Patient Groups
Pregnancy
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Desonide is classified as Pregnancy Category C. Animal studies have shown teratogenic effects with corticosteroids.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenic effects, though systemic absorption from topical use is minimal.
Second Trimester:
Generally considered safer than first trimester, but still use with caution.
Third Trimester:
No specific risks identified beyond general corticosteroid effects; however, avoid extensive use.
Lactation
Caution should be exercised when desonide is administered to a nursing woman. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Avoid applying to the breast area to prevent infant ingestion.
Infant Risk:
L3 (Moderate risk) - Due to potential for systemic absorption and excretion into breast milk, though unlikely with proper topical use. Monitor infant for adverse effects.
Pediatric Use
Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature patients because of a larger skin surface area to body weight ratio. Use the least potent corticosteroid for the shortest duration possible. Avoid occlusion. Monitor for growth retardation and delayed weight gain.
Geriatric Use
No overall differences in safety or effectiveness have been observed between elderly and younger patients. However, elderly patients may have thinner skin, which could potentially increase the risk of local adverse effects like skin atrophy.
Clinical Information
Clinical Pearls
- Desonide is a low-potency topical corticosteroid, making it suitable for use on sensitive areas (face, groin, axillae) and in pediatric patients, but still requires careful monitoring.
- Always apply a thin layer; more cream does not mean better results and can increase the risk of side effects.
- Educate patients on the importance of not using the cream for longer than prescribed, especially on the face, to prevent skin thinning and other local side effects.
- If no improvement is seen after 2-4 weeks, re-evaluate the diagnosis or treatment plan.
- Avoid abrupt discontinuation after prolonged use on large areas, as this can lead to rebound flares of the skin condition.
Alternative Therapies
- Hydrocortisone (lower potency topical corticosteroid)
- Triamcinolone acetonide (medium potency topical corticosteroid)
- Fluocinolone acetonide (medium potency topical corticosteroid)
- Pimecrolimus cream (non-steroidal calcineurin inhibitor)
- Tacrolimus ointment (non-steroidal calcineurin inhibitor)
- Crisaborole ointment (non-steroidal phosphodiesterase-4 inhibitor)
Cost & Coverage
Average Cost:
$15 - $40 per 15gm tube
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (for generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.