Desowen 0.05% Cream 60gm
It is used to treat skin rashes and other skin irritation.
Drug Class
Topical Corticosteroid
Pharmacologic Class
Corticosteroid, Low Potency
Pregnancy Category
Category C
FDA Approved
Aug 1978
DEA Schedule
Not Controlled
Overview
What is this medicine?
Desonide cream is a mild topical steroid medication used to reduce redness, itching, and swelling caused by various skin conditions like eczema and 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.
Keep the medication away from your mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the area being treated.
Clean the affected area before applying the medication and make sure it is dry.
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.
Avoid applying the medication to your face, underarms, or groin area unless your doctor specifically tells you to do so.
Storage and Disposal
Store this 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.
Keep the medication away from your mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the area being treated.
Clean the affected area before applying the medication and make sure it is dry.
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.
Avoid applying the medication to your face, underarms, or groin area unless your doctor specifically tells you to do so.
Storage and Disposal
Store this 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 skin area as directed by your doctor, usually two or three times a day.
- Gently rub the cream into the skin until it disappears.
- Wash your hands before and after applying the cream, unless your hands are the treated area.
- Do not use more cream than prescribed or apply it more often than directed.
- Avoid applying the cream to your eyes, mouth, or inside your nose.
- Do not use on broken skin, open wounds, or infected areas unless specifically instructed by your doctor.
- Do not cover the treated area with bandages or tight dressings unless your doctor tells you to, as this can increase absorption and side effects.
- Do not use for longer than prescribed, especially on the face, groin, or armpits, or in children.
- Keep out of reach of children.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin film to the affected areas two or three times daily.
Condition-Specific Dosing:
eczema:
Apply a thin film to the affected areas two or three times daily.
dermatitis:
Apply a thin film to the affected areas two or three times daily.
Pediatric Dosing
Neonatal:
Not established (increased risk of systemic absorption and HPA axis suppression)
Infant:
Apply a thin film to the affected areas two or three times daily. Use with caution and for the shortest duration possible due to increased risk of systemic absorption and HPA axis suppression.
Child:
Apply a thin film to the affected areas two or three times daily. Use with caution and for the shortest duration possible due to increased risk of systemic absorption and HPA axis suppression.
Adolescent:
Apply a thin film to the affected areas two or three times daily.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed (minimal systemic absorption)
Moderate:
No adjustment needed (minimal systemic absorption)
Severe:
No adjustment needed (minimal systemic absorption)
Dialysis:
No specific considerations (minimal systemic absorption)
Hepatic Impairment:
Mild:
No adjustment needed (minimal systemic absorption)
Moderate:
No adjustment needed (minimal systemic absorption)
Severe:
No adjustment needed (minimal systemic absorption)
Pharmacology
Mechanism of Action
Desonide is a low-potency topical corticosteroid. Corticosteroids exert their effects by binding to glucocorticoid receptors in the cytoplasm, leading to the formation of a steroid-receptor complex. This complex translocates to the nucleus, where it modulates gene expression, leading to the synthesis of anti-inflammatory proteins (e.g., lipocortins) and inhibition of pro-inflammatory mediators (e.g., prostaglandins, leukotrienes, cytokines). This results in anti-inflammatory, antipruritic, and vasoconstrictive actions.
Pharmacokinetics
Absorption:
Bioavailability:
Varies (systemic absorption depends on vehicle, integrity of epidermal barrier, duration of exposure, and use of occlusive dressings). Generally minimal.
Tmax:
Not typically quantified for topical application due to minimal systemic absorption.
FoodEffect:
Not applicable (topical administration).
Distribution:
Vd:
Not typically quantified for topical application.
ProteinBinding:
Not typically quantified for topical application; systemically absorbed corticosteroids are highly protein-bound.
CnssPenetration:
Limited
Elimination:
HalfLife:
Not well-defined for topical application due to minimal systemic absorption.
Clearance:
Not typically quantified for topical application.
ExcretionRoute:
Renal (for systemically absorbed drug), biliary.
Unchanged:
Not significant for topical use
Pharmacodynamics
OnsetOfAction:
Rapid (symptomatic relief within hours to days)
PeakEffect:
Not typically quantified for topical application.
DurationOfAction:
Varies depending on application frequency and condition.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
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 passing out
+ 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. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor or seek medical help:
Burning or stinging
Dry skin
* Signs of a common cold
Reporting Side Effects
This is not a complete list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
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 passing out
+ 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. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor or seek medical help:
Burning or stinging
Dry skin
* Signs of a common cold
Reporting Side Effects
This is not a complete list of possible side effects. If you have questions or concerns about side effects, contact 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:
- Worsening of your skin condition or no improvement after a few days/weeks of use.
- Severe burning, itching, irritation, or redness at the application site.
- Signs of skin infection (e.g., pus, fever, increased pain, spreading redness).
- Skin thinning, easy bruising, or stretch marks appearing where the cream is applied.
- Unusual hair growth or acne-like breakouts on the treated skin.
- Any signs of systemic side effects like unusual weight gain, swelling, or fatigue (rare, but report immediately).
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.
The presence of an infection at the site where this medication will be applied.
* If you have thinning skin at the application site.
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 if it is safe to take this medication with your other medications and health issues.
Remember, do not start, stop, or modify 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.
The presence of an infection at the site where this medication will be applied.
* If you have thinning skin at the application site.
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 if it is safe to take this medication with your other medications and health issues.
Remember, do not start, stop, or modify 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, and consult with your doctor about this potential risk.
When using this medication in children, exercise caution, as the risk of certain side effects may be higher in this population. In some cases, this medication may affect growth in children and teenagers, and regular growth checks may be necessary. Discuss this with your doctor.
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 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, and consult with your doctor about this potential risk.
When using this medication in children, exercise caution, as the risk of certain side effects may be higher in this population. In some cases, this medication may affect growth in children and teenagers, and regular growth checks may be necessary. Discuss this with your doctor.
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 before breastfeeding your child.
Overdose Information
Overdose Symptoms:
- Prolonged or excessive use, especially over large areas or under occlusion, can lead to systemic absorption and symptoms of hypercorticism (e.g., Cushing's syndrome, hyperglycemia, glucosuria).
- Adrenal suppression (HPA axis suppression) may occur, particularly in children.
What to Do:
Discontinue the medication gradually under medical supervision. Symptomatic and supportive treatment. Call 1-800-222-1222 (Poison Control Center) for advice.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify any signs of infection or contraindications.
Timing: Prior to initiation of therapy.
Routine Monitoring
Efficacy of treatment
Frequency: Regularly, as clinically indicated (e.g., weekly to bi-weekly initially)
Target: Reduction in inflammation, pruritus, and lesion size.
Action Threshold: If no improvement or worsening, re-evaluate diagnosis and treatment plan.
Local adverse effects (e.g., skin atrophy, striae, telangiectasias, folliculitis, perioral dermatitis)
Frequency: At each follow-up visit, especially with prolonged use.
Target: Absence of adverse effects.
Action Threshold: If present, reduce frequency, switch to lower potency, or discontinue.
Signs of systemic absorption (e.g., Cushing's syndrome, hyperglycemia, HPA axis suppression)
Frequency: Periodically, especially with extensive use, prolonged therapy, or in pediatric patients.
Target: Normal physiological function.
Action Threshold: If suspected, perform appropriate laboratory tests (e.g., plasma cortisol, ACTH stimulation test) and consider discontinuation or dose reduction.
Symptom Monitoring
- Worsening of skin condition
- New skin irritation, burning, itching, or redness
- Skin thinning, easy bruising, or striae
- Development of acne-like eruptions or folliculitis
- Signs of skin infection (pus, fever, increased pain)
- Unusual hair growth
- Changes in skin pigmentation
- Fatigue, weight gain, or swelling (rare, indicative of systemic absorption)
Special Patient Groups
Pregnancy
Category C. Desonide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown teratogenic effects with corticosteroids. Systemic absorption is minimal with topical use, but caution is advised.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity, though systemic absorption is low.
Second Trimester:
Minimal systemic absorption, generally considered safer than higher potency steroids.
Third Trimester:
Minimal systemic absorption, generally considered safer than higher potency steroids.
Lactation
L3 (Moderately Safe). It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Use with caution. If used, avoid applying to the breast area to prevent infant ingestion.
Infant Risk:
Low risk of adverse effects to the infant due to minimal systemic absorption, but monitor for any unusual symptoms.
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 amount for the shortest duration possible. Avoid occlusive dressings. Monitor for growth retardation and delayed weight gain.
Geriatric Use
No specific dosage adjustments are typically required. However, geriatric patients may have thinner skin, which could potentially increase systemic absorption or local adverse effects like skin atrophy. Monitor for skin fragility and other local adverse reactions.
Clinical Information
Clinical Pearls
- Desonide is a low-potency topical corticosteroid, making it suitable for sensitive areas like the face, groin, and armpits, and for pediatric use, but still with caution.
- Always apply a thin layer; using more does not increase efficacy but increases the risk of side effects.
- Avoid prolonged continuous use, especially on the face or in intertriginous areas, to minimize the risk of skin atrophy, telangiectasias, and perioral dermatitis.
- If no improvement is seen after 2-4 weeks, re-evaluate the diagnosis and treatment plan.
- Patients should be educated on proper application technique and the importance of not using occlusive dressings unless specifically instructed by a physician.
- For chronic conditions, consider intermittent therapy (e.g., 2-3 days on, 4-5 days off) to reduce side effects.
Alternative Therapies
- Hydrocortisone (lower potency topical corticosteroid)
- Triamcinolone acetonide (medium potency topical corticosteroid)
- Fluocinolone acetonide (medium potency topical corticosteroid)
- Pimecrolimus cream (Elidel - calcineurin inhibitor, non-steroidal)
- Tacrolimus ointment (Protopic - calcineurin inhibitor, non-steroidal)
- Crisaborole ointment (Eucrisa - phosphodiesterase-4 inhibitor, non-steroidal)
- Moisturizers/Emollients (for barrier repair and hydration)
Cost & Coverage
Average Cost:
$20 - $100 per 60gm 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's essential to contact your doctor for further guidance. 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 be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.