Betacort Cream Special Precautions

Avoid extensive or prolonged use in pregnancy and children below 4 years. Avoid contact with eyes.
Long-term continuous topical therapy should be avoided where possible, particularly in infants and children, as adrenal suppression can occur even without occlusion.
The face, more than other areas of the body, may exhibit atrophic changes after prolonged treatment with potent topical corticosteroids. If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye, as glaucoma might result. If used in childhood or on the face, courses should be limited if possible to five days and occlusion should not be used.
Appropriate antimicrobial therapy should be used whenever treating inflammatory lesion which have become infected. Any spread of infection requires withdrawal of the topical corticosteroid therapy and systemic administration of Antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressings, and so the skin should be cleansed before a fresh dressing is applied.
Use in Children: Since adrenal suppression and growth retardation due to the systemic absorption of topical adrenocorticoids, have been documented in children, special care must be exercised in using these agents in the paediatric patient, especially when extensive areas are treated or if an occlusive dressing is used. It is recommended that only low-potency topical corticoids that are not fluorinated and that have a free 17- hydroxyl group be used in children unless there is a very specific indication for one of the other topical corticoids. As a general rule, paediatric therapy continuing for longer than 2 weeks and consisting of doses in excess of one daily application (with intermediates or high potency corticoids) or two daily applications (with low potency corticoids) should be evaluated carefully by the physician. This is especially important if medication is applied to more than 5 to 10 % of body surface or if an occlusive dressing is used. A tight-fitting diaper or one covered with plastic pants may constitute an occlusive dressing.
Use in Pregnancy & Lactation: Although studies in humans have not been done, risk-benefit must be considered since studies in animals have shown that adrenocorticoids, when used in large amounts for prolonged periods of time are systemically absorbed and may cause foetal abnormalities (FDA Pregnancy Category C).