Elocon

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Elocon on Prescriptsy

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Elocon is the brand name for mometasone furoate 0.1%, a potent topical corticosteroid manufactured by Organon (formerly MSD/Merck Sharp and Dohme).

It is licensed in the United Kingdom for the treatment of inflammatory skin conditions that respond to topical corticosteroid therapy, including atopic eczema (atopic dermatitis), psoriasis, seborrhoeic dermatitis, contact dermatitis, and other corticosteroid-responsive dermatoses.

Elocon is available as a cream, ointment, and scalp lotion, providing flexibility for treatment of different body sites and skin types.

Inflammatory skin conditions are extremely common in the UK.

Atopic eczema affects approximately 1 in 5 children and 1 in 12 adults, while psoriasis affects around 1.8 million people.

These conditions cause significant physical discomfort, sleep disturbance, and psychological distress, and they frequently impair quality of life, work productivity, and social participation.

Topical corticosteroids remain the mainstay of treatment for inflammatory flares, and Elocon is one of the most widely prescribed potent topical steroids in UK dermatological practice.

This page provides a comprehensive clinical overview of Elocon, including how it works, correct application technique, dosing guidance, side effects, safety warnings, and how to obtain a prescription in the UK.

Important safety information about Elocon

Before reading further, note the following essential safety points about Elocon.

• Elocon is a potent topical corticosteroid and should be used at the lowest effective dose for the shortest period necessary to bring a flare under control.
• Do not use Elocon on the face for more than 5 days unless specifically instructed by your prescriber. Facial skin is thin and particularly susceptible to corticosteroid side effects.
• Prolonged or inappropriate use can cause irreversible skin damage, including permanent skin thinning, stretch marks, and visible blood vessels.
• Elocon must not be applied to untreated skin infections, rosacea, acne, or perioral dermatitis.

Understanding inflammatory skin conditions

Atopic eczema

Atopic eczema is a chronic, relapsing inflammatory skin condition characterised by dry, itchy, and inflamed skin.

It results from a complex interaction between genetic predisposition (particularly filaggrin gene mutations that impair the skin barrier), immune dysregulation (a Th2-skewed inflammatory response), and environmental triggers (such as irritants, allergens, stress, and climate).

The hallmark symptom is intense pruritus (itching), which drives a scratch-itch cycle that damages the skin and perpetuates inflammation.

Eczema commonly affects the flexures (inner elbows, behind the knees), the face, the neck, and the hands.

Psoriasis

Psoriasis is a chronic, immune-mediated inflammatory skin disease driven by T-cell-mediated overactivation of the innate and adaptive immune systems, leading to accelerated keratinocyte proliferation.

The characteristic clinical feature is well-demarcated, raised, erythematous plaques covered with silvery-white scale, commonly affecting the elbows, knees, scalp, and lower back.

Psoriasis has a significant systemic inflammatory component and is associated with psoriatic arthritis, cardiovascular disease, metabolic syndrome, and psychological morbidity.

The role of topical corticosteroids

Topical corticosteroids have been the cornerstone of treatment for inflammatory skin conditions since their introduction in the 1950s.

They are classified by potency in the UK using the BNF system: mild (for example, hydrocortisone 1%), moderate (for example, clobetasone butyrate 0.05%), potent (for example, mometasone furoate 0.1%, betamethasone valerate 0.1%), and very potent (for example, clobetasol propionate 0.05%).

The choice of potency depends on the severity of the condition, the body site, the patient's age, and the duration of treatment required.

NICE Clinical Knowledge Summaries and BAD (British Association of Dermatologists) guidelines recommend using the least potent corticosteroid that controls symptoms, stepping up only when milder preparations are insufficient.

How Elocon works: mechanism of action

Mometasone furoate is a synthetic glucocorticoid that exerts its anti-inflammatory effects by binding to intracellular glucocorticoid receptors (GR) within skin cells, including keratinocytes, fibroblasts, endothelial cells, and inflammatory leucocytes.

Upon binding, the mometasone-GR complex translocates to the nucleus and modulates gene transcription through two primary mechanisms.

Transactivation involves the upregulation of anti-inflammatory genes, including those encoding lipocortin-1 (annexin A1), which inhibits phospholipase A2 and thereby reduces the production of pro-inflammatory arachidonic acid metabolites (prostaglandins and leukotrienes).

Transrepression involves the suppression of pro-inflammatory transcription factors such as NF-kB and AP-1, leading to reduced production of cytokines (including IL-1, IL-6, TNF-alpha), chemokines, adhesion molecules, and enzymes such as matrix metalloproteinases (MMPs).

The net clinical effect is a reduction in redness (through vasoconstriction and reduced capillary permeability), swelling (through reduced oedema and leucocyte infiltration), itching (through suppression of pruritic mediators), and scaling (through normalisation of keratinocyte proliferation).

Mometasone furoate has a high lipophilicity, which facilitates skin penetration, and a favourable therapeutic index, meaning it delivers strong local anti-inflammatory activity with relatively low systemic absorption when applied to intact skin at recommended doses.

Clinical evidence and national guidelines

Mometasone furoate 0.1% has been extensively studied in randomised controlled trials for atopic eczema, psoriasis, and other inflammatory dermatoses.

Clinical trials demonstrate that once-daily application of mometasone furoate cream or ointment provides comparable or superior efficacy to twice-daily application of other potent topical corticosteroids, including betamethasone valerate 0.1%.

The once-daily dosing regimen improves adherence and is a practical advantage over twice-daily alternatives.

NICE Clinical Knowledge Summaries on eczema and psoriasis recommend potent topical corticosteroids for moderate to severe flares that do not respond to emollients and mild or moderate corticosteroids.

The BAD guidelines on atopic eczema emphasise that topical corticosteroids should be used proactively in a "step-up, step-down" approach, with potent preparations reserved for flare treatment and milder preparations or emollients for maintenance.

The concept of "weekend therapy" or "proactive maintenance therapy" (applying a potent corticosteroid twice weekly to previously affected areas) has been shown to reduce the frequency of eczema flares and is endorsed by NICE and BAD guidance.

Correct application technique

The fingertip unit system

The fingertip unit (FTU) is a practical measure developed to help patients apply the correct amount of topical corticosteroid.

One FTU is the amount of cream or ointment expressed from a standard tube with a 5 mm diameter nozzle, applied from the tip of an adult index finger to the first crease.

One FTU weighs approximately 0.5 grams and is sufficient to cover an area equivalent to two flat adult palms (including fingers).

The following table provides approximate FTU guidance for adult body areas.

• Face and neck: 2.5 FTUs
• One hand (front and back): 1 FTU
• One arm: 3 FTUs
• One leg: 6 FTUs
• Trunk (front): 7 FTUs
• Trunk (back including buttocks): 7 FTUs

For children, the amounts are proportionally smaller and should be guided by the child's body surface area. Your prescriber or pharmacist can provide specific guidance.

Application steps

Wash and dry the affected area gently. If using an emollient, apply it first and wait at least 30 minutes before applying Elocon.

Squeeze the appropriate number of FTUs onto your fingertip. Dot the cream or ointment over the affected area and spread it thinly and evenly. Do not rub vigorously.

Wash your hands after application unless the hands are the treated area. Apply once daily, preferably at the same time each day.

Choosing between cream, ointment, and scalp lotion

Elocon cream is a lighter, vanishing formulation that is well tolerated on moist, weeping, or acutely inflamed skin.

It is also preferred for use in skin folds (axillae, groin) and on hairy areas where ointments may be cosmetically unacceptable.

Elocon ointment is greasier and more occlusive, providing greater hydration and enhanced penetration.

It is more suitable for chronic, dry, lichenified (thickened), or scaly skin conditions such as chronic plaque psoriasis or chronic hand eczema.

Elocon scalp lotion is a liquid formulation designed for application to the scalp, making it practical for scalp psoriasis and seborrhoeic dermatitis of the scalp without the cosmetic inconvenience of creams or ointments on hair.

Side effects of Elocon

Local side effects

The most commonly reported local adverse effects include a transient burning or stinging sensation at the application site, mild itching, and skin dryness.

Folliculitis (small red bumps around hair follicles) may occur, particularly when Elocon is applied to hairy areas or under occlusion.

Side effects associated with prolonged use

With prolonged, excessive, or inappropriate use, potent topical corticosteroids can cause local skin changes including atrophy (thinning), striae (stretch marks), telangiectasia (visible small blood vessels), purpura (easy bruising), hypopigmentation (lightening of the skin), and acneiform eruptions.

Perioral dermatitis, a persistent red bumpy rash around the mouth, may develop with facial use. These changes may be slow to develop and some, particularly striae, are irreversible.

Systemic side effects

When applied to large body surface areas, broken skin, or under occlusive dressings, sufficient mometasone may be absorbed systemically to suppress the HPA axis.

Clinical features of systemic corticosteroid excess (iatrogenic Cushing syndrome) include weight gain, moon face, skin fragility, hyperglycaemia, and in children, growth retardation.

These effects are rare with appropriate use at recommended doses and durations.

Secondary infection

Topical corticosteroids suppress local immune responses, which may allow secondary bacterial (for example, Staphylococcus aureus), fungal (for example, dermatophyte), or viral (for example, herpes simplex) infections to develop or worsen.

If the treated area becomes increasingly red, swollen, painful, crusted, or blistered, stop Elocon and seek medical advice promptly.

When to seek medical advice

Contact your GP or dermatologist if your skin condition is not improving after 2 weeks of treatment, if it is worsening, if you notice signs of skin thinning or stretch marks, if signs of infection develop, or if you experience any unexpected symptoms.

Report any suspected adverse reactions via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk .

Warnings and precautions

Duration of use

Elocon should be used for the shortest duration necessary to bring a flare under control. For most conditions, this means days to a few weeks.

Continuous long-term daily use of potent topical corticosteroids is not recommended without specialist supervision.

Once the condition has improved, treatment should be stepped down to a less potent corticosteroid, an emollient alone, or proactive intermittent maintenance therapy as directed by your prescriber.

Sensitive body sites

The face, eyelids, genitalia, and skin folds are areas of thin skin where corticosteroid absorption is significantly higher and the risk of local side effects is greatest.

Elocon should only be used on these areas under specific prescriber instruction and for the minimum duration.

Application near the eyes carries a risk of glaucoma and cataract with prolonged use. Milder preparations are generally preferred for these sites.

Children

Children have a higher surface-area-to-body-weight ratio than adults, which increases the relative systemic exposure from topical corticosteroids. Elocon is not licensed for children under 2 years.

In children aged 2 and over, treatment should be for the shortest duration and smallest amount needed to control symptoms.

Application under nappies or tight-fitting garments should be avoided as these act as occlusive dressings. Growth should be monitored in children requiring repeated courses of potent topical corticosteroids.

Topical corticosteroid withdrawal

The MHRA issued a Drug Safety Update in 2021 regarding topical corticosteroid withdrawal reactions.

Prolonged, frequent use of potent topical corticosteroids, particularly on the face and genital area, may lead to a withdrawal syndrome characterised by intense redness, burning, stinging, and peeling that spreads beyond the originally treated area.

If suspected, management should involve gradual dose reduction under dermatological supervision rather than abrupt cessation.

How to get an Elocon prescription in the UK

Elocon is a prescription-only medicine (POM) in the UK and is not available over the counter.

Prescriptions can be obtained from your GP, a dermatologist, or an authorised online prescriber registered with the GPhC.

Before prescribing, the clinician will assess the nature and severity of your skin condition, confirm the diagnosis, review previous treatments, and check for contraindications.

The standard NHS prescription charge in England is currently 9.90 pounds per item. Prescriptions are free for all patients in Scotland, Wales, and Northern Ireland.

Patients with certain conditions, including those aged 60 and over, may be eligible for prescription charge exemptions in England.

Living with eczema and psoriasis: practical management

Effective management of chronic inflammatory skin conditions extends beyond topical corticosteroids.

Regular, liberal use of emollients (moisturisers) is the single most important daily measure for maintaining the skin barrier and reducing flare frequency in eczema.

Apply emollients generously and frequently, at least twice daily and after bathing, even when the skin appears clear.

Use soap substitutes (such as emulsifying ointment or dermol) instead of soap, shower gel, or bubble bath, as detergent-based products strip lipids from the skin barrier and trigger flares.

Identify and avoid individual triggers where possible, including biological washing powders, certain fabrics (particularly wool), excessive heat, stress, and relevant allergens.

Keep nails short to minimise skin damage from scratching. Wear cotton or silk next to the skin.

For psoriasis, regular use of emollients, careful sun exposure (but not sunburn), stress management, and maintaining a healthy weight can help reduce flare severity.

Smoking and excessive alcohol consumption are associated with more severe psoriasis.

When to seek urgent medical advice

Seek urgent medical advice from your GP, dermatologist, or NHS 111 if your skin condition is rapidly worsening, if you develop widespread blistering or crusting (which may indicate eczema herpeticum, a medical emergency), if your skin becomes hot, swollen, and painful (suggesting cellulitis), or if you feel generally unwell with a skin flare.

Call 999 if you have signs of a severe allergic reaction such as facial swelling, difficulty breathing, or collapse.

Report suspected adverse reactions via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk .

Sources

• Elocon Cream 0.1%, Summary of Product Characteristics (EMC)
• Mometasone furoate, British National Formulary (BNF)
• NICE CKS: Eczema, atopic
• NICE CKS: Psoriasis
• British Association of Dermatologists patient information
• Atopic eczema, NHS
• MHRA Yellow Card Scheme