Persivate contains betamethasone valerate 0.1%, a potent topical steroid. It is prescribed for inflammatory skin conditions — eczema, dermatitis and psoriasis — in short courses. It is prescription-only, and it is not a general-purpose skin cream. It must not be used for skin lightening.
What is Persivate?
Persivate contains betamethasone valerate 0.1% and is Schedule 4 in South Africa — prescription-only. It is available as a cream and an ointment.
Its position on the potency scale is the most useful thing to know:
| Potency class | Examples | Typical use |
|---|---|---|
| Mild | Hydrocortisone 1% | Face, groin, children, mild eczema |
| Moderate | Betamethasone valerate 0.025% | Moderate eczema on the body |
| Potent | Betamethasone valerate 0.1% (Persivate) | Resistant eczema and psoriasis |
| Very potent | Clobetasol (Dovate) | Severe conditions; short courses only |
Betamethasone valerate 0.1% is roughly 50 to 100 times more potent than hydrocortisone. These are not interchangeable, and a stronger steroid is not simply a faster version of a weaker one — the risk of skin thinning and related harm rises steeply with potency.
Betamethasone works by suppressing the immune and inflammatory response in the skin: reducing inflammatory chemicals, calming immune cells, narrowing blood vessels to reduce redness, and slowing the excessive cell turnover of psoriasis.
Cream or ointment? Ointments are greasier, more moisturising and generally more effective on dry, thickened or scaly skin. Creams absorb better and suit moist or weeping areas and hair-bearing skin.
A serious misuse to name plainly. In South Africa, potent steroid creams including Persivate are widely misused as skin-lightening products, often on the face over long periods. This causes real and often permanent harm: thinned skin, permanent visible blood vessels, stretch marks, severe steroid-induced acne, a red burning rash that flares whenever the cream is stopped (topical steroid withdrawal), increased infections, and — through absorption — effects on the body’s own hormone production. Facial skin is thin and absorbs far more than skin elsewhere, making it the worst possible site for a potent steroid. If you are using it this way, a doctor can help you stop safely — stopping abruptly after prolonged use often causes a severe rebound flare.
What is Persivate commonly used for?
A doctor may prescribe it for short courses in:
- Eczema and atopic dermatitis, where mild steroids have not been enough.
- Contact dermatitis, from irritants or allergens.
- Psoriasis, on the body, scalp, palms and soles — though generally not the face or skin folds.
- Discoid eczema.
- Lichen simplex and lichen planus.
- Seborrhoeic dermatitis, on the body.
- Severe insect bite reactions.
- Other inflammatory skin conditions not responding to weaker steroids.
It is intended for short-term use — commonly up to two weeks at a time, on limited areas. Longer courses need medical supervision and planned review.
It should not be used for: acne, rosacea, fungal infections such as ringworm or thrush, bacterial infections such as impetigo, cold sores, nappy rash, or itching of unknown cause.
On a fungal or bacterial infection it makes things worse. It suppresses the local immune response, so the infection spreads while the redness temporarily fades — masking what is happening. Ringworm treated with a potent steroid becomes an extensive, atypical rash that is harder to diagnose and treat.
How Persivate fits into this medicine category
| Group | Examples | Role |
|---|---|---|
| Topical corticosteroids | Betamethasone (Persivate, Clomaderm), hydrocortisone, clobetasol | Reduce inflammation, graded by potency |
| Combination steroid + antibiotic | Fucibet | Inflamed and infected skin |
| Topical antifungals | Clotrimazole, miconazole | Ringworm, thrush, athlete’s foot |
| Topical antibiotics | Mupirocin | Bacterial skin infections |
| Emollients | Aqueous cream, ointments | Moisturise; the foundation of eczema care |
| Calcineurin inhibitors | Tacrolimus, pimecrolimus | Steroid-sparing, useful on the face |
Emollients matter more than most people expect. In eczema, regular generous moisturising reduces how much steroid is needed and how often flares occur. See the skin and wound care medicines hub.
What to check before using Persivate
Use it only on the skin it was prescribed for, for as long as you were told. Do not carry a tube over to a new rash months later, and do not share it — a rash that looks similar may be fungal, in which case the cream will make it worse.
Apply a thin layer, usually once or twice daily. More does not work better; it only increases absorption and side effects.
Keep using emollients, applied at a different time from the steroid.
Tell your doctor or pharmacist if you:
- Are using it on the face, eyelids, armpits or groin. These absorb far more, and potent steroids are generally avoided there.
- Are using it on a child, who absorbs proportionally more relative to body size.
- Have any skin infection at the site — bacterial, fungal or viral.
- Have acne, rosacea or perioral dermatitis, all worsened by potent steroids.
- Have leg ulcers, where steroids delay healing.
- Are applying it to large areas, or under dressings, plastic pants or nappies, which greatly increase absorption.
- Are pregnant or breastfeeding. Avoid applying it to the breast before feeding.
- Have diabetes, or take oral or inhaled steroids.
- Have psoriasis. Stopping a potent steroid abruptly can trigger a severe flare, so this needs supervision.
Wash your hands after applying, unless your hands are the area being treated.
Possible cautions and when to ask a pharmacist or doctor
Common local effects are burning or stinging on application, dryness and irritation.
With prolonged use, or on thin skin, more serious effects develop — and several do not fully reverse:
- Skin thinning (atrophy), leaving skin fragile, easily torn and bruised.
- Permanent stretch marks, particularly in the armpits, groin and inner thighs.
- Visible broken blood vessels, especially on the face.
- Steroid-induced acne or perioral dermatitis.
- Increased hair growth at the site, or hair loss.
- Lightening or darkening of the skin.
- Delayed healing, and more frequent skin infections.
- Topical steroid withdrawal — burning, red, spreading skin whenever the cream is stopped, which drives continued use.
With extensive or prolonged use the steroid is absorbed into the body, and can suppress the adrenal glands’ own cortisol production, raise blood sugar, and cause Cushing’s syndrome. This is much more likely in children, on large areas, on the face and under dressings.
Contact your doctor if:
- The condition worsens, or does not improve within two weeks.
- The area becomes more red, swollen, painful, warm, weeping or crusted — possible infection.
- The rash spreads or changes character, which may indicate a masked fungal infection.
- You develop stretch marks, thinning or visible vessels.
- You have used it longer than prescribed, or the skin flares whenever you stop.
- You are using it on your face, or for skin lightening.
Do not simply stop after prolonged use — ask your doctor, as reducing it gradually is often necessary to avoid a severe rebound.
Related medicine guides
Frequently asked questions
What is Persivate cream used for? Inflammatory skin conditions — eczema, dermatitis and psoriasis — in short courses. It contains betamethasone valerate 0.1%, a potent steroid.
What is Persivate ointment used for? The same conditions. Ointment suits dry, thickened or scaly skin; cream suits moist or hair-bearing areas.
Is Persivate strong? Yes — it is a potent steroid, roughly 50 to 100 times more potent than hydrocortisone. It is meant for short courses on limited areas.
Can I use it on my face? Generally no. Facial skin is thin and absorbs far more, making thinning, visible blood vessels and steroid acne much more likely.
Can I use it to lighten my skin? No. This is a common and harmful misuse causing permanent thinning, stretch marks, visible blood vessels, severe acne and rebound rashes. Ask a doctor for help stopping safely.
Can I use it on ringworm or a fungal rash? No. It suppresses the local immune response, so the infection spreads while the redness fades — making it worse and harder to diagnose.
How long can I use it? Usually up to two weeks at a time, on limited areas. Longer use needs medical supervision.
What happens if I stop suddenly? After prolonged use the skin can flare severely. Speak to your doctor about reducing it gradually.