Repivate is a betamethasone cream — a potent topical steroid prescribed for eczema, dermatitis, psoriasis and other inflammatory skin conditions. It is effective and it is not a general-purpose skin cream: it is prescribed for a defined condition, for a defined period, and misused it thins skin permanently.
What is Repivate?
The South African Medicine Price Registry lists Repivate as a Schedule 4 cream containing betamethasone 15 mg per 15 g — which works out to 0.1%.
Betamethasone is a potent corticosteroid. Topical steroids are classified by strength into four broad groups, and where a product sits determines what it may safely be used for and for how long.
Corticosteroids work by switching off the inflammatory response in the skin at the level of the genes involved. They reduce redness, swelling and — importantly — the itch that drives scratching, which is what keeps eczema going.
A steroid does not cure the condition. Eczema and psoriasis are long-term problems of the skin. A steroid settles a flare; it does not remove the tendency to flare. That is what emollients do, applied daily whether or not the skin looks well.
Betamethasone appears in South Africa under several names including Clomaderm, Persivate and Dovate. Some are betamethasone valerate and some dipropionate, and some products combine betamethasone with an antifungal or antibiotic — check your own tube, because a combination product is not interchangeable with a plain one.
What is Repivate commonly used for?
- Atopic eczema, particularly moderate to severe flares on the body and limbs.
- Contact dermatitis, allergic and irritant.
- Discoid (nummular) eczema.
- Psoriasis — plaques on the body, under supervision.
- Lichen planus and lichen simplex.
- Seborrhoeic dermatitis, on advice.
- Severe insect bite reactions and sunburn, short-term.
- Hand and foot eczema, where thicker skin needs a stronger preparation.
Where it should not go without specific advice: the face, eyelids, genitals, and skin folds such as the armpits, groin and under the breasts. Skin at those sites is thin and absorbs far more, and potent steroids can cause lasting damage there quickly. A mild steroid such as hydrocortisone is the usual choice for those areas.
What it does not treat:
Infection. Repivate contains no antibiotic or antifungal. On a fungal rash it calms the redness while the fungus spreads underneath, producing a larger, oddly shaped rash that is harder to recognise and to treat — a genuinely common problem. On bacterially infected skin it can make matters worse.
Acne and rosacea, which steroids typically aggravate.
How Repivate fits into this medicine category
| Potency | Examples | Typical use |
|---|---|---|
| Mild | Hydrocortisone 1% | Face, folds, children, mild eczema |
| Moderate | Clobetasone butyrate | Moderate eczema; delicate sites briefly |
| Potent | Betamethasone (Repivate, Clomaderm), methylprednisolone aceponate | Moderate to severe eczema, dermatitis, psoriasis |
| Very potent | Clobetasol propionate | Severe or resistant conditions, specialist use |
| Antifungals | Clotrimazole (Canex V) | Fungal infection |
| Emollients | Emulsifying ointment, aqueous cream | Daily barrier care — the long-term treatment |
See the skin and wound care hub.
What to check before using Repivate
Do not use it on a rash that has not been identified. This matters more with potent steroids than with almost any other topical medicine, because a wrong diagnosis does not simply fail — it makes the condition worse while appearing to help for a few days.
Do not use it on infected skin. Signs include weeping, golden crusting, pus, spreading redness, heat, increasing pain or fever.
Tell your doctor or pharmacist if:
- You are treating the face, eyelids, genitals or skin folds.
- You are treating a child. Children absorb far more relative to their size, and potent steroids in children should be directed by a doctor.
- You are pregnant or breastfeeding. If used on the breast, wash it off before feeding.
- You have rosacea, perioral dermatitis or acne.
- You have psoriasis — steroids are used, but stopping can cause a rebound flare, so this needs supervision.
- You need to treat large areas or use it long-term.
- You have leg ulcers, where steroids raise the risk of infection.
Using it properly:
- Apply a thin layer, once or twice daily as directed, to affected skin only.
- Use the fingertip unit as a guide — the amount on an adult fingertip covers about two adult palms of skin.
- Do not use it for more than two weeks continuously without medical advice, and less on delicate sites.
- Do not cover with an airtight dressing unless instructed — occlusion greatly increases absorption.
- Keep using your emollient, with fifteen to twenty minutes between the two.
- Do not share it, and do not keep it as a general-purpose cream for future rashes.
- Wash your hands afterwards unless treating them.
Possible cautions and when to ask a pharmacist or doctor
Used correctly for short courses on the right diagnosis, potent topical steroids are safe and effective — and under-treating a flare out of steroid fear causes its own harm, through sleepless scratching and infection.
Prolonged or excessive use has real and partly permanent effects, mostly local:
- Skin thinning, with shininess, visible blood vessels and easy bruising
- Stretch marks, which are permanent
- Increased hair growth, or lightening of treated skin
- Perioral dermatitis around the mouth
- Rebound flare on stopping after prolonged use
- Masked or worsened infection
- With heavy use over large areas — particularly in children — absorption enough to affect the body
Stop and seek advice if the treated skin becomes thinner, shinier, marked with stretch marks or visible vessels, or if the rash worsens rather than settles.
Get emergency help for swelling of the face, lips or tongue, difficulty breathing, or a rapidly spreading blistering rash.
Contact your doctor if:
- The rash is not improving after one to two weeks, or returns as soon as you stop.
- The skin becomes weeping, crusted, pustular, hot or painful, or you develop a fever.
- Small blisters, punched-out sores or rapidly spreading painful lesions appear — this can be eczema herpeticum, needing urgent treatment.
- You are using it most weeks, which means the underlying condition needs a better long-term plan.
- You were given it for a rash that has never been formally diagnosed.
- Eczema is disturbing sleep.
Related medicine guides
Frequently asked questions
What is Repivate cream used for? Inflammatory skin conditions — eczema, dermatitis, psoriasis, lichen planus and severe bite or sunburn reactions. It contains betamethasone 0.1%, a potent topical steroid.
Is it strong? Yes, it is in the potent class — considerably stronger than hydrocortisone.
Can I use it on my face? Not without specific medical advice, and then only briefly. Facial skin is thin and potent steroids can cause lasting thinning and visible vessels there.
Can I use it on ringworm or a fungal rash? No. It contains no antifungal. The redness settles while the fungus spreads, making the problem harder to treat.
How long can I use it? Generally up to two weeks continuously, less on delicate sites. Longer use should be supervised.
Can I use it as a general skin cream? No. It is a prescription treatment for diagnosed conditions, not a moisturiser or an all-purpose rash cream.
Do I still need my moisturiser? Yes. Emollients used daily are what reduce how often flares happen. The steroid only treats the flare.
What happens if I use it too long? Skin can thin permanently, with visible blood vessels and stretch marks, and stopping after prolonged use can cause a rebound flare.