Mometasone for skin (Elocon): cream, ointment and scalp lotion

Mometasone is a corticosteroid for the skin. The NHS says it treats itching, swollen and irritated skin in eczema, covering atopic dermatitis and seborrhoeic dermatitis, and in psoriasis. It is not effective for acne or rosacea. Elocon is the brand name listed.

It is described as stronger than some other treatments and is typically prescribed after a milder steroid such as hydrocortisone has proved insufficient. The three forms are a cream, an ointment and a scalp lotion.

The medicine reduces the swelling, or inflammation, in the skin, which settles itch and irritation. It manages symptoms rather than curing the underlying condition, so flares can return.

The NHS says your skin should begin to improve after a few days. If nothing has improved within 14 days, or 5 days in children, contact your doctor.

Most adults and children aged 2 and over can use mometasone skin treatments. Say so beforehand if you have had an allergic reaction to mometasone or another medicine, have chickenpox or shingles, acne or rosacea, an active skin infection, broken skin or cuts or itchy skin that is not red or inflamed, or if you are trying for a baby, are pregnant or are breastfeeding.

Cream suits moist, weepy skin and ointment suits dry or flaky areas. Apply a thin layer in the direction of hair growth and cover all of the irritated skin. The scalp lotion goes on once a day, wet or dry hair, with drops placed directly on the scalp and massaged until absorbed.

The standard pattern is once a day for 1 to 2 weeks, measured in fingertip units, where one unit treats an area about twice the size of a palm. For children the maximum is 5 days unless a doctor extends it, and children need dosing advice from a pharmacist or doctor. Face use needs approval and is capped at 5 days.

Wait at least 20 to 30 minutes before moisturiser and at least 10 minutes before dressings. Never cover a child's treated skin with a dressing or nappy. A missed application should be done when remembered unless the next is almost due. An accidental extra amount is unlikely to harm; wash the area well.

Mild effects include a burning or stinging feeling for a few minutes that stops after a few days, lighter or darker patches of skin and irritation. With long use, skin thinning and stretch marks can occur.

Serious effects include underactive adrenal glands, especially at high doses or with certain other medicines, new or worsening skin infections, raised pus-filled bumps in psoriasis, and new vision problems. Adrenal warning signs are a very upset stomach or vomiting, great tiredness, bad dizziness or fainting, muscle weakness, mood changes, loss of appetite and weight loss.

• Call 111 or your doctor for a new infection, a psoriasis complication or adrenal symptoms.

• Call 999 for anaphylaxis, such as swelling of the lips or throat, wheezing, a swollen or blistered rash, or fainting.

• Report suspected side effects through the Yellow Card scheme.

Extended use carries risks of adrenal gland problems, raised blood sugar, skin thinning and vision problems, and a rare slowing of growth in children. Stopping suddenly can cause rebound burning and redness over a bigger area, so reduction should be gradual under a doctor's guidance.

People on high doses or at risk of adrenal insufficiency may be given a steroid card, blue for high-dose applications and red as an emergency card, so any clinician treating them knows about the steroid.

It is safe in pregnancy because very little enters the blood and almost none reaches the baby. During breastfeeding it can be used on small areas for short periods; wash off anything applied to the breasts before a feed, keep the baby from treated skin, and note that a cream is easier to remove than an ointment. There is no evidence it affects fertility.

Tell your prescriber if you take HIV medicines such as ritonavir or cobicistat, antifungals such as itraconazole, or other steroid products including eczema creams, inhalers, tablets, injections or nasal spray. Alcohol is safe, food does not interact, and there are no sedative effects on driving. It does not interfere with contraception, and vaccines should be given on skin that has not been treated.