A Comprehensive Monograph on Ulobetasol (Halobetasol): Pharmacology, Clinical Efficacy, and Safety Profile

Section 1: Executive Summary

Ulobetasol is a synthetic topical corticosteroid characterized by its super-high potency, placing it in the most powerful class of such agents used in dermatology.[1] Known interchangeably by its International Nonproprietary Name (INN), Ulobetasol, and its United States Adopted Name (USAN), Halobetasol, this small molecule drug is structurally analogous to clobetasol.[3] It is clinically indicated for the short-term treatment of inflammatory and pruritic manifestations associated with corticosteroid-responsive dermatoses, including severe conditions like eczema, dermatitis, and plaque psoriasis.[3]

The therapeutic effects of Ulobetasol—anti-inflammatory, antipruritic, and vasoconstrictive—are derived from its primary mechanism as a potent agonist of the nuclear glucocorticoid receptor.[3] This interaction modulates gene expression, leading to the inhibition of pro-inflammatory pathways, such as those mediated by NF-Kappa B, and the promotion of anti-inflammatory proteins like lipocortins. This dual action results in a powerful and rapid suppression of cutaneous inflammation.[2]

Ulobetasol is available in multiple formulations, including 0.05% cream and ointment for general dermatoses, and more recent 0.01% and 0.05% lotions and a 0.05% foam developed specifically for plaque psoriasis.[6] A combination product, Duobrii®, which pairs 0.01% ulobetasol propionate with the retinoid tazarotene, is also available for psoriasis, representing a strategy to enhance efficacy and manage the disease through multiple pathways.[1]