Is half strength of 0.05 % betamethasone valerate cream still effective in the treatment of phimosis in young children?

0.05 % betamethasone valerate cream is generally used as an alternative to circumcision for the treatment of phimosis in boys. The aim of this study is to determine whether the half-strength formula (0.025 %) of betamethasone is as effective as 0.05 % betamethasone. All boys with phimosis seen at our institution between 2010 and 2012, whose parents complained that their children had problems of micturition, i.e., crying and ballooning, and sought for some instructions or treatments, were instructed to apply betamethasone valerate cream. Two strengths, 0.05 and 0.025 %, were randomly applied to each patient twice a day for 2 months. The patients whose parents were not willing to the conservative treatment underwent circumcision. Of the 47 patients, 23 boys with an average age of 16.65 ± 4.052 months (range 11-24 months) were given 0.025 % betamethasone cream, whereas the remaining 24 boys in control group with an average age of 18.42 ± 5.030 months (range 10-24 months) were instructed to apply with 0.05 % betamethasone valerate cream. Using unpaired t test, the age in both groups were comparable (p = 0.1932). There was a decrease in phimosis grade by the end of the therapeutic course in both groups. Further analysis using Mann-Whitney test revealed that the phimosis grade in the half-strength group (0.025 % strength) was significantly lower to the phimosis grade in the control (0.05 % betamethasone) group (p = 0.0003). There was no diversion from steroid application to circumcision or any side effects in the both groups. 0.025 % betamethasone valerate cream produced a clinical improvement. However, the half-strength formula was not effective as the conventional formula of 0.05 % betamethasone valerate cream.