# Betamethasone-Tolnaftate-Gentamicin-Clioquinol in Nigeria - Source: https://ogbogwu.com/drugs/betamethasone-tolnaftate-gentamicin-clioquinol/ - Drug class: Topical corticosteroid + antifungal + antibiotic + antiseptic combination (Dermatology) - Also known as: Quadruple action cream, 4-action cream, Quadriderm-type cream - Prescription required: yes - Last updated: August 2026 ## Price in Nigeria Betamethasone-Tolnaftate-Gentamicin-Clioquinol prices in Nigeria vary by brand, strength, and where you buy it. Confirm the current price with a licensed pharmacy, and always check the product is NAFDAC-registered before you pay. ## What is Betamethasone-Tolnaftate-Gentamicin-Clioquinol? Betamethasone-tolnaftate-gentamicin-clioquinol is a four-ingredient skin preparation: a potent steroid (betamethasone) to calm inflammation and itching, an antifungal (tolnaftate), an antibiotic (gentamicin), and an antiseptic that is also active against fungi (clioquinol). In Nigerian markets it sells as "quadruple action" or "4-action" cream — the four-ingredient sibling of the triple action creams, with tolnaftate, gentamicin and clioquinol in place of the triple's clotrimazole and neomycin. The idea is to cover an inflamed rash that might be fungal, bacterial or both without waiting to find out which. That makes it genuinely useful for short courses on mixed or unclear skin infections — and easy to misuse, because the steroid component makes almost any rash look better for a while, including rashes the cream is quietly making worse. Like the triple action creams, it is meant for short-term use on limited areas. The betamethasone in it is a potent steroid: used for weeks on end, or on the face or skin folds, it thins the skin, lightens it, and can entrench the very fungal infection the cream was bought for. ## What is Betamethasone-Tolnaftate-Gentamicin-Clioquinol used for? - Inflamed fungal skin infections — ringworm (tinea corporis), athlete's foot, jock itch — where itching and redness are severe - Eczema or dermatitis that has become infected, where fungus or bacteria are suspected alongside the inflammation - Short-term treatment of mixed skin infections while the skin settles enough for a single-purpose treatment ## Dosage Always follow a doctor's or pharmacist's instructions; this is general reference information. - Adults: Apply a thin layer to the affected area only, twice daily, and rub in gently. Wash your hands after applying unless the hands are being treated. Use for a maximum of 2 weeks; if the skin is not clearly better by then, stop and see a doctor or pharmacist rather than continuing. Avoid the face, armpits, groin folds and broken skin unless a doctor has specifically told you to treat there. - Children: Use in children only on a doctor's or pharmacist's advice, on small areas, for the shortest possible time. Children's skin absorbs the steroid far more readily — never use it under a nappy/diaper, where the covering multiplies absorption. - Elderly: No separate dose, but older skin is thinner and tears more easily — the thinnest possible layer for the shortest possible time. More cream is not more effective — a thin layer treats the skin; a thick layer only increases side effects. If the problem is fungal, finish with an antifungal-only cream for 1–2 weeks after the rash clears instead of continuing the steroid combination. Clioquinol can stain skin, hair and fabric yellow — let it dry before dressing. ## Side effects Common: Burning, stinging or itching where it is applied (usually settles quickly); Yellow staining of skin or clothing from the clioquinol; Skin dryness or mild peeling; Lightening of the treated patch (a steroid warning sign with continued use, not a benefit). Serious (seek medical help immediately): Skin thinning, stretch marks (striae) and easy bruising after prolonged use — stretch marks are permanent; Rebound flare: skin that erupts angrily when the cream is stopped after long continuous use; Spreading, disguised fungal infection (tinea incognito) — the rash loses its ring shape but keeps growing; Allergic contact reaction to gentamicin or clioquinol (worsening redness, swelling, weeping skin); Acne-like eruptions or excessive facial hair with long use on the face; In infants or with heavy prolonged use over large areas: enough steroid can be absorbed to affect the body internally. When to see a doctor: See a doctor or pharmacist if the skin is not clearly improving after 2 weeks, if the rash keeps spreading, if the treated skin is becoming lighter, thinner or marked with lines, or if you have used it continuously for more than a month — stopping suddenly after long use can cause a severe flare, and a doctor can plan a safe taper. ## Warnings Do not take if: Known allergy to betamethasone, tolnaftate, gentamicin, clioquinol or iodine/quinoline compounds; Viral skin conditions (chickenpox, shingles, cold sores) — the steroid lets them spread; Acne, rosacea or perioral dermatitis — steroid creams make all three worse; Untreated tuberculosis of the skin. Interactions: Other steroid creams or oral steroids — the doses add up; Clioquinol can interfere with thyroid function tests — mention it if you are being tested. Pregnancy & breastfeeding: Use in pregnancy or while breastfeeding only on a doctor's advice, on small areas for short periods. Do not apply on or near the breast before feeding. ## Brands in Nigeria Well-known NAFDAC-registered brands: Epiderm (Shalina Healthcare Nigeria Limited, made in India); Visiderm (Elbe Pharma Nigeria Limited, made in India). Full searchable brand list: https://ogbogwu.com/drugs/betamethasone-tolnaftate-gentamicin-clioquinol/brands/ ## How to verify it is genuine 1. Check that the pack lists all four ingredients — betamethasone, tolnaftate, gentamicin and clioquinol — with their strengths 2. Find the NAFDAC registration number printed on the tube and carton 3. Enter the number in our free NAFDAC checker to confirm it matches this product and maker 4. Buy from a registered pharmacy or a known market seller — steroid creams are among the most commonly faked skin products Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/ ## FAQs ### What is the difference between quadruple action and triple action cream? Both are steroid combination creams built around betamethasone. Triple action creams add clotrimazole (antifungal) and neomycin (antibiotic); quadruple action creams like Epiderm and Visiderm instead combine tolnaftate (antifungal), gentamicin (antibiotic) and clioquinol (an antiseptic that also fights fungus). The uses, the short-course rule and the risks of overuse are essentially the same. ### Is quadruple action cream a bleaching cream? No — and the lightening people notice is a warning sign, not a benefit. The betamethasone in it thins and lightens skin as a side effect of prolonged use, alongside stretch marks and fragile skin that do not reverse. Using it deliberately to lighten skin trades a temporary tone change for permanent skin damage. ### Why is my rash coming back worse after stopping the cream? Two common reasons. If the rash was fungal, the steroid was suppressing the redness while the fungus kept growing — it returns larger once the cream stops (doctors call this tinea incognito). And skin treated with a potent steroid for a long time can flare angrily when it is withdrawn. Either way, see a pharmacist or doctor rather than restarting the cream — the fix is usually an antifungal-only cream, or a planned taper. ## Sources - NAFDAC Greenbook (official register of approved products in Nigeria) - British National Formulary (BNF) - Nigerian Standard Treatment Guidelines (Federal Ministry of Health)