Based on their strengths or the ability to constrict the blood vessels in the upper dermis, topical steroids are divided into seven groups. Fluocinonide is a potent class II topical steroid.
Marketed under the brand names Lidex, Lidex-E, Fluonex, or Vanos, fluocinonide is a corticosteroid that is available in the form of a cream, ointment, emollient, solution, or gel. In case of the 0.05% fluocinonide cream, each gram comprises 0.5 mg fluocinonide in a cream base. The cream base is composed of propylene glycol, 1,2,6-hexanetriol, stearyl alcohol, polyethylene glycol 8000, and citric acid.
An effective glucocorticoid, the topical application of fluocinonide is recommended for individuals affected by certain inflammatory skin conditions. Though dermatologists usually prescribe the weakest steroid on account of the adverse effects associated with the prolonged use of corticosteroids, there are times when strong or potent steroids need to be applied to alleviate the symptoms in a shorter period. The absorption of the medicine depends on the base or the vehicle that is used for delivering the drug. Ointments and gels have a higher absorption rate than creams and lotions. For best results, the medicine must be applied as per the instructions given by the dermatologist or the manufacturer.
Being a corticosteroid, fluocinonide is prescribed for individuals affected by the following skin disorders:
➠ Seborrheic dermatitis
➠ Contact dermatitis
➠ Allergic reactions
All the aforementioned skin conditions are characterized by inflammation and other symptoms such as:
Both eczema and psoriasis are chronic skin conditions. Psoriasis is characterized by dry red patches of skin that are covered with scales, and can affect the skin on the scalp, ears, etc. Eczema causes dry, red, thickened patches of skin. If the affected skin is scratched, it can lead to the formation of open sores. Coming into contact with irritants or allergens can also cause the skin to get inflamed.
Fluocinonide can be topically applied by individuals affected by the aforementioned skin conditions. Mostly, dermatologists prescribe it in a concentration of 0.05% as a cream, gel, or ointment. It can also be prescribed for individuals affected by scalp psoriasis, which is a type of psoriasis that is characterized by patches of red, raised skin and silvery scales over the scalp. The symptoms of scalp psoriasis include burning sensation, itching, and soreness. This condition is believed to be an immune-mediated inflammatory disorder, wherein the immune system increases the rate at which the skin cells regenerate, thereby leading to the formation of a thick crust of skin on the scalp. The hair follicles can weaken, in case the affected individual scratches the scalp vigorously, which in turn can cause hair breakage. While fluocinonide can help treat the inflammation, its use will not help treat hair loss.
While applying the drug topically, make sure that you follow the instructions provided on the label. Otherwise, follow the instructions given by the dermatologist. It is essential to apply it only for the duration and in the manner that has been prescribed. Mostly, the medicine is applied twice a day. The doctor will tell you the amount you need to use (in terms of fingertip units), depending on the extent of inflammation or the size of the area of the skin affected by inflammation. Here are the instructions that need to be followed:
➠ Before applying the ointment, wash the affected skin properly.
➠ Take a small amount of the ointment/cream/gel, and spread it uniformly into a thin film on the affected area. Make sure that you rub the cream on the skin gently.
➠ If you are applying the medicine on your face, make sure that it doesn’t enter your eyes.
➠ In case you are applying fluocinonide solution or gel on your scalp for treating scalp psoriasis, you should first part your hair. Thereafter, take a small amount of the medicine, and apply it on the affected area of the scalp. Rub it in carefully and gently. Let it dry.
More often than not, the part of the skin on which the cream/lotion/ointment/gel is applied is not covered after application. However, sometimes, the doctor might recommend the application of an occlusive dressing over the affected area so as to improve the absorption rate. In such cases, follow the instructions given below:
➠ Wash the affected area of the skin properly.
➠ Apply the medicine, rubbing it very gently over the affected skin.
➠ Put a plastic wrap on the affected skin, and put a gauze or adhesive tape on the healthy skin surrounding the treated area.
➠ Remove and change the dressing, as directed by your doctor.
➠ Before applying a new dressing, wash the skin and apply the medication.
Don’t apply the dressing, unless your doctor recommends it. If you notice swelling, redness, and pus, inform your doctor.
Being a potent corticosteroid, the risk of untoward effects is high, especially when this drug is not applied in the prescribed manner. Moreover, topical application of fluocinonide must be avoided in certain cases. These include:
☒ Individuals with a history or hypersensitivity to any of the ingredients used in this drug
☒ Pregnant women and nursing mothers
☒ Those below the age of 12 years
The Food and Drug Administration has placed fluocinonide to pregnancy category C. This means that animal studies have provided evidence of adverse effect on the fetus, but well-controlled studies have not been conducted to study the effects in pregnant women. Thus, this drug should not be used, unless it is prescribed by the doctor. Mostly, drugs in category C are prescribed, only if the benefits outweigh the risks. Similarly, there’s a lack of evidence on the risk to infants during breastfeeding due to absorption of the drug into breast milk. Similarly, the safety of the drug has not been established in children who are below the age of 12 years.
It is also essential to inform the doctor about:
➠ Any existing medical condition
➠ Prescription/non-prescription drugs you are currently taking
➠ Conception while using fluocinonide
This drug should not be applied on open wounds or infected skin. Moreover, topical application on the face, skin creases, armpits, and genital/rectal areas should be avoided, unless directed by your doctor. While applying fluocinonide, other skin preparations/cosmetic products must not be applied on the treated area.
Being a potent corticosteroid, there is a risk of certain adverse effects. The serious side effects associated with the use of fluocinonide are the ones that indicate absorption of this drug into the blood through the skin. These symptoms include:
➠ Blurred vision
➠ Sleep-related problems
➠ Mood changes
➠ Muscle weakness or fatigue
➠ Weight gain
Other adverse effects include:
➠ Dry, cracked skin
➠ Thinning of the skin
➠ Soreness of the skin
➠ A change in the color of the skin
➠ Burning sensation
Medical help must be sought immediately, if one develops an allergic reaction. The symptoms of an allergic reaction include:
➠ Severe skin rash
➠ Breathing problems
➠ Difficulty in swallowing
➠ Swelling on the face, lips, tongue, and throat
Since fluocinonide is placed under the category of potent topical corticosteroids, it is essential that it is applied for a shorter period of time to avoid the adverse effects that could be associated with its systemic absorption into the bloodstream. Moreover, it should never be applied on healthy skin. Applying it for a longer duration or in larger doses can cause untoward effects. One must inform the doctor about the drugs one is taking to avoid adverse drug interactions. The drug must also be stored at room temperature, and should be kept out of reach of children.