Topical Fluocinonide for Dermatological Conditions

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If you've got a skin condition that causes severe itching, your doctor may prescribe fluocinonide (brand names include Lidex and Vanos). Fluocinonide is a strong corticosteroid that reduces skin swelling, itching, and redness. It treats various allergic skin conditions, as well as atopic dermatitis (eczema), contact dermatitis (including rashes caused by poison oak and ivy), xerotic dermatitis (dry skin), psoriasis, and other causes of itching.

How It Works

Corticosteroids work by reducing the body’s production of prostaglandins and leukotrienes, chemicals that prompt inflammation and cause swelling and itching. This reaction is common among some acute and chronic skin conditions alike, although they may manifest differently beyond the shared symptom of itching.

How It's Used

Fluocinonide is available as an ointment, cream, solution, and gel, and comes in different dosages. In general, fluocinonide is applied to the affected skin areas two to three times a day for up to two weeks at a time. The exact dose, application, and instructions, however, will be different for different patients.

Some doctors recommend bandaging the area where the medication was applied (to increase absorption), while others may recommend against this. It is important to follow your doctor's directions for using fluocinonide carefully. You should never use it more frequently or for a longer time than prescribed, as it can cause side effects.

Precautions

As with all medications, it's important to inform your doctor about any health conditions or allergies you have, as well as any other medications you are using (topically or otherwise). In addition, take the following precautions when using fluocinonide:

  • Clean and dry the affected area before applying fluocinonide.
  • Wash your hands before and after use. (If applying to your hands, don’t wash your hands after applying the medication.)
  • Apply only a thin film of the medication. Fluocinonide is very strong and a small amount is effective.
  • Apply fluocinonide to your skin only. Avoid getting it in your mouth, nose, and eyes.
  • Don’t apply fluocinonide to your face, underarms, or groin area unless you are told to do so by your doctor.
  • Do not use cosmetics or other skincare products on the treated areas without your doctor's approval.

Side Effects

Initially, fluocinonide can cause burning, additional itching, irritation, or dryness, but these symptoms usually subside in a few days. Less common side effects—which indicate that a call to your doctor is in order—include:

  • Blistering, burning, crusting, dryness, or flaking of the skin
  • Redness, inflamed, or sore skin
  • Easy bruising or thinning of the skin
  • Headache
  • Fever
  • Chills
  • Muscle aches
  • Fatigue or weakness
  • Fever
  • Muscle aches
  • Sore throat
  • Stuffy or runny nose
  • Unusual tiredness or weakness
  • Acne
  • Increased hair growth on the forehead, back, arms, and legs
  • Lightening of normal skin color
  • Reddish purple lines on the arms, face, legs, trunk, or groin
  • Softening of the skin

In rare cases, using fluocinonide for a long time or over large areas of the body can lead to serious conditions involving hormones and the adrenal glands, including:

  • Adrenal insufficiency: This condition can occur when the adrenal glands don't produce enough of the hormones adrenaline and cortisol. Symptoms can include dizziness, weakness, loss of appetite, or stomach upset. This condition can sometimes occur after fluocinonide treatment has stopped.
  • Cushing syndrome: If fluocinonide is absorbed into your bloodstream, it can cause Cushing syndrome, a condition where your body makes too much cortisol. Symptoms include a moon-shaped face and a lump of fat between the shoulders, as well as high blood sugar and high blood pressure.

Contraindications

Your doctor can advise you as to whether or not it is safe for you to use fluocinonide, but, in general, you should not use it if:

  • You have rosacea, perioral dermatitis, or a fungal or bacterial infection
  • You are pregnant. Fluocinonide is considered a category C drug, which means there haven’t been enough studies done in humans to be certain if the drug might affect a fetus.
  • You are breastfeeding. It isn’t known if fluocinonide passes into breast milk or if it causes side effects in a nursing baby.

In addition, it is not known for sure if fluocinonide is safe to use in children younger than 12. Children may absorb higher amounts of fluocinonide than adults, possibly affecting growth and development.

If you are pregnant, breastfeeding, or have any other concerns about using fluocinonide, your doctor will be able to help you weigh the risks and benefits of using this drug.

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Article Sources
  • Boguniewicz M, Leung DYM. Atopic Dermatitis. J Allergy Clin Immunol. 2006; 117(2):S475-80.