Vanos (Fluocinonide) – Topical

What Is Vanos?

Vanos (fluocinonide) is a corticosteroid cream used in people 12 years and older to treat skin problems such as psoriasis, eczema, and other conditions that cause redness and itching. Corticosteroids are one of many types of steroids. Corticosteroids, like fluocinonide, are an important part of our biology and affect the immune response in our bodies.

Vanos is a prescription drug, which means a licensed healthcare provider must prescribe it for you.

Drug Facts

Generic Name: Fluocinonide

Brand Name(s): Vanos

Administration Route(s): Topical

Drug Availability: Prescription

Therapeutic Classification: Corticosteroid

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Fluocinonide

Dosage Form(s): Cream

What Is Vanos Used For?

The Food and Drug Administration (FDA) approved Vanos to treat:

  • Eczema (also called atopic dermatitis): Rash-like redness of the skin that usually includes itching (pruritus)
  • Localized vitiligo: Blotchy loss of skin color that happens when pigment-producing cells die or stop working
  • Phimosis: When foreskin cannot be pulled back over the head of the penis
  • Lichen planus: Red or purple flat-topped bumps with itching
  • Localized bullous pemphigoid: Itchy, fluid-filled blisters that form along skin creases
  • Psoriasis: A condition in which skin cells build up and form dry, itchy patches
Vanos (Fluocinonide) Drug Information - Illustration by Dennis Madamba

Verywell / Dennis Madamba

How to Use Vanos

Only apply Vanos cream as prescribed, meaning only as often as your healthcare provider instructs. Fluocinonide is one of the most potent (strongest) topical steroids. It is meant to be used on your skin, but not in especially sensitive areas like your eyes, face, groin, or underarms.

Apply a thin layer of Vanos to the affected area or areas and rub into the skin, washing your hands afterward. Do not apply other products to these areas or covering Vanos with a dressing without speaking to your healthcare provider first.

If the area you’re treating gets worse or does not improve within two weeks, speak with your prescriber to discuss the next steps. Vanos should not be used for longer than two weeks at a time.

Storage

Store Vanos at room temperature (59 degrees to 86 degrees Fahrenheit) with the cap on tightly.

If you’re traveling by plane, it’s best to keep Vanos in your carry-on luggage and tightly capped so that pressure changes don’t cause leaks. Don’t leave Vanos in the car or outside for long periods in hot or cold temperatures (below 59 degrees or above 86 degrees).

Off-Label Uses

Vanos and other topical steroids may be used for conditions other than those listed by the FDA. One example may be contact dermatitis, such as a rash due to poison ivy or an unknown cause.

How Long Does Vanos Take to Work?

You can expect to see your symptoms start to get better a few days after you begin using steroid creams like Vanos. If you don’t see improvement after a week, give your healthcare provider a call. Use Vanos cream for no longer than two weeks in a row.

What Are the Side Effects of Vanos?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The following are some of the more common side effects of topical steroid use, and most are reversible once you stop using the cream. 

Keep in mind these common side effects are usually localized to the site of application, meaning they occur where you use the cream. Avoid using Vanos on extra sensitive areas like your face.

Common side effects of Vanos include:

  • Headache
  • Burning where applied
  • Skin atrophy, or thinning of the skin
  • Redness or discoloration of the skin
  • Striae (stretch marks)
  • Acne and purpura (purplish marks due to thinner skin being less able to support blood vessels)

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Severe skin rash
  • Signs of skin infection like swelling, redness, and pus oozing where you applied Vanos
  • Sudden weight gain
  • Unusual tiredness
  • Muscle weakness

Long-Term Side Effects

The risk of lasting side effects is low if you are only using corticosteroids like Vanos for a short time (no longer than two weeks).

Using Vanos for more than two weeks at a time may suppress your immune system, making it easier for you to get sick and harder to heal from cuts or wounds.

Another long-term side effect that can potentially occur during treatment or after you stop using fluocinonide cream is called hypothalamic-pituitary-adrenal (HPA) axis suppression.

HPA axis suppression can occur if you:

  • Apply Vanos cream over a large area
  • Use Vanos for a longer period than prescribed
  • Use the cream on a cut or wound 
  • Have liver failure
  • Are also using another corticosteroid

Symptoms of HPA axis suppression include weakness and fatigue, tiredness during the day, headache, and nausea. If you do experience HPA axis suppression, your symptoms will most likely go away after you stop using Vanos. If you are using Vanos as it is prescribed to you, the risk of HPA axis suppression is low.

Report Side Effects

Vanos may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Vanos Should I Use?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For topical dosage forms (cream, gel, ointment, or solution):
    • For redness, itching, and swelling of the skin:
      • Adults—Apply to the affected area of the skin two to four times per day.
      • Children—Apply to the affected area of the skin two to four times per day.
  • For topical dosage form (cream):
    • For atopic dermatitis:
      • Adults and children 12 years of age and older—Apply to the affected area of the skin once a day.
      • Children younger than 12 years of age—Use is not recommended.
    • For psoriasis:
      • Adults and children 12 years of age and older—Apply to the affected area of the skin one to two times per day.
      • Children younger than 12 years of age—Use is not recommended.

Modifications

Using Vanos in children younger than 12 or in people older than 65 is a decision that should be considered carefully. Compared to adults, children have a greater skin surface area relative to their overall size. This means they are at a greater risk of HPA axis and immune suppression.

Not enough individuals aged 65 and older were included in initial clinical studies of fluocinonide to know if they might respond differently. Since older people are more likely to have already fragile skin, impaired wound healing, or altered mental status, the benefits of using corticosteroids should outweigh the risk of potential side effects they may cause.

Kids and older individuals may need to use the lowest steroid potency necessary, for the shortest amount of time. Using fluocinonide and other topical steroids once a day has been shown to be as effective as using it twice a day or more often.

Missed Dose

If you forget a dose of Vanos, you can apply it as soon as you remember. If you are closer to your next dose than the dose you missed, skip the missed dose and wait for your next scheduled one. For example, if you normally apply Vanos cream once a day at 8 a.m., and you remember at 9 p.m. that you forgot that morning, just wait and apply it the next morning at 8 a.m.

Overdose: What Happens If I Use Too Much Vanos?

If you use only as much Vanos cream as directed, you shouldn’t be at risk of using too much or overdosing. If you accidentally double up doses, continue your schedule as usual unless you notice a reaction, such as a severe skin rash. In that case, stop using the medication until you speak to your healthcare provider. You might consider keeping a calendar and checking off each dose at the times you use Vanos.

What Happens If I Overdose on Vanos?

If you think you or someone else may have overdosed on Vanos, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses, has a seizure, has trouble breathing, or can’t wake up after using too much Vanos, call 911 immediately.

Precautions

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It is very important that your doctor check the progress of you or your child at regular visits for any unwanted effects that may be caused by this medicine.

If your or your child's symptoms do not improve within a few days, or if they become worse, check with your doctor.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. The risk is greater for children and patients who use large amounts for a long time. Talk to your doctor right away if you or your child have more than one of these symptoms while you are using this medicine: blurred vision; dizziness or fainting; a fast, irregular, or pounding heartbeat; increased thirst or urination; irritability; or unusual tiredness or weakness.

Stop using this medicine and check with your doctor right away if you or your child have a skin rash, burning, stinging, swelling, or irritation on the skin.

Do not use cosmetics or other skin care products on the treated areas.

What Are Reasons I Shouldn’t Take Vanos?

Vanos can hide symptoms of certain bacterial skin infections. You shouldn’t take Vanos if you have a bacterial infection such as: 

  • Carbuncles (cluster of boils, which are painful, infected, pus-filled bumps)
  • Cellulitis (skin infection causing redness, swelling, and pain)
  • Erysipelas (infection of the upper layers of the skin)
  • Furuncles (boils)
  • Impetigo (common, highly contagious childhood infection causing sores around the nose and mouth)

Vanos use also is not recommended if you have a fungal infection, since it can delay the right treatment and lessen your response to drugs that properly treat these infections.

What Other Medications Interact With Vanos?

As long as you are using Vanos for your prescribed amount of time, the risk of major drug interactions is fairly low. Using steroids topically means a minimal amount of the drug ends up in your bloodstream. In fact, this is often a reason drugs are used topically—to avoid interactions with systemic drugs (drugs you take by mouth that are absorbed into your system).

A few types of drugs you still may want to watch out for and discuss with your healthcare provider include:

  • Antifungal drugs: Using steroid products such as fluocinonide has been shown to decrease how well antifungal drugs work.
  • Antibiotics: Although steroids treat inflammation associated with many infections, they also lower your ability to fight infections.
  • Other steroid drugs: Remember that Vanos is a highly potent steroid cream. Using additional steroid products at the same time will increase your risk for side effects and is unlikely to provide additional benefits.

What Medications Are Similar?

Some other topical steroids with very high potency that are similar to Vanos include:

  • Clobetasol: Clobetasol is available in many different formulations, such as foam, ointment, shampoo, and cream under brand names such as Clobex, Cormax, Olux, and Temovate. It is used to treat scalp conditions in addition to skin conditions.
  • Betamethasone: Betamethasone is very similar to clobetasol, and also used for skin conditions like psoriasis and eczema. It is available in similar formulations under brand names Diprolene and Sernivo.
  • Diflorasone: Diflorasone is available as a cream and an ointment under the brand names Psorcon and ApexiCon E. It is also used to treat eczema and psoriasis.
  • Halobetasol: Available under the brand name Ultravate, halobetasol is available in different formulations and is also used to treat eczema and psoriasis.

This list is a list of drugs also prescribed for psoriasis and other skin conditions. It is NOT a list of drugs recommended to take with fluocinonide. In fact, you should not take these drugs together. Ask your healthcare practitioner if you have questions.

The drugs listed above are similar in strength to Vanos. Many other topical corticosteroids exist that are of lower potency than these drugs and treat less severe skin conditions or are used in more sensitive areas such as the face or groin regions.

Frequently Asked Questions

  • What is Vanos used for?

    Vanos is used to treat skin conditions such as eczema and psoriasis. Both conditions are caused by the overactivation of your immune system. When this happens defensive cells that should protect you from foreign substances like germs cause harm to you instead.

  • How does Vanos work?

    Vanos is a topical corticosteroid. It is a cream applied to your skin that works in several different ways. It works with your body to produce proteins that block inflammation and stop your immune system from producing too many self-harming cells. Together these mechanisms result in the improvement of itching, pain, and the scaly or red appearance of various skin conditions.

  • How long does it take for Vanos to work?

    You should start to see positive results from Vanos within a couple of days after beginning use. If a week has gone by and you don’t see any improvement, or if your symptoms worsen, you’ll want to call your healthcare provider to discuss other options.

  • How do I safely stop taking Vanos?

    If you are prescribed Vanos for two weeks, take it for the full two weeks. Do not stop taking it after one week even if your symptoms have improved. Even if your skin seems better sooner, you need to take the prescribed course for it to fully work.

How Can I Stay Healthy While Taking Vanos?

For conditions like eczema and psoriasis, you can focus on caring for your skin by also following nondrug treatment recommendations. Keep your skin clean and moisturized, but remember to apply moisturizer at least 15 minutes after you apply Vanos. Avoid known triggers for these conditions and try to maintain low stress.

It’s easy to think you no longer need to keep using a drug because your symptoms have gone away. However, it’s important to finish your treatment for your prescribed length of time. This will prevent your symptoms from returning and allow the medication to do its job fully.

Remember, the risk of side effects is low if you are using your Vanos cream as directed by your healthcare provider.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. InformedHealth.org [Internet]. Eczema: Steroids and other topical medications.

  6. Knutsson KA, Iovieno A, Matuska S, Fontana L, Rama P. Topical Corticosteroids and Fungal Keratitis: A Review of the Literature and Case Series. J Clin Med. 2021;10(6):1178. doi: 10.3390/jcm10061178

By Sara Hoffman, PharmD
Sara is a clinical pharmacist that believes everyone should understand their medications, and aims to achieve this through her writing.