From the Guidelines
Fluocinolone cream should be used with caution and under the guidance of a healthcare provider due to its potential side effects and the risk of tachyphylaxis, which may affect its long-term efficacy in treating psoriasis and other inflammatory skin conditions. When considering the use of fluocinolone cream, it's essential to weigh its benefits against its potential risks, particularly in the context of long-term treatment, as most clinical trials have only evaluated its efficacy over several weeks 1. The efficacy of fluocinolone acetonide, a class VI corticosteroid, has been demonstrated in a randomized, double-blind, vehicle-controlled trial, where 83% of patients with severe scalp psoriasis showed significant improvement compared to 36% of vehicle-treated patients 1. However, the potential for tachyphylaxis, or the loss of effectiveness with continued use, is a concern, although it remains unclear whether this is due to a true loss of medication efficacy or decreased patient compliance 1. Key considerations for the use of fluocinolone cream include:
- Applying it thinly to affected areas 2-3 times daily or as directed by a healthcare provider
- Limiting treatment duration to 2-4 weeks to minimize side effects
- Avoiding use on the face, groin, or armpits unless specifically prescribed for these areas
- Being aware of common side effects such as skin thinning, stretch marks, and increased susceptibility to skin infections
- Using the medication exactly as prescribed and following proper hygiene and application guidelines to minimize risks.
From the FDA Drug Label
DESCRIPTION Fluocinolone Acetonide Topical Oil, 0.01% contains fluocinolone acetonide {(6α, 11β, 16α)-6,9-difluro-11,21-dihydroxy-16,17[(1-methylethylidene)bis(oxy)]-pregna-1,4-diene-3,20-dione, cyclic 16,17 acetal with acetone}, a synthetic corticosteroid for topical dermatologic use. INDICATION AND USAGE Fluocinolone Acetonide Topical Oil, 0.01% is a low to medium potency corticosteroid indicated: In adult patients for the treatment of psoriasis of the scalp (Scalp Oil).
The fluocinolone cream is not mentioned in the provided drug labels. However, the labels describe fluocinolone acetonide topical oil, which is used for the treatment of psoriasis of the scalp in adult patients 2 and for atopic dermatitis in adults and pediatric patients 2 years and older 2.
- The indications for fluocinolone acetonide topical oil include:
- Psoriasis of the scalp (Scalp Oil) in adult patients
- Atopic dermatitis in adults and pediatric patients 2 years and older
- The formulation of fluocinolone acetonide topical oil is a blend of oils, which contains isopropyl alcohol, isopropyl myristate, light mineral oil, oleth-2, and refined peanut oil NF 2.
From the Research
Fluocinolone Cream
- Fluocinolone acetonide is a topical corticosteroid used to treat various skin conditions, including eczema and dermatitis 3, 4, 5.
- Studies have shown that fluocinolone acetonide cream is effective in treating atopic dermatitis, chronic eczematous dermatitis, and nummular dermatitis 3, 5.
- Fluocinolone acetonide 0.01% in peanut oil has been found to be an effective and safe treatment for childhood atopic dermatitis, even in patients with peanut sensitivity 5.
Efficacy and Safety
- Fluocinolone acetonide has been shown to be more effective than other topical corticosteroids in some cases 3.
- The medication has been found to be well-tolerated, with no evidence of adrenal suppression or adverse local effects in children 5.
- However, long-term use of topical corticosteroids, including fluocinolone acetonide, can lead to skin thinning and other adverse effects 6.
Treatment of Eczema
- Topical corticosteroids, such as fluocinolone acetonide, are commonly used to treat eczema 6, 7.
- The goal of therapy is to restore the function of the epidermal barrier and reduce skin inflammation 7.
- Proactive therapy with twice weekly use of topical corticosteroids and calcineurin inhibitors can help reduce the time to the next eczematous flare 7.