From the Guidelines
Fluocinonide should be avoided on the face due to its high potency and increased risk of side effects, except for short-term use under medical supervision. The use of topical corticosteroids like fluocinonide on the face poses significant risks, including skin atrophy, striae, folliculitis, telangiectasia, and purpura, as highlighted in the joint AAD-NPF guidelines of care for the management and treatment of psoriasis with topical therapy 1. Key points to consider when evaluating the use of fluocinonide on the face include:
- The face and intertriginous areas are at greatest risk to develop adverse effects from topical corticosteroid use
- Topical corticosteroids may exacerbate acne, rosacea, perioral dermatitis, and tinea infections
- Rebound can occur from abrupt withdrawal of topical corticosteroids Given these risks, lower-potency alternatives like hydrocortisone 1% or desonide are generally safer options for facial skin concerns. If fluocinonide is prescribed for facial use, it should typically be limited to 2 weeks or less, and patients should be closely monitored for signs of adverse effects. Ultimately, consultation with a healthcare provider is essential to determine the most appropriate treatment for facial skin conditions, taking into account the specific condition, its severity, and location 1.
From the Research
Safety of Floucinonide for Facial Use
- The safety of floucinonide, a topical corticosteroid, for use on the face has been evaluated in several studies 2, 3, 4.
- A study published in the American Journal of Clinical Dermatology found that a triple combination cream containing fluocinolone acetonide (a similar corticosteroid to floucinonide) was safe and effective for the treatment of facial melasma, with minimal adverse events 2.
- However, another study published in the British Medical Journal reported adverse effects, including skin atrophy and telangiectasia, in patients with rosacea who used topical fluorinated corticosteroids, including floucinonide, on the face 3.
- A histological examination of skin biopsies from patients with melasma who used a triple combination cream containing fluocinolone acetonide found no significant signs of skin atrophy after 6 months of treatment 4.
Potential Risks and Benefits
- The use of floucinonide on the face may be associated with an increased risk of skin atrophy, particularly with long-term use 3.
- However, other studies have found that short-term treatment with floucinonide can improve skin barrier function and reduce symptoms of atopic dermatitis 5.
- It is essential to weigh the potential benefits and risks of using floucinonide on the face and to monitor patients closely for any adverse effects 2, 3, 4, 5.
- Additionally, there have been reports of central serous retinopathy associated with the use of topical corticosteroids, including floucinonide, although this is a rare and potentially reversible condition 6.